Early Vitreous Surgery in the Treatment of Aggressive Posterior Retinopathy of Prematurity

Терещенко, А. В.; Сидорова, Ю А; Trifanenkova, I.G.; Терещенкова, М. С.; Исаев, С. В.; Белый, Ю. А.; Ерохина, Е. В.

doi:10.18008/1816-5095-2017-1-32-39

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“…Однако нарушение технологии и сроков проведения лазерного лечения приводит к прогрессированию заболевания, которое достигает 40 % случаев при тяжёлых формах активной РН, что требует проведения следующего этапа лечения -витрэктомии [1,5,7]. Ранняя витрэктомия, проводимая до момента массивного разрастания ФВТ (не позднее 2-3 недель после ЛКС), с анатомическим прилеганием макулярной зоны приводит к благоприятному исходу в 67-85 % случаев [3,11,12].…”

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Time of vitreal surgery for active retinopathy of prematurity

Терещенко

Trifanenkova

Yudina

et al. 2021

Acta biomedica scientifica

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Background. The anatomical and functional results of surgery for retinopathy of prematurity (ROP) are determined not only by the stage of the pathological process, but also depend on the timing of its implementation.The aim: to estimate the effectiveness of vitrectomy for severe active retinopathy of prematurity, depending on the timing of surgical treatment.Methods. Vitreoretinal surgery was performed in 138 children (198 eyes) with severe stages of ROP. All patients were divided into three groups depending on the timing of surgical treatment: group 1 – 42–48 weeks of postconceptual age (PCA), with the progression of ROP after laser coagulation of the retina (LCS), group 2 – 39–41 weeks of PCA, with the progression of ROP after LCS, group 3 – 36–39 weeks of PCA, without previous LCS. A 3-port transscleral 27-G vitrectomy was performed by all patients. At the postoperative period, the results of vitrectomy were estimated by the anatomical attachment of the retina. The follow-up period was 12 months. Results. In group 1, in 31 cases (73.8 %), the surgical intervention was completed with silicone tamponade. By the end of the follow-up period, anatomical retinal attachment was achieved in 17 eyes (40.5 %).In group 2, surgical intervention was completed with silicone tamponade in 29 eyes (42 %). By the end of the follow-up period, anatomical retinal attachment was achieved in 52 eyes (75 %).In group 3, surgical intervention was completed with silicone tamponade in 11 of 87 eyes (12.6 %). Anatomical retinal attachment was achieved in 80 eyes (92 %).Conclusion. Untimely vitrectomy (42–48 weeks of PCA) in cases of ROP progression after LCR led to a worse result. If progress of ROP after laser treatment happens, early vitrectomy (39–41 weeks of PCA) should be performed. Primary vitrectomy should be performed in case of the optimal timing of laser treatment has been missed (after 36 weeks of PCV).

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Section: Discussionunclassified