Хирургическое лечение регматогенной отслойки сетчатки с массивной пролиферативной витреоретинопатией на фоне рубцовой стадии ретинопатии недоношенных. Клинический случай

Abstract

Purpose. Demonstration of clinical case of surgical treatment of rhegmatogenous retinal detachment (RD) with massive proliferative vitreoretinopathy (PVR) against the background of cicatricial stage of retinopathy of prematurity (ROP). Material and methods. Patient O. was born at gestational age of 28 weeks with a body weight 1600 g. At age of 4 years, patient diagnosed “retinopathy of prematurity stage II, cicatricial period of the right eye. Subatrophy of the left eye”. At age of 12 years, rhegmatogenous subtotal RD, PVR C 1–12 post, developed against the background of the cicatricial stage of ROP in the right eye. 25G vitrectomy with tamponade perfluorinated compound with replacement for silicone, restrictive laser photocoagulation were performed. Results. Complete attachment of the RD was achieved. The silicone was removed after 6 months. Attachment of the retina was noted during 2 years. Visual acuity (VA) was 0.4. RD recurrence happened 2 years later, VA of the right eye – no light perception. 25G vitrectomy with membrane removal and “Pfocalin” tamponade was performed. During staged surgery: “Pfocalin” was removed, laser photocoagulation and silicone tamponade were performed. VA on the 3rd day – 0.1. Intraocular pressure – 14 mm Hg. After 1 month, the VA of the right eye is 0.1. After 6 months, the VA is 0.2, the retina is attach. Conclusions. 1. Rhegmatogenous RD develops with varying degrees of cicatricial ROP. 2. Despite the successful RD surgery against the background of cicatricial ROP, the stability of visual functions and retinal status, in the long-term period, RD recurrence is possible due to development of severe PVR. 3. The decision to terminate silicone tamponade in such cases should be made on an individual basis. 4. Based on the foregoing, long-term monitoring of patients with regressed stages of ROP is required. Keywords: retinopathy of prematurity, retinal detachment, proliferative vitreoretinopathy.