Cureus. 2024 Dec 19;16(12):e76000. doi: 10.7759/cureus.76000. eCollection 2024 Dec.
ABSTRACT
A significant percentage of patients with retinopathy of prematurity (ROP) who progressed to stages 4 and 5 of ROP will require surgical intervention. Scleral buckling surgery is widely employed for the restoration of retinal detachment in advanced cases of ROP. This systematic review and meta-analysis aim to review the anatomical and visual outcomes following scleral buckling surgery in ROP of stages 4 and 5. We performed a systematic literature search in two databases (MEDLINE and EMBASE), according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, from January 2000 to July 2024 for studies examining the anatomical and functional outcomes resulting from the scleral buckling procedure in premature infants with advanced ROP. We used the inverse variance random effects model to calculate pooled effect estimates and conducted a single-arm proportional meta-analysis. The study was conducted based on a prespecified protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO) database with registration number CRD42024557314. Ten eligible studies for our systematic review were identified. The pooled prevalence for the anatomic outcome, that is the proportion of retinal reattachment, was estimated at 65% (95% Cl [0.49 – 0.82], p-value 0 < 0.0001). The visual outcome was investigated through five studies. The prevalence of normal visual acuity or mild visual impairment, defined as visual acuity between 6/18 and 6/60 as per the World Health Organisation (WHO) visual impairment recommendations, was calculated at 41% (95% Cl [0.29; 0.52], p-value < 0.0001, I2 =0.02%). The follow-up period ranged between one month and 88 months across all studies. Scleral buckling surgery contributes to the mitigation of the progression of retinal detachment in premature infants afflicted with advanced ROP. The anatomical outcomes demonstrate more favourable results in comparison to visual outcomes. Future prospective studies with extended and explicit follow-up periods and larger populations would significantly enhance the existing body of knowledge in this field.
PMID:39835066 | PMC:PMC11743321 | DOI:10.7759/cureus.76000
