Тактика и результаты лечения при увеальных осложнениях лазеркоагуляции при ретинопатии недоношенных

Abstract

A pronounced inflammatory process from the anterior and posterior parts of the eye may occur, as a complications after laser coagulation in retinopathy of prematurity (ROP), in which there is a need for surgical treatment. Purpose. To determine the optimal tactics for the treatment of uveal complications of laser coagulation in ROP. Material and methods. For 2014-2020 we examined and performed surgical intervention in 21 children with uveal complications after laser coagulation (27 eyes), Most of the children were deeply premature (born at 24-26 weeks of gestation) with a birth weight of 500 g to 900 g with concomitant pathology from the central nervous system. Сomplicated cataracts developed for all children. All children underwent surgical treatment: reconstruction of the anterior chamber, microinvasive cataract extraction, vitrectomy (if necessary, schvartectomy). A single surgical intervention was performed on 24 eyes. In 3 eyes with a post-aggressive form of ROP and a history of sepsis, reoperative treatment was required. All children had no primary IOL implantation. IOL implantation was performed in one childe at an older age. Results. As a result of the treatment, in 89% of cases (24 eyes), there was a complete relief of the inflammatory process and restoration of the transparency of the media after a single surgical intervention. In childe who underwent secondary IOL implantation in the long term, there was a complicated course of early postoperative period and repeated reconstructive surgery required. Conclusions. Uveal complications after laser coagulation of the retina for ROP are observed mainly in children born in early gestation (24-26 weeks) with low birth weight (less than 1000 g). When carrying out the surgical treatment of uveal complications - cataract extraction, which has developed as a result of laser coagulation for ROP, vitrectomy is mandatory, and, if necessary, schwartectomy. When deciding on the secondary implantation of IOLs, it is necessary to take into account the high probability of an unfavorable course of the postoperative period in children with previous uveitis after laser treatment for retinopathy and prematurity. Key words: retinopathy of prematurity, uveal complications, cataract.