Эписклеральное круговое пломбирование в лечении отслойки сетчатки в рубцовой фазе ретинопатии недоношенных

Abstract

Purpose . Determination of the clinical indicates and the effectiveness of episcleral circular buckling in the treatment for late retinal detachment at cicatricial retinopathy of prematurity (ROP). Material and methods . 12 patients (14 eyes) having cicatricial ROP were examined. The age of patients was from 8 months until 14 years. The spontaneous regression of ROP was diagnosed for four cases (two children having 2nd stage of ROP and two children having 3rd stage of ROP). The regression for 3 children occurred after transpupillary retinal laser coagulation (RLC) had been performed in the active period (one during 2nd stage of ROP, two – during 3rd stage of ROP). Three children had the regression after early lens sparing vitrectomy. Among these children, two children underwent surgical treatment due to progressing of the pathological process after RLC. Episcleral circular buckling was performed for all patients (12 children, 14 eyes). It was performed for the single sighted eye in three patients. The surgery was performed for both eyes simultaneously in two patients. The observation period ranged from 1.5 to 2.5 years. The silicone buckle was dissected any cases. Results . The tractions managed to be stopped through three months in all cases. A complete anatomical attachment of retina was achieved in 11 eyes. The detachment did not spread at three cases. The recurrence of retinal detachment happened in the remote postoperative period in two cases (in terms of 9 and 17 months). The proliferative process activated in first case. In second case the progression of axial myopia happened with increasing of the anteroposterior size of the eye. The silicone tamponade vitrectomy needed to be performed in both cases. Conclusions . 1. Cicatricial retinopathy of prematurity is characterized by the risk of developing late complications, at any degree of residual changes in active ROP. The adequate organization and continuity in the process of dynamic observation of children affected ROP and the conducted treatment timely are required. 2. Episcleral circular buckling is effective method of a surgical treatment provided the detection of early complications of cicatricial ROP timely. It lets achieve the positive anatomical and functional results and save visual functions.