532nm 倍频 Nd-YAG 绿光激光光凝治疗早产儿视网膜病变的安全性和有效性。
Safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser photocoagulation for treatment of retinopathy of prematurity.
机构信息
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
出版信息
Indian J Ophthalmol. 2019 Jun;67(6):860-865. doi: 10.4103/ijo.IJO_325_19.
PURPOSE
To evaluate the safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser for treatment of retinopathy of prematurity (ROP).
METHODS
This retrospective interventional case series included infants undergoing treatment for ROP with 532 nm green laser between January 2012 and March 2017 at a single tertiary-care referral center. Review of clinical records was done to identify baseline ROP characteristics, procedural difficulties, complications related to the laser procedure and outcome of treatment at ≥ 1 year of follow-up.
RESULTS
There are about 347 eyes of 182 infants were included in this present study. ROP presented in zone I in 76 eyes (21.9%) and zone II in 271 eyes (78.1%). Tunica vasculosa lentis (TVL) was present in 43.8% and pre-existing vitreous hemorrhage in 4.6% of the eyes. 532 nm green laser could be performed as a primary procedure in all eyes, including those with TVL. 322 eyes completed a minimum follow up of 1 year with a mean follow up of 22.8 months (range, 12-54 months). At the last follow-up visit, 298 (92.5%) of the 322 eyes had a favorable outcome. On logistic regression analysis, pre-existing fibrovascular proliferation (p = 0.04) and new-onset fibrovascular proliferation after treatment (p = 0.001) were the most significant independent predictors of poor outcome. Complications encountered were new-onset hemorrhage in 36 eyes (11.2%), anterior segment ischemia in two eyes (0.006%) and cataract in one eye (0.003%).
CONCLUSION
532 nm frequency-doubled Nd-YAG green laser appears to be safe and effective in the treatment of ROP.
目的
评估 532nm 倍频 Nd-YAG 绿光激光治疗早产儿视网膜病变（ROP）的安全性和疗效。
方法
本回顾性介入病例系列研究纳入了 2012 年 1 月至 2017 年 3 月期间在一家三级转诊中心接受 532nm 绿光激光治疗 ROP 的婴儿，对临床记录进行了回顾，以确定基线 ROP 特征、手术难度、与激光治疗相关的并发症以及≥1 年随访时的治疗结果。
结果
本研究共纳入 182 名婴儿的 347 只眼。ROP 病变位于 I 区的有 76 只眼（21.9%），位于 II 区的有 271 只眼（78.1%）。76.3%的眼中存在血管鞘膜（TVL），4.6%的眼中存在玻璃体积血。所有的眼均能进行 532nm 绿光激光治疗，包括存在 TVL 的眼。322 只眼完成了至少 1 年的随访，平均随访时间为 22.8 个月（范围 12-54 个月）。在最后一次随访时，322 只眼中 298 只（92.5%）有良好的治疗效果。logistic 回归分析显示，治疗前存在纤维血管增殖（p=0.04）和治疗后出现新发性纤维血管增殖（p=0.001）是治疗效果不良的最显著独立预测因素。并发症包括 36 只眼（11.2%）新发性出血、2 只眼（0.006%）前段缺血和 1 只眼（0.003%）白内障。
结论
532nm 倍频 Nd-YAG 绿光激光治疗 ROP 似乎是安全且有效的。
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