Офтальмохирургия (Oct 2015)
EFFICIENCY OF OUTCOMES IN SURGICAL TREATMENT FOR THE STAGE 5 OF RETINOPATHY OF PREMATURITY
Abstract
Purpose. To evaluate the long-term anatomical and functional outcomes of surgical treatment of the terminal stage of retinopathy of prematurity (ROP).Material and methods. The analysis of long-term anatomical and functional results lensvitrshvartectomy (LVSHE) at the ROP stage V was performed at the Leningrad Regional Pediatric Clinical Hospital in 92 patients (180 eyes) aged from 2 to 17 years (mean 4.0±0.2). A method for an anatomical evaluation of efficiency for surgical treatment of retinal detachment is proposed on the basis of calculation of the retinal attachment coefficient (Cf), as the ratio of the area of the digital image of the attached retina to the total area of digital fundus images.Results. The complete anatomical success was achieved in 35.6% (64 eyes of 53 patients), partial – in 37.2% of cases (67 eyes, 51 children), total retinal detachment was inoperable in 27.2% (49 eyes, 42 children). In the first group of patients (mean age for the LVSHE – 3.9±0.2 months) the Cf was 0.5±0.04, in the second group (age – 7.9 ±0.1 months.) – 0.6±0.03, in the third group (age – 17.1±1.52 months) – 0.4±0.02. In the groups 1 and 2 indices were statistically not significantly different, while the area of retinal attachment in the group 3 of patients was significantly lower (p<0.001). A positive functional outcome (Vis≥0.001) was registered in 34 eyes, at the same time its share was significantly higher in eyes with retinal attachment in patients who had the surgery in the active ROP phase at the age of 5 months. The average visual acuity was 0.01±0.002.Conclusions. The results dictate the need for an individual approach to the choice of the period for the LVSHE and, if possible implementation of the surgical treatment as soon as possible in the maximum early terms from the beginning of retinal detachment development.
