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早产出生患者的晚期视网膜脱离:玻璃体切割术的治疗效果

Late retinal detachment in patients born prematurely: outcome of primary pars plana vitrectomy.

作者信息

Jandeck Claudia, Kellner Ulrich, Foerster Michael H

机构信息

University Eye Clinic, Universitätsklinikum Benjamin Franklin, Berlin, Germany.

出版信息

Arch Ophthalmol. 2004 Jan;122(1):61-4. doi: 10.1001/archopht.122.1.61.

Abstract

OBJECTIVE

To describe the indications and results of pars plana vitrectomy for rhegmatogenous retinal detachment in patients born prematurely.

PATIENTS AND METHODS

Between 1995 and 2001, primary vitrectomy for retinal detachment was performed in a consecutive series of 11 eyes of 10 patients. Gestational age ranged from 26 to 30 weeks, and birth weight ranged from 810 g to 1475 g.

RESULTS

Myopia was found in 9 of 11 eyes. Two patients initially had a vitreous hemorrhage. One of these children was previously treated with cryotherapy during the acute phase of stage 3+ retinopathy of prematurity. Three eyes had a normal posterior pole and only mild peripheral retinal changes. Primary vitrectomy was performed in all 11 eyes. Patients received follow-up for 7.2 months to 6.6 years (mean, 2.7 years). Three eyes with severe cicatricial changes due to retinopathy of prematurity needed multiple procedures with silicone oil tamponade for reattachment. In 10 (90%) of 11 eyes, the retina was completely attached at the last follow-up visit. Visual acuity ranged from light perception to 20/25 in the affected eye.

CONCLUSIONS

Patients born prematurely may develop late-onset retinal detachment due to vitreoretinal changes caused by retinopathy of prematurity. Primary vitrectomy is an effective treatment technique for retinal detachment in patients born prematurely.

摘要

目的

描述对早产儿孔源性视网膜脱离行玻璃体切除术的适应证及结果。

患者与方法

1995年至2001年期间,对10例患者的11只眼连续进行了视网膜脱离的原发性玻璃体切除术。孕周为26至30周,出生体重为810克至1475克。

结果

11只眼中有9只发现近视。2例患者最初有玻璃体出血。其中1例患儿在早产儿视网膜病变3+期急性期曾接受冷冻治疗。3只眼后极部正常,仅周边视网膜有轻度改变。11只眼均行原发性玻璃体切除术。患者随访时间为7.2个月至6.6年(平均2.7年)。3只因早产儿视网膜病变出现严重瘢痕改变的眼需要多次手术并使用硅油填充以实现视网膜复位。在最后一次随访时,11只眼中有10只(90%)视网膜完全复位。患眼视力从光感至20/25不等。

结论

早产儿可能因早产儿视网膜病变引起的玻璃体视网膜改变而发生迟发性视网膜脱离。原发性玻璃体切除术是治疗早产儿视网膜脱离的一种有效技术。

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