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针对侵袭性早产儿视网膜病变的早期玻璃体手术

Early vitreous surgery for aggressive posterior retinopathy of prematurity.

作者信息

Azuma Noriyuki, Ishikawa Kaoru, Hama Yukiko, Hiraoka Miina, Suzuki Yumi, Nishina Sachiko

机构信息

Department of Ophthalmology, National Center for Child Health and Development, Tokyo, Japan.

出版信息

Am J Ophthalmol. 2006 Oct;142(4):636-43. doi: 10.1016/j.ajo.2006.05.048.

Abstract

PURPOSE

To assess the efficacy of early vitrectomy for aggressive posterior retinopathy of prematurity (ROP) to stop progression of retinal detachment.

DESIGN

Retrospective, noncomparative, consecutive case series.

METHODS

Twenty-two eyes (15 patients) with aggressive posterior ROP underwent vitrectomy with or without lens sparing, because retinal photocoagulation failed to stop progression of fibrovascular proliferation, despite being performed early, densely, and with early retreatment. We assessed the status of retinal attachment and foveal formation ophthalmoscopically and the presence or absence of fixation of visual behavior.

RESULTS

Follow-up ranged from six to 12 months (mean, 9 months). Six eyes (100%) in which a lens-sparing vitrectomy was performed developed a large tractional retinal detachment. In contrast, the retinas were completely reattached in 16 eyes (100%) in which vitrectomy with lensectomy was performed, nine eyes (56%) had foveal configuration, and 14 eyes (88%) had steady fixation.

CONCLUSIONS

These results suggest that early vitrectomy is effective for preventing retinal detachment in aggressive posterior ROP.

摘要

目的

评估早期玻璃体切除术治疗侵袭性早产儿视网膜病变(ROP)以阻止视网膜脱离进展的疗效。

设计

回顾性、非对照、连续病例系列。

方法

22只眼(15例患者)患有侵袭性后部ROP,因尽管早期、密集地进行了视网膜光凝并早期再次治疗,但仍未能阻止纤维血管增殖的进展,而接受了保留晶状体或不保留晶状体的玻璃体切除术。我们通过检眼镜检查评估视网膜附着状态和黄斑形成情况,以及视觉行为注视的有无。

结果

随访时间为6至12个月(平均9个月)。接受保留晶状体玻璃体切除术的6只眼(100%)发生了大范围牵引性视网膜脱离。相比之下,接受晶状体切除玻璃体切除术的16只眼(100%)视网膜完全复位,9只眼(56%)有黄斑形态,14只眼(88%)有稳定注视。

结论

这些结果表明,早期玻璃体切除术对预防侵袭性后部ROP的视网膜脱离有效。

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