Objective: This study was done to determine the efficacy of closed vitrectomy on long-term visual acuity of stage 5 retinopathy of prematurity.

Methods: We studied the visual acuity of eyes that had undergone retinal reattachment by closed vitrectomy for stage 5 retinopathy of prematurity and were followed up for more than three years.

Results: Forty-nine eyes of 31 patients among a total of 71 eyes of 48 consecutive patients were operated on and followed up for more than three years. Retinal reattachment occurred in 29 (59%) of the 49 eyes. Six patients (eight eyes) did not respond to visual acuity testing because of mental retardation or cerebral palsy. Measured visual acuity in the remaining 21 eyes varied from no light perception in one eye, light perception in four eyes, Recognizable hand movement in three eyes, 20/2,000 to 20/200 in seven eyes, 20/200 to 20/25 in five eyes, and 20/25 in one eye. No correlation was seen between visual outcome and factors such as gestational age, birth weight, and configuration of retinal detachment. Markedly better visual acuity was obtained in eyes that underwent initial surgery within four months of birth.

Conclusions: Useful vision can be obtained after reattachment of the retina by closed vitrectomy on some patients who have stage 5 retinopathy of prematurity. Better visual acuity may be obtained by earlier surgery.