Karacorlu Murat, Hocaoglu Mumin, Sayman Muslubas Isil, Arf Serra
Istanbul Retina Institute, Istanbul, Turkey.
Br J Ophthalmol. 2017 Jun;101(6):730-734. doi: 10.1136/bjophthalmol-2016-309198. Epub 2016 Sep 15.
To assess long-term functional results after vitrectomy for stages 4 and 5 retinopathy of prematurity (ROP).
Retrospective analysis of data from eyes that underwent lens-sparing vitrectomy (LSV) or combined lensectomy and vitrectomy (LV) and had a follow-up of at least 5 years.
Eighty-eight eyes of 65 infants who underwent LSV or LV for stage 4 or 5 ROP were included in the study. The mean follow-up was 6.9 years. The anatomic success rate was 89% (17/19) for stage 4A, 63% (24/38) for stage 4B, and 42% (13/31) for stage 5. Forty-five eyes (51%) had measurable visual acuity (VA). The approximate Snellen VA equivalent was 20/550 for stage 4A, 20/1600 for stage 4B, and 20/4000 for stage 5. The remaining 39% (34/88) had light perception or no light perception. Owing to neurological conditions, VA in nine eyes (10%) could not be measured. Anatomic and visual outcomes were not associated with surgical technique.
Surgery for stage 4A ROP has better visual success. Acceptable vision for stage 4B and poor for stage 5 ROP, despite retinal reattachment, is thought to be secondary to irreversible injury to either the retina or visual nervous pathways, or both.
评估4期和5期早产儿视网膜病变（ROP）玻璃体切除术后的长期功能结果。
对接受保留晶状体玻璃体切除术（LSV）或晶状体切除术联合玻璃体切除术（LV）且随访至少5年的眼部数据进行回顾性分析。
65例因4期或5期ROP接受LSV或LV手术的婴儿的88只眼纳入研究。平均随访时间为6.9年。4A期的解剖成功率为89%（17/19），4B期为63%（24/38），5期为42%（13/31）。45只眼（51%）有可测量的视力（VA）。4A期的近似斯内伦视力等效值约为20/550，4B期为20/1600，5期为20/4000。其余39%（34/88）有光感或无光感。由于神经方面的情况，9只眼（10%）的VA无法测量。解剖和视觉结果与手术技术无关。
4A期ROP手术的视觉成功率更高。尽管视网膜复位，但4B期的视力尚可接受，而5期ROP的视力较差，这被认为是视网膜或视觉神经通路或两者受到不可逆损伤的继发结果。
