{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:43:33Z","timestamp":1790390613351,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, Culture, Sport, Science and Technology, Japan","award":["20K09800"],"award-info":[{"award-number":["20K09800"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This study evaluated the long-term visual outcomes of patients in whom at least one eye underwent successful lens-sparing vitrectomy (LSV) for stage 4A retinopathy of prematurity (ROP). A retrospective chart review was conducted using the data of 61 eyes of 42 patients with a minimum 4-year follow-up after successful LSV, with or without anti-vascular endothelial growth factor (VEGF) therapy, and whose best-corrected visual acuity (BCVA) was measurable using Landolt rings at the final visit. The mean age at the final follow-up was 10.1 \u00b1 3.3 years. Before LSV, all eyes underwent laser ablation therapy. Twenty eyes (32.8%) with high vascular activity received anti-VEGF therapy before LSV. The mean decimal BCVA at the final follow-up was 0.23 \u00b1 0.26 (range: hand motion to 1.2). Twenty-three eyes (54.1%) had a decimal BCVA of \u22650.4. Among 49 phakic eyes at the final examination, the mean refractive error was \u221210.1 \u00b1 5.0 D, with 37 eyes (75.5%) having high myopia (&gt;\u22126.0 D). No significant differences were observed in terms of decimal BCVA and refractive errors between eyes with and without anti-VEGF therapy. Approximately half of the patients had a decimal BCVA of \u22650.4, despite myopic refraction after successful LSV for stage 4A ROP. LSV for stage 4A ROP seemed to be associated with good visual function, despite myopic refraction.<\/jats:p>","DOI":"10.3390\/ijms24032416","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T01:58:59Z","timestamp":1674784739000},"page":"2416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long-Term Visual Prognosis of Patients Following Lens-Sparing Vitrectomy for Stage 4A Retinopathy of Prematurity"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0836-5816","authenticated-orcid":false,"given":"Chiharu","family":"Iwahashi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Kindai University, Osakasayama 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Kindai University, Osakasayama 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Kuniyoshi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Kindai University, Osakasayama 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8364-0948","authenticated-orcid":false,"given":"Shunji","family":"Kusaka","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Kindai University, Osakasayama 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.survophthal.2016.12.004","article-title":"Advances in understanding and management of retinopathy of prematurity","volume":"62","author":"Hartnett","year":"2017","journal-title":"Surv. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/pr.2013.205","article-title":"Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010","volume":"74","author":"Blencowe","year":"2013","journal-title":"Pediatr. Res"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Early Treatment For Retinopathy Of Prematurity Cooperative Group (2003). Revised indications for the treatment of retinopathy of prematurity: Results of the early treatment for retinopathy of prematurity randomized trial. Arch. Ophthalmol., 121, 1684\u20131694.","DOI":"10.1001\/archopht.121.12.1684"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1136\/bjo.2008.140657","article-title":"Efficacy of intravitreal injection of bevacizumab for severe retinopathy of prematurity: A pilot study","volume":"92","author":"Kusaka","year":"2008","journal-title":"Br. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1056\/NEJMoa1007374","article-title":"Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity","volume":"364","author":"Kennedy","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1016\/S0140-6736(19)31344-3","article-title":"Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): An open-label randomised controlled trial","volume":"394","author":"Stahl","year":"2019","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1001\/jama.2022.10564","article-title":"Effect of intravitreal aflibercept vs. laser photocoagulation on treatment success of retinopathy of prematurity: The FIREFLEYE randomized clinical trial","volume":"328","author":"Stahl","year":"2022","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/archophthalmol.2011.1802","article-title":"Significant treatment failure with intravitreous bevacizumab for retinopathy of prematurity","volume":"130","author":"Patel","year":"2012","journal-title":"Arch. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1097\/IAE.0000000000001685","article-title":"Progressive retinal detachment in infants with retinopathy of prematurity treated with intravitreal bevacizumab or ranibizumab","volume":"38","author":"Yonekawa","year":"2018","journal-title":"Retina"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.1097\/IAE.0000000000003249","article-title":"Clinical features and outcomes of infants with retinopathy of prematurity who fail anti-VEGF therapy","volume":"41","author":"Xu","year":"2021","journal-title":"Retina"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"785292","DOI":"10.3389\/fped.2022.785292","article-title":"Characteristics of eyes developing retinal detachment after anti-vascular endothelial growth factor therapy for retinopathy of prematurity","volume":"10","author":"Kondo","year":"2022","journal-title":"Front. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1016\/S0161-6420(01)00809-0","article-title":"Lens-sparing vitreous surgery for tractional stage 4A retinopathy of prematurity retinal detachments","volume":"108","author":"Capone","year":"2001","journal-title":"Ophthalmology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1001\/archopht.122.12.1816","article-title":"Lens-sparing vitrectomy for progressive tractional retinal detachments associated with stage 4A retinopathy of prematurity","volume":"122","author":"Moshfeghi","year":"2004","journal-title":"Arch. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/j.ophtha.2005.03.031","article-title":"Anatomic success rate after 3-port lens-sparing vitrectomy in stage 4A or 4B retinopathy of prematurity","volume":"112","author":"Lakhanpal","year":"2005","journal-title":"Ophthalmology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1001\/archophthalmol.2011.253","article-title":"Modified 23-gauge vitrectomy system for stage 4 retinopathy of prematurity","volume":"129","author":"Wu","year":"2011","journal-title":"Arch. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1016\/j.ophtha.2004.05.030","article-title":"Lens-sparing vitrectomy for stage 4 retinopathy of prematurity","volume":"111","author":"Hubbard","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1001\/archopht.1992.01080140140042","article-title":"Lens-sparing vitreoretinal surgery in infants","volume":"110","author":"Maguire","year":"1992","journal-title":"Arch. