Seiberth V, Linderkamp O, Vardarli I
Department of Ophthalmology, Klinikum Mannheim, Faculty for Clinical Medicine of the University of Heidelberg, Germany.
Arch Ophthalmol. 1997 Oct;115(10):1270-5. doi: 10.1001/archopht.1997.01100160440008.
To evaluate the efficacy and safety of transscleral diode laser photocoagulation for the treatment of threshold retinopathy of prematurity (ROP).
Fifty eyes of 25 preterm infants (birth weight, 510-1200 g [864+/-178 g ¿mean+/-SD¿]; gestational age, 24-29 weeks [26.7+/-1.7 weeks]) with threshold ROP were treated with diode laser photocoagulation (wavelength, 810 nm). One eye of each infant was treated transsclerally while the fellow eye had transpupillary coagulation using the laser indirect ophthalmoscope. Follow-up ranged from 2 to 22 months (10.0+/-5.3 months).
The regression of acute ROP and the incidence of adverse treatment effects.
In 25 (100%) of the eyes treated transpupillarly and in 24 (96%) of the eyes treated transsclerally, ROP regressed after a single or a second laser treatment and the outcome was a flat, attached retina. One eye (4%) with disease in zone I failed to improve after transscleral laser treatment and ROP progressed to stage 4B with a partially attached retina, although additional retinal detachment surgery with an encircling band was performed. No adverse side effects as a result of diode laser treatment were noted except for a small amount of retinal-preretinal bleeding in the ridge in 9 (36%) of the transsclerally and in 5 (20%) of the transpupillarly coagulated eyes. There were no adverse side effects (eg, cataract formation) in the anterior segments of the eyes.
The results suggest that transscleral diode laser coagulation is as effective in the treatment of threshold ROP as transpupillary diode laser photocoagulation. Only minor side effects were noted. Transscleral diode laser photocoagulation seems to be an advantageous treatment method if transpupillary treatment bears an increased risk of cataract formation.
评估经巩膜二极管激光光凝术治疗阈值期早产儿视网膜病变（ROP）的疗效和安全性。
25例早产儿（出生体重510 - 1200 g [864±178 g（均值±标准差）]；胎龄24 - 29周[26.7±1.7周]）的50只眼睛患有阈值期ROP，接受了二极管激光光凝术（波长810 nm）治疗。每例婴儿的一只眼睛经巩膜治疗，而另一只眼睛使用激光间接检眼镜进行经瞳孔光凝。随访时间为2至22个月（10.0±5.3个月）。
急性ROP的消退情况及不良治疗效果的发生率。
经瞳孔治疗的25只眼睛（100%）和经巩膜治疗的24只眼睛（96%）在单次或第二次激光治疗后ROP消退，结果为视网膜扁平且附着。1只（4%）I区患病眼睛经巩膜激光治疗后未改善，ROP进展至4B期，视网膜部分附着，尽管进行了额外的环扎视网膜脱离手术。除了9只（36%）经巩膜治疗的眼睛和5只（20%）经瞳孔光凝的眼睛在嵴处有少量视网膜 - 视网膜前出血外，未发现二极管激光治疗的不良副作用。眼睛前段未出现不良副作用（如白内障形成）。
结果表明经巩膜二极管激光光凝术在治疗阈值期ROP方面与经瞳孔二极管激光光凝术同样有效。仅观察到轻微副作用。如果经瞳孔治疗有增加白内障形成的风险，经巩膜二极管激光光凝术似乎是一种有利的治疗方法。
