All-Nasal" Approach for 25-Gauge Lens Sparing Vitrectomy in Stage 4B Retinopathy of Prematurity.

Purpose To describe a novel "all-nasal" approach for lens sparing vitrectomy in stage 4B retinopathy of prematurity. Methods This is a pilot study in infants with Stage 4B retinopathy of prematurity. Eyes included had tractional retinal detachment approaching the retrolental space temporally. The surgeon sat nasal to the eye being operated. Infusion was placed in the center between the superonasal and inferonasal ports. The surgical technique and anatomical outcomes of eyes undergoing "all-nasal" lens sparing vitrectomy are reported. Results Eight eyes with Stage 4B retinopathy of prematurity were operated with this approach. All surgical objectives could be achieved with this technique. Lensectomy could be avoided in seven of the eight eyes (87.5%). At 6 months of follow-up, retinal reattachment could be achieved in 6 eyes (75%). Conclusion All-nasal approach for lens sparing vitrectomy appears safe and effective in Stage 4B retinopathy of prematurity.