Лечение активных стадий ретинопатии недоношенных с использованием современных технологий

Abstract

Purpose. To show the basic regulations of the complex retinopathy of prematurity (ROP) treatment with use of retinal pattern scanning laser coagulation and early vitrectomy. Material and methods. Pascal pattern scanning retina laser coagulation of (RLC) was performed in children for stage 2 ROP type 2, stage 3 ROP type 2 and subclinical stage and early clinical stage of aggressive posterior ROP according to the classification developed at the Kaluga Branch of the S. Fyodorov Eye Microsurgery State Institution. Early 3-ports 25G vitrectomy was carried out in case of ROP progressing 2-4 weeks after the laser treatment. Results. Between 2003 and 2011 total 823 different surgical interventions for infants with active ROP was performed: 737 retinal laser coagulations, 3-port lens preserving vitrectomy – 72, 3-ports lensvitrectomy – 14. Treatment efficacy was in classical ROP course 98.6% for stage 2 and stage 3 ROP (regress of the disease occurred in 557 of 565 eyes), and 74.4% for aggressive posterior ROP (regress of the disease occurred in 128 of 172 eyes). The total efficacy of the complex treatment was 92.9% (regress of the disease occurred in 685 of 737 eyes). Conclusion. The basic regulations of the complex ROP treatment are an early, within first 6 weeks of chronologic age, photocoagulation to delay progression of the retinal detachment and to stabilize vascularity, and an early vitrectomy in case of ROP progressing after the laser treatment.