Seiberth V, Linderkamp O, Vardarli I, Knorz M C, Liesenhoff H
Universitäts-Augenklinik, Klinikum Mannheim.
Ophthalmologe. 1996 Apr;93(2):182-9.
Laser photocoagulation in retinopathy of prematurity (ROP) appears to have fewer adverse effects and to be at least as effective as cryotherapy.
To evaluate the efficacy and safety of diode laser photocoagulation we examined 50 eyes affected by stage 3+ ROP in 30 very low birth weight infants (gestational age 24-29 weeks, mean +/- SD 26.5 +/- 1.4 weeks; birth weight 480-1400 g, 898 +/- 208 g) in a prospective (uncontrolled) clinical study. Photocoagulation treatment was performed using a diode laser (810 nm) with a laser indirect ophthalmoscope delivery system. Follow-up ranged from 3 to 23 months (10.5 +/- 6.4 months).
In 46 (92%) of the 50 eyes ROP regressed after a single laser treatment and the outcome was a flat, attached retina. Two eyes (4%) had a second laser session and one other eye (2%) had additional retinal detachment surgery, resulting in the regression of ROP and a flat, attached retina. Thus, the success rate was 98% (49 out of 50 eyes). In 1 (2%) of the 50 eyes treatment failed and ROP progressed to stage 5, although additional retinal detachment surgery was performed. No adverse side effects of diode laser treatment were noted, except for a small amount of retinal/preretinal bleeding in the ridge in 8 eyes (16%) and slight postoperative anterior chamber bleeding in 1 eye (2%) with dense tunica vasculosa lentis. There were neither lenticular opacities nor cataract formation.
Diode laser photo coagulation using the laser indirect ophthalmoscope for stage 3+ ROP was easy to administer. Laser treatment had only minor side effects and was at least as effective as cryotherapy.
早产儿视网膜病变（ROP）的激光光凝术似乎不良反应较少，且至少与冷冻疗法效果相当。
在一项前瞻性（非对照）临床研究中，我们检查了30例极低出生体重儿（胎龄24 - 29周，平均±标准差26.5±1.4周；出生体重480 - 1400 g，898±208 g）的50只患有3+期ROP的眼睛，以评估二极管激光光凝术的疗效和安全性。使用带有激光间接检眼镜传输系统的二极管激光（810 nm）进行光凝治疗。随访时间为3至23个月（10.5±6.4个月）。
50只眼中有46只（92%）在单次激光治疗后ROP消退，结果是视网膜扁平且附着。2只眼（4%）进行了第二次激光治疗，另一只眼（2%）进行了额外的视网膜脱离手术，导致ROP消退且视网膜扁平并附着。因此，成功率为98%（50只眼中的49只）。50只眼中有1只（2%）治疗失败，ROP进展至5期，尽管进行了额外的视网膜脱离手术。除了8只眼（16%）的嵴部有少量视网膜/视网膜前出血以及1只眼（2%）因晶状体血管膜致密出现轻微的术后前房出血外，未观察到二极管激光治疗的不良副作用。既没有晶状体混浊也没有白内障形成。
使用激光间接检眼镜对3+期ROP进行二极管激光光凝术操作简便。激光治疗仅有轻微副作用，且至少与冷冻疗法效果相当。
