Objective: To evaluate the anatomical and visual results of a primary scleral buckling procedure for the treatment of stage 4A and 4B retinopathy of prematurity (ROP) in Thai patients.

Material and Method: The data of premature infants treated with a primary scleral buckling procedure for stage 4 ROP from December 2000 to May 2004 were retrospectively reviewed. The outcomes measures were anatomical success, visual outcomes, and refractive error at the end of follow-up.

Results: Sixteen eyes of ten patients underwent a scleral buckling procedure and had the mean follow-up period of 17.3 months (range 3-44 months). The anatomical success was 100% (8 of 8 eyes) in stag 4A and 50% (4 of 8 eyes) in stage 4B. At the end of the follow-up, the buckle was removed in 92% (11 of 12 eyes) of retina-attached eyes and showed a mean myopic refraction of -8.68 diopters (range -4.75 to 13.50). Favorable visual outcome was 50% (4 of 8 eyes) in stage 4A and 12.5% (1 of 8 eyes) in stage 4B.

Conclusion: Scleral buckling appears to play a role in reducing the progression from stage 4 to stage 5 ROP. The anatomical success rate was excellent but the visual results remain challenging for these cases.

Keywords: Scleral buckling, Retinopathy of prematurity, Thai patients