Holz Eric R
Baylor Eye Clinic, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.
Trans Am Ophthalmol Soc. 2009 Dec;107:300-10.
To study the refractive outcomes of 3-port lens-sparing vitrectomy (LSV) for subtotal retinal detachments due to retinopathy of prematurity (ROP). Lens-sparing vitrectomy may provide superior refractive outcomes by limiting induced myopia of prematurity.
This is a retrospective, consecutive, nonrandomized, comparative (paired eye) study. Entrance criteria were previous complete ablative laser for threshold ROP in both eyes, followed by LSV in one eye for stage 4A traction retinal detachment. Both eyes then maintained complete retinal attachment. Main outcome variables were cycloplegic refraction, keratometry, and biometric values for axial length, lens thickness, and anterior chamber depth.
Nine patients met inclusion criteria. Lens-sparing vitrectomy eyes were significantly less myopic than control eyes (-6.78 D vs -10.33 D, P < .005). The reduction in myopia in LSV eyes was predominantly due to increased anterior chamber depth (3.81 mm +/- 0.217 vs 2.96 mm +/- 0.232, P < .005). There was a minor contribution from reduced corneal power in LSV eyes (43.89 D +/- 0.253 vs 44.20 D +/- 0.265, P < .005). There was a minor negative impact from increased lens thickness in LSV eyes (3.85 +/- 0.32 mm vs 3.74 +/- 0.31, P < .005). There was no significant difference in axial length or lens power between the LSV and control groups.
The data demonstrate that infant eyes undergoing 3-port LSV for stage 4A ROP develop less myopia than fellow eyes treated with laser alone. The difference is due to posterior displacement of the lens-iris diaphragm with a smaller contribution from reduced corneal power. The reduction in myopia may improve functional outcomes following 3-port LSV for stage 4A ROP.
研究三通道保留晶状体玻璃体切除术（LSV）治疗早产儿视网膜病变（ROP）所致部分视网膜脱离的屈光结果。保留晶状体玻璃体切除术可能通过限制早产儿近视的发生来提供更好的屈光结果。
这是一项回顾性、连续、非随机、对照（配对眼）研究。入选标准为双眼先前均接受过阈值ROP的完全性激光消融治疗，随后一只眼接受LSV治疗4A期牵引性视网膜脱离。双眼均维持视网膜完全附着。主要观察指标为睫状肌麻痹验光、角膜曲率测量以及眼轴长度、晶状体厚度和前房深度的生物测量值。
9例患者符合纳入标准。接受保留晶状体玻璃体切除术的眼比对照眼近视程度明显减轻（-6.78 D对-10.33 D，P < 0.005）。LSV眼近视度数的降低主要是由于前房深度增加（3.81 mm±0.217对2.96 mm±0.232，P < 0.005）。LSV眼角膜屈光度降低有较小影响（43.89 D±0.253对44.20 D±0.265，P < 0.005）。LSV眼晶状体厚度增加有较小负面影响（3.85±0.32 mm对3.74±0.31，P < 0.005）。LSV组和对照组之间眼轴长度或晶状体屈光度无显著差异。
数据表明，接受三通道LSV治疗4A期ROP的婴儿眼比仅接受激光治疗的对侧眼近视程度轻。差异是由于晶状体-虹膜隔向后移位，角膜屈光度降低的影响较小。近视程度的降低可能改善三通道LSV治疗4A期ROP后的功能结果。
