Лазерные методы лечения активной ретинопатии недоношенных: от режима одиночного импульса до навигации

Abstract

Purposе. Тo present the stages of development of laser technologies for the treatment of active retinopathy of prematurity at the S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch. Material and methods. Transpupillary laser photocoagulation of the retina was performed in 1546 children (2523 eyes) with active ROP from 2004 to 2021. Laser coagulation of the retina was carried out on various stationary laser ophthalmocoagulators acting in green and yellow spectra with a wavelength of 532 nm, 561 nm and 577 nm. Indications for laser treatment were the 2 nd and the 3 rd stage of the disease with an unfavorable course, the stage of early clinical manifestations, and the stage of manifestation of aggressive posterior ROP. Results. As the technology of retinal laser photocoagulation improved in patients with active ROP, the efficiency naturally increased and the duration of laser treatment decreased. Currently, the effectiveness of transpupillary laser coagulation of the retina using a hexagonal pattern has made it possible to achieve regression of the disease at the 2 nd stage with an unfavorable course in 100 % of cases, at the 3 rd stage with an unfavorable course type – in 97 %. The time for laser coagulation of the retina for the 2 nd stage was 6 ± 2 minutes, for the 3 rd stage it was 8 ± 3 minutes. Navigation assisted laser coagulation of the retina is the latest trend in laser treatment of active ROP. Conclusion. Permanent improvement of laser ophthalmocoagulators and the introduction of new methods of laser coagulation into clinical practice determine their continuous progress in achieving the maximum percentage of regression of active ROP with a minimum duration of the treatment session. Keywords: retinal laser photocoagulation, retinopathy of prematurity, ophthalmocoagulator.