Vitrectomy with closed triple incisions for stage 4 or 5 retinopathy of prematnrity
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
- Issue:
- 1
- DOI:
- No doi available
- Key Word:
- 视网膜病,早产儿/治疗;视网膜脱离/外科学;玻璃体切除术
Abstract： 目的 探讨闭合式三切口玻璃体视网膜手术治疗4期和5期早产儿视网膜病变(ROP)的临床效果.方法 回顾性分析26例ROP患儿32只眼行闭合式玻璃体视网膜手术治疗的临床资料.其中,男性18例,女性8例;出生孕周27～35周,平均孕周29.4周;出生体重960～2200 g,平均体重1434.6 g.手术时年龄为出生后50～705 d,平均158.3 d.32只跟中ROP5期病变13只眼,4期病变19只眼(4A期10只眼,4B期9只眼).其中11只眼因ROP阈值病变或阈值前病变1型接受间接检眼镜激光光凝治疗,1只眼再次接受冷冻治疗,病变未能控制进展至4期或5期.玻璃体视网膜手术采用闭合式三切口入路,其中11只眼保留晶状体,21只眼行晶状体切除.手术后随访2～24个月,主要随访视网膜复位情况.结果 所有患儿手术过程顺利.4期的19只眼中,4A期的10只眼视网膜均完全复位,占100%.3只眼有视盘黄斑牵引;4只眼分别于视盘前、鼻侧视网膜前及颞侧周边部残余机化增生膜;1只眼手术后玻璃体少量积血,2周后吸收;1只眼手术后并发白内障.4B期的9只眼,视网膜完全复位6只眼,占66.7%.但均周边广泛瘢痕机化,1只眼有视盘黄斑牵引;另外3只眼视网膜未复位,手术后即有玻璃体积血,其中2只眼合并前房积血.5期的13只眼,3只眼视网膜完全复位,占23.1%.其中2只眼周边广泛瘢痕机化,视网膜血管细,视盘色淡;1只眼颞侧视网膜皱襞;1只眼视网膜大部分复位,占7.7%,鼻侧视网膜有增生膜和浅脱离;另外7只眼视网膜均未复位.结论 4期ROP通过保留或不保留晶状体的闭合式三切口玻璃体视网膜手术治疗,能够使视网膜有效解剖复位,手术成功率较高;但对于5期ROP,玻璃体视网膜手术效果差,成功率较低.
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