Autrata R, Senková K, Holousová M, Helmanová I, Pyrochtová S
Department of Pediatric Ophthalmology, Faculty of Medicine, Masaryk University Hospital, Brno, Czech Republic.
Eur J Ophthalmol. 2008 Jan-Feb;18(1):112-7. doi: 10.1177/112067210801800119.
To report the structural, functional, and refractive outcome, safety, and effectiveness of combined cryotherapy and diode laser indirect photocoagulation in the treatment of threshold retinopathy of prematurity (ROP).
Medical records of patients developing threshold ROP between 1995 and 2003 were reviewed to identify those with combined treatment and followed up for at least 4 years postoperatively. A total of 94 patients (172 eyes) received combined treatment. Data consisted of grade of ROP pre- and postoperatively, most recent fundus examination, birthweight, visual acuity, complications, and refraction. Diode laser was used to ablate posterior avascular retina, and cryotherapy was used for anterior retina.
A total of 149 (87%) eyes responded to combined treatment and they had favorable anatomic outcome at last examination. In 131 eyes (76%), functional outcome was favorable (visual acuity better than 20/200) at last examination. Perioperative complications included hemorrhages in 26% of eyes, which resorbed spontaneously. Mean duration of treatment was 31 minutes/eye. At final visit (4 to 12 years), 115 eyes (66.8%) refracted were myopic, of which 26 (22.5%) had high myopia over -6 diopters.
Combined cryotherapy and diode laser photocoagulation for ROP in our patients resulted in regression of threshold ROP with relatively successful structural and functional outcomes. Combined therapy may be faster and useful for eyes with very posterior ROP. This may decrease the number of complications occurring when excessive cryotherapy or laser photoablation must be used in zone 1 ROP.
报告联合冷冻疗法和二极管激光间接光凝治疗阈值期早产儿视网膜病变（ROP）的结构、功能和屈光结果、安全性及有效性。
回顾1995年至2003年间发生阈值期ROP患者的病历，以确定接受联合治疗的患者，并在术后至少随访4年。共有94例患者（172只眼）接受了联合治疗。数据包括术前和术后ROP分级、最近的眼底检查、出生体重、视力、并发症及屈光情况。使用二极管激光消融后部无血管视网膜，冷冻疗法用于前部视网膜。
共有149只眼（87%）对联合治疗有反应，在最后一次检查时解剖结果良好。131只眼（76%）在最后一次检查时功能结果良好（视力优于20/200）。围手术期并发症包括26%的眼发生出血，出血均自行吸收。平均治疗时间为每只眼31分钟。在最后一次随访（4至12年）时，115只眼（66.8%）屈光为近视，其中26只眼（22.5%）为近视度数超过-6屈光度的高度近视。
在我们的患者中，联合冷冻疗法和二极管激光光凝治疗ROP可使阈值期ROP消退，结构和功能结果相对成功。联合治疗对于ROP非常靠后的眼可能更快且有用。这可能会减少在1区ROP中必须使用过度冷冻疗法或激光光凝时发生的并发症数量。
