Viteroretinal surgery шn the late complications of the cicatricial phase of retinopathy of prematurity

    Abstract

    Viteroretinal surgery шn the late complications of the cicatricial phase of retinopathy of prematurity

    Yu.D. Kuznetsova , I.B. Astasheva , S.A. Obrubov , E.V. Gamayunova

    The Russian Pediatric Clinical Hospital of the N. I. Pirogov Russian National Research Medical University, Moscow
The N. I. Pirogov Russian National Research Medical University, Moscow

    Purpose. Definition of terms and indications for vitreoretinal intervention in case of late complications in the cicatricial phase of retinopathy of prematurity.

    Material and methods. In the period 2014-2018 vitreoretinal interventions were carried out in 43 children (48 eyes) with complications in the cicatricial phase of the ROP (microinvasive vitrectomy (39 eyes – 81.2%) and lensvitrectomy (9 eyes – 18.8%). Children were born at a gestational age of 26-32 weeks, with weight from 550 g to 1700. Children at the time of surgery were aged: 19 children – from 6 months to 1 years, 15 children – from 1 to 2 years old, 9 children – from 2 to 4 years old. Previously 11 children (12 eyes) had an active ROP stage III, 28 children (32 eyes) – an active stage IVa, 4 children (4 eyes) – a spontaneous regression of stage IVa. Almost all children (91.7% (44 eyes)) in the active phase underwent surgical interventions: laser coagulation of the retina or a combination of laser coagulation with vitreoretinal intervention. During dynamic observation of this group of children, negative dynamics was revealed as for on the part of the vitreous body and the retina.

    Results. In all cases, a positive anatomical result was achieved in the outcome. Full retinal attachments during the surgical treatment (using vitrectomy) with the initial signs of the negative dynamics appearance was obtained in 100% of cases (31 eyes), during the surgical treatment using vitrectomy (8 eyes) and lensvitrectomy (9 eyes) in late periods – in 64.7% (11 eyes). Within the dynamic follow-up no further progression of the process was noted taking into consideration the elimination of the traction component.

    Conclusion. During the dynamic observation of patients in the cicatricial phase of the ROP with the appearance of negative dynamics regarding the vitreous body and retina, it is necessary to carry out early vitreoretinal interventions, regardless of the child’s age, to stabilize the process and prevent the occurrence of total traction-rhegmatogenous retinal detachment and retinoschisis.

    Key words: retinopathy of prematurity, late complications, cicatricial phase, traction retinal detachment, vitrectomy.