Tufail A, Singh A J, Haynes R J, Dodd C R, McLeod D, Charteris D G
Moorfields Eye Hospital, City Road, London EC1V 2PD, UK.
Br J Ophthalmol. 2004 Feb;88(2):243-6. doi: 10.1136/bjo.2003.022962.
To report the clinical findings, management, and outcomes in eyes undergoing surgery for regressed retinopathy of prematurity (ROP) with vitreoretinal complications.
Retrospective review of 40 eyes of 32 patients with regressed ROP who presented between 1989 and 2001 at two UK referral centres.
Of 29 eyes presenting with rhegmatogenous retinal detachment (RRD), 15 initially underwent a scleral buckling procedure and 14 initially underwent vitrectomy with or without additional buckling. Primary surgery was anatomically successful in 11/15 eyes that underwent a non-vitrectomy retinal detachment repair and 8/14 that required vitrectomy. The final reattachment rate after reoperation was 28/29 eyes. Median visual acuity improved from 6/60 to 6/36 following retinal detachment repair. A further 11 eyes of eight patients from this series underwent prophylactic surgery, laser, or cryotherapy for predisposing vitreoretinal pathology and/or retinal breaks, all of which were stabilised.
In eyes with RRD and signs of regressed ROP successful reattachment of the retina can be achieved using either vitrectomy or external surgery with an associated overall improvement in visual acuity. A range of external and closed microsurgical approaches is required to effectively deal with the diverse manifestations of regressed ROP.
报告接受手术治疗的早产儿视网膜病变(ROP)退行期合并玻璃体视网膜并发症患眼的临床特征、治疗方法及治疗效果。
回顾性分析1989年至2001年间在英国两家转诊中心就诊的32例ROP退行期患者的40只患眼。
29只出现孔源性视网膜脱离(RRD)的患眼中,15只最初接受了巩膜扣带术,14只最初接受了玻璃体切除术,部分联合巩膜扣带术。非玻璃体切除视网膜脱离修复手术的15只眼中,11只初次手术获得解剖复位成功;需要玻璃体切除的14只眼中,8只初次手术成功。再次手术后最终视网膜复位率为29只眼中的28只。视网膜脱离修复术后,视力中位数从6/60提高到6/36。该系列中的另外8例患者的11只眼因存在玻璃体视网膜病变和/或视网膜裂孔的易患因素而接受了预防性手术、激光或冷冻治疗,所有这些情况均得到稳定。
对于RRD且有ROP退行期体征的患眼,采用玻璃体切除术或外路手术均可成功实现视网膜复位,视力也会随之整体提高。需要一系列外路和闭合式显微手术方法来有效应对ROP退行期的各种表现。