Витрэктомия на воздухе в хирургическом лечении ретинопатии недоношенных

Abstract

Purpose . To develop the vitrectomy technique under the air medium in case of progressive retinopathy of prematurity (ROP) after the laser treatment with a formation of local traction retinal detachment. Material and methods. The clinical material consisted of 30 ROP patients (42 eyes) aged 7-11 weeks of life (post-conceptual age – 37-43 weeks), in which 2-3 weeks after laser treatment for the ROP stage III (29 eyes) and aggressive posterior ROP (13 eyes) signs of further progression of the disease was observed, that was expressed in increased vascular activity in the posterior pole of the eye, intensity of retinal edema in the fovea area, the growth of fibrovascular tissue along the shaft and into the vitreous body with the formation of vitreoretinal tractions, the formation of local tractional retinal detachment with extent not more than 4-hour meridians. All patients underwent an early lens-sparing 3-port vitrectomy using the 25g systems of the Constellation device (Alcon, USA). Results . In the postoperative period the anatomic results of the early vitrectomy was estimated by the retinal attachment. The full retinal attachment was achieved in 40 eyes (95.2%), partial – 2 (4.8%). The regression of the disease was characterized by the absence of extra-renal proliferation. Positive dynamics of the process was confirmed by a fixed and statistically significant normalization of morphometric criteria. During the analysis of surgical treatment results the indications for an early vitrectomy were determined when signs of ROP progression after retinal coagulation. Conclusion . In accordance with the obtained data, it was found that the optimal period to carry out the early lens-sparing vitrectomy is 2-3 weeks after laser coagulation of the retina in case of signs of disease progression, which ensures a maximum efficiency of surgical treatment.