Pearce I A, Pennie F C, Gannon L M, Weindling A M, Clark D I
Department of Ophthalmology, Walton Hospital, Liverpool.
Br J Ophthalmol. 1998 Nov;82(11):1254-9. doi: 10.1136/bjo.82.11.1254.
BACKGROUND/AIMS: In the management of retinopathy of prematurity (ROP), several studies have demonstrated laser photocoagulation to be as effective as cryotherapy in reducing the incidence of unfavourable structural outcome. However, few data are available on the functional outcome. The 3 year visual acuity outcome of infants treated with laser or cryotherapy in a neonatal unit is presented.
The case notes of 34 infants (64 eyes) treated with cryotherapy, between 1989 and 1992, and 32 infants (59 eyes) treated with laser, between 1992 and 1995, were reviewed.
In the cryotherapy group 69% of eyes had a favourable structural outcome. Of these structurally successful eyes 62.5%, 35.0%, and 33.3% of eyes had visual acuities within normal limits at the 12 month, 24 month, and 36 month corrected age milestones respectively. In the laser group 93% of eyes had a favourable structural outcome. Of these structurally successful eyes 96.4%, 66.7%, and 59.5% of eyes had visual acuities within normal limits at the 12 month, 24 month, and 36 month corrected age milestones respectively.
In the management of ROP, when laser photocoagulation induces a structurally successful result, the potential for normal visual acuity development at 3 years is high. Whether the poorer functional outcome of the eyes treated with cryotherapy is an artefact of the historical nature of the study or as a result of an adverse effect of the destructive transcleral application is unknown.
背景/目的：在早产儿视网膜病变（ROP）的治疗中，多项研究表明激光光凝术在降低不良结构结局发生率方面与冷冻疗法效果相当。然而，关于功能结局的数据却很少。本文呈现了一家新生儿病房中接受激光或冷冻疗法治疗的婴儿3年视力结局情况。
回顾了1989年至1992年间接受冷冻疗法治疗的34例婴儿（64只眼）以及1992年至1995年间接受激光治疗的32例婴儿（59只眼）的病历。
在冷冻疗法组中，69%的眼睛获得了良好的结构结局。在这些结构成功的眼睛中，分别有62.5%、35.0%和33.3%的眼睛在矫正年龄12个月、24个月和36个月时视力在正常范围内。在激光治疗组中，93%的眼睛获得了良好的结构结局。在这些结构成功的眼睛中，分别有96.4%、66.7%和59.5%的眼睛在矫正年龄12个月、24个月和36个月时视力在正常范围内。
在ROP的治疗中，当激光光凝术取得结构成功的结果时，3岁时正常视力发育的可能性很高。冷冻疗法治疗的眼睛功能结局较差是研究的历史性质导致的假象，还是经巩膜破坏性应用的不良影响所致，目前尚不清楚。
