Bahrani Hasan M, Alhasseny Khitam Fakhir
American Eye & Retina Center, Erbil, Iraq.
Pediatric Ophthalmology Department, Ibn Al-Haytham Teaching Eye Hospital, Baghdad, Iraq.
Clin Ophthalmol. 2023 Dec 29;17:4033-4041. doi: 10.2147/OPTH.S443810. eCollection 2023.
Stage 4 and 5 retinopathy of prematurity (ROP) is a serious condition that may require surgical intervention at some point. Timely intervention is a key element and, with the peculiarity of eyes among this group that necessities a certain level of surgical standards, operations cannot be undertaken in any surgical eye center.
To recognize the outcomes of vitrectomy in Iraqi preterm babies with stage 4 and 5 ROP, and to study factors that might increase the risk of re-detachment in operated eyes.
A prospective cohort study undertaken from November 2020 to June 2023 for Iraqi preterm babies presenting with stage 4 and 5 ROP requiring surgical intervention. Each patient had a follow-up duration of 9 months. The primary follow-up outcome was anatomical success rate (flat versus detached), and the secondary outcome was to identify the postoperative complications.
This study enrolled 19 children; 11 males and eight females (number of eyes operated on was was 31), with a mean gestational age of 29.4±2.1 weeks. There were six (19.4%) eyes that did not develop any complications, five (16.1%) eyes developed postoperative vitreous hemorrhage, five (16.1%) eyes developed cataract, three (9.7%) eyes underwent a second vitrectomy, and seven (22.6%) eyes developed secondary glaucoma. The surgical success rates were 90.9% for stage 4a, 57.1% for stage 4b, and 33.3% for stage 5a.
This study presented the first surgical experience for vitrectomy in children with retinopathy of prematurity in our country, and the results were encouraging with an overall surgical success rate of 64.5%, and 19.4% of eyes did not develop any complication until the 1-year of follow-up.
4期和5期早产儿视网膜病变（ROP）是一种严重疾病，在某些时候可能需要手术干预。及时干预是关键因素，鉴于该群体眼睛的特殊性，需要一定水平的手术标准，并非任何眼科手术中心都能开展此类手术。
了解伊拉克4期和5期ROP早产儿玻璃体切除术的效果，并研究可能增加手术眼再次脱离风险的因素。
对2020年11月至2023年6月期间出现4期和5期ROP且需要手术干预的伊拉克早产儿进行前瞻性队列研究。每位患者的随访期为9个月。主要随访结果是解剖学成功率（视网膜平复与脱离），次要结果是确定术后并发症。
本研究纳入19名儿童；11名男性和8名女性（手术眼数为31只），平均胎龄为29.4±2.1周。有6只眼（19.4%）未出现任何并发症，5只眼（16.1%）发生术后玻璃体出血，5只眼（16.1%）发生白内障，3只眼（9.7%）接受了二次玻璃体切除术，7只眼（22.6%）发生继发性青光眼。4a期手术成功率为90.9%，4b期为57.1%，5a期为33.3%。
本研究展示了我国早产儿视网膜病变患儿玻璃体切除术的首次手术经验，结果令人鼓舞，总体手术成功率为64.5%，19.4%的眼睛在随访1年时未出现任何并发症。
