Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
Cumhuriyet University Faculty of Medicine, Department of Ophthalmology, Sivas, Turkey
Turk J Ophthalmol. 2021 Aug 27;51(4):225-230. doi: 10.4274/tjo.galenos.2020.07377.
We report the safety and efficacy of simultaneous bilateral vitrectomy for stage 4 and stage 5 retinopathy of prematurity (ROP).
Babies who had immediate sequential bilateral vitrectomy surgery for stage 4 or stage 5 ROP were included in this retrospective study. Clinical history, demographic characteristics of the patients, surgical procedure details, perioperative and postoperative ophthalmic and systemic complications, and postoperative anatomical success rates were evaluated. General anesthesia features were also recorded.
Seventy eyes of 35 babies who had immediate sequential bilateral vitrectomy surgery for stage 4 or stage 5 ROP were reviewed. At the time of surgery, the mean age was 41.4±4.9 weeks. There was preoperative plus disease in 58.6% of the eyes. The mean surgery/eye ratio was 1.2. Mean anesthesia time was 95±64 minutes. The mean follow-up was 28.1 months (3 to 84 months). Anatomical success was 95.7% for stage 4A (44/46 eyes), 83.3% for stage 4B (15/18 eyes), and 50% for stage 5 (3/6 eyes) ROP. Patients with stage 5 ROP had significantly less anatomical success than stage 4A and 4B (p=0.004). None of the patients had endophthalmitis and anesthesia-related severe complications.
Immediate sequential bilateral vitrectomy surgery can be considered an option for patients with active bilateral stage 4 and stage 5 ROP. The risk of endophthalmitis should be weighed against the risks of disease progression and anesthesia-related complications.
我们报告了 4 期和 5 期早产儿视网膜病变（ROP）同期双侧玻璃体切除术的安全性和有效性。
本回顾性研究纳入了因 4 期或 5 期 ROP 而行即刻序贯双侧玻璃体切除术的患儿。评估了患儿的临床病史、人口统计学特征、手术过程细节、围手术期和术后眼部及全身并发症以及术后解剖成功率。还记录了全身麻醉的特点。
对 35 例因 4 期或 5 期 ROP 而行即刻序贯双侧玻璃体切除术的 70 只眼进行了回顾。手术时平均年龄为 41.4±4.9 周。术前+病变占 58.6%。平均每眼手术/眼比为 1.2。平均麻醉时间为 95±64 分钟。平均随访时间为 28.1 个月（3 至 84 个月）。4A 期 ROP 的解剖成功率为 95.7%（44/46 眼），4B 期为 83.3%（15/18 眼），5 期为 50%（3/6 眼）。5 期 ROP 患儿的解剖成功率明显低于 4A 期和 4B 期（p=0.004）。无一例患儿发生眼内炎和与麻醉相关的严重并发症。
对于活跃的双侧 4 期和 5 期 ROP 患者，即刻序贯双侧玻璃体切除术可作为一种选择。应权衡眼内炎的风险与疾病进展和与麻醉相关的并发症的风险。