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1097\/00006982-200410000-00011","article-title":"Comparison of retinal outcomes after scleral buckle or lens-sparing vitrectomy for stage 4 retinopathy of prematurity","volume":"24","author":"Hartnett","year":"2004","journal-title":"Retina"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1016\/j.ophtha.2004.06.021","article-title":"Visual outcomes after lens-sparing vitrectomy for stage 4A retinopathy of prematurity","volume":"111","author":"Prenner","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1001\/archopht.124.5.675","article-title":"Visual outcomes after 3-port lens-sparing vitrectomy in stage 4 retinopathy of prematurity","volume":"124","author":"Lakhanpal","year":"2006","journal-title":"Arch. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1136\/bjophthalmol-2011-301353","article-title":"Long-term visual outcomes following lens-sparing vitrectomy for retinopathy of prematurity","volume":"96","author":"Singh","year":"2012","journal-title":"Br. J. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1136\/bjophthalmol-2016-309198","article-title":"Long-term functional results following vitrectomy for advanced retinopathy of prematurity","volume":"101","author":"Karacorlu","year":"2017","journal-title":"Br. J. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5053","DOI":"10.1038\/s41598-022-09053-8","article-title":"Neurodevelopmental outcomes in very low birthweight infants with retinopathy of prematurity in a nationwide cohort study","volume":"12","author":"Ahn","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/OPX.0b013e3181a76e55","article-title":"Visual acuity norms in pre-school children: The multi-ethnic pediatric eye disease study","volume":"86","author":"Pan","year":"2009","journal-title":"Optom. Vis. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.ajo.2011.07.005","article-title":"Serum concentrations of bevacizumab (avastin) and vascular endothelial growth factor in infants with retinopathy of prematurity","volume":"153","author":"Sato","year":"2012","journal-title":"Am. J. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1001\/jamaophthalmol.2014.5373","article-title":"Serum levels of vascular endothelial growth factor and related factors after intravitreous bevacizumab injection for retinopathy of prematurity","volume":"133","author":"Wu","year":"2015","journal-title":"JAMA Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1097\/IAE.0000000000003196","article-title":"Factors associated with reactivation after intravitreal bevacizumab or ranibizumab therapy in infants with retinopathy of prematurity","volume":"41","author":"Iwahashi","year":"2021","journal-title":"Retina"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e20183537","DOI":"10.1542\/peds.2018-3537","article-title":"Neurodevelopmental outcomes of preterm infants with retinopathy of prematurity by treatment","volume":"144","author":"Natarajan","year":"2019","journal-title":"Pediatrics"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Arima, M., Akiyama, M., Fujiwara, K., Mori, Y., Inoue, H., Seki, E., Nakama, T., Tsukamoto, S., Ochiai, M., and Ohga, S. (2020). Neurodevelopmental outcomes following intravitreal bevacizumab injection in Japanese preterm infants with type 1 retinopathy of prematurity. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0230678"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1016\/j.ophtha.2019.03.048","article-title":"Neurodevelopmental outcomes after intravitreal bevacizumab therapy for retinopathy of prematurity: A prospective case-control study","volume":"126","author":"Fan","year":"2019","journal-title":"Ophthalmology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/S2352-4642(21)00195-4","article-title":"2-year outcomes of ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW extension study): Prospective follow-up of an open label, randomised controlled trial","volume":"5","author":"Marlow","year":"2021","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_32","first-page":"300","article-title":"Refractive outcomes of three-port lens-sparing vitrectomy for retinopathy of prematurity (An AOS Thesis)","volume":"107","author":"Holz","year":"2009","journal-title":"Trans. Am. Ophthalmol. Soc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"841","DOI":"10.4103\/ijo.IJO_165_17","article-title":"Influence of laser versus lens-sparing vitrectomy on myopia in children with retinopathy of prematurity","volume":"65","author":"Agarkar","year":"2017","journal-title":"Indian J. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1177\/1120672120946938","article-title":"Lens-sparing vitrectomy for stage 4A retinopathy of prematurity in infants with aggressive-posterior ROP: Anatomic and functional results","volume":"31","author":"Macor","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2147\/EB.S99306","article-title":"Review of effects of anti-VEGF treatment on refractive error","volume":"8","author":"Geloneck","year":"2016","journal-title":"Eye Brain"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1016\/j.ophtha.2021.05.031","article-title":"International Classification of Retinopathy of Prematurity, 3rd ed","volume":"128","author":"Chiang","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"216","DOI":"10.4103\/tjo.tjo_102_18","article-title":"Current concepts and techniques of vitrectomy for retinopathy of prematurity","volume":"8","author":"Kusaka","year":"2018","journal-title":"Taiwan J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/S0886-3350(13)80659-1","article-title":"Posterior capsulorhexis with optic capture: Maintaining a clear visual axis after pediatric cataract surgery","volume":"20","author":"Gimbel","year":"1994","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.ophtha.2009.09.002","article-title":"Vision-related function after ranibizumab treatment by better- or worse-Seeing Eye: Clinical trial results from Marina and Anchor","volume":"117","author":"Bressler","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/S0161-6420(99)00133-5","article-title":"Levodopa may improve vision loss in recent-onset, nonarteritic anterior ischemic optic neuropathy","volume":"107","author":"Johnson","year":"2000","journal-title":"Ophthalmology"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/3\/2416\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:16:38Z","timestamp":1760120198000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/3\/2416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,26]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijms24032416"],"URL":"https:\/\/doi.org\/10.3390\/ijms24032416","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,26]]}}}