PDF(Pubmed)
Abstract：
OBJECTIVE: To verify the feasibility and safety of staged lensectomy and vitrectomy in stage 5C retinopathy of prematurity (ROP) with corneal opacification.
METHODS: This was a retrospective, interventional, consecutive case series. Twenty-two eyes of 18 stage 5C ROP patients with corneal opacification were included. Regular combined lensectomy and vitrectomy were not prescribed due to the invisible fundus. Staged lensectomy and posterior vitrectomy were performed. The anatomical and visual outcomes were reviewed at the final follow-up visit.
RESULTS: The mean gestational age of ROP patients was 29.3±1.6wk (range: 27-32wk), comprising 8 males and 10 females. The average birth weight was 1363.0±300.0 g. All the eyes had corneal opacity and flat or disappeared anterior chambers pre-operatively. Two eyes had complicated cataract and 7 eyes had retrolental fibroplasia. Six eyes had posterior pupillary synechiae or membranes. Seven (31.8%) eyes had vascularly active retinas. The average interval between two procedures was 6.8±4.6mo (2.5-18.5mo). After surgeries, all the patients had normal anterior chambers. Fourteen eyes had clear corneas. The intraocular pressure of 3 eyes with glaucoma was controlled by medication. Two eyes had ocular phthisis. The retina was reattached in 3 eyes and partially attached in 11 eyes. Visual acuity ranged from no light perception to hand motion.
CONCLUSIONS: Staged lensectomy and vitrectomy are procedures that can halt progression to further complications and preserve some useful eyesight in stage 5C ROP patients with corneal opacification. The earlier the lensectomy is performed, the better the prognosis is.
METHODS: This was a retrospective, interventional, consecutive case series. Twenty-two eyes of 18 stage 5C ROP patients with corneal opacification were included. Regular combined lensectomy and vitrectomy were not prescribed due to the invisible fundus. Staged lensectomy and posterior vitrectomy were performed. The anatomical and visual outcomes were reviewed at the final follow-up visit.
RESULTS: The mean gestational age of ROP patients was 29.3±1.6wk (range: 27-32wk), comprising 8 males and 10 females. The average birth weight was 1363.0±300.0 g. All the eyes had corneal opacity and flat or disappeared anterior chambers pre-operatively. Two eyes had complicated cataract and 7 eyes had retrolental fibroplasia. Six eyes had posterior pupillary synechiae or membranes. Seven (31.8%) eyes had vascularly active retinas. The average interval between two procedures was 6.8±4.6mo (2.5-18.5mo). After surgeries, all the patients had normal anterior chambers. Fourteen eyes had clear corneas. The intraocular pressure of 3 eyes with glaucoma was controlled by medication. Two eyes had ocular phthisis. The retina was reattached in 3 eyes and partially attached in 11 eyes. Visual acuity ranged from no light perception to hand motion.
CONCLUSIONS: Staged lensectomy and vitrectomy are procedures that can halt progression to further complications and preserve some useful eyesight in stage 5C ROP patients with corneal opacification. The earlier the lensectomy is performed, the better the prognosis is.
摘要：
目的：验证分期晶状体切除术和玻璃体切除术治疗伴有角膜混浊的5C期早产儿视网膜病变（ROP）的可行性和安全性。
方法：这是一个回顾性研究，介入,连续病例系列。包括18例5CROP患者的22只眼角膜混浊。由于眼底不可见，未开常规联合晶状体切除术和玻璃体切除术。进行分期晶状体切除术和后路玻璃体切除术。在最后一次随访时对解剖和视觉结果进行审查。
结果：ROP患者的平均胎龄为29.3±1.6wk（范围：27-32wk），包括8名男性和10名女性。平均出生体重为1363.0±300.0g。所有眼睛术前角膜混浊，前房平坦或消失。2只眼患有复杂性白内障，7只眼患有视网膜后纤维增生。六只眼睛有瞳孔后粘连或膜。7只（31.8％）眼睛有血管活跃的视网膜。两次手术之间的平均间隔为6.8±4.6mo（2.5-18.5mo）。手术后,所有患者前房均正常.14只眼睛有清晰的角膜。3眼青光眼的眼压通过药物控制。两只眼睛有视力。视网膜在3只眼中重新附着，在11只眼中部分附着。视力范围从无光感知到手部运动。
结论：分期性晶状体切除术和玻璃体切除术可以阻止进展为进一步的并发症，并在有角膜混浊的5C期ROP患者中保留一些有用的视力。晶状体切除术越早，预后越好。
方法：这是一个回顾性研究，介入,连续病例系列。包括18例5CROP患者的22只眼角膜混浊。由于眼底不可见，未开常规联合晶状体切除术和玻璃体切除术。进行分期晶状体切除术和后路玻璃体切除术。在最后一次随访时对解剖和视觉结果进行审查。
结果：ROP患者的平均胎龄为29.3±1.6wk（范围：27-32wk），包括8名男性和10名女性。平均出生体重为1363.0±300.0g。所有眼睛术前角膜混浊，前房平坦或消失。2只眼患有复杂性白内障，7只眼患有视网膜后纤维增生。六只眼睛有瞳孔后粘连或膜。7只（31.8％）眼睛有血管活跃的视网膜。两次手术之间的平均间隔为6.8±4.6mo（2.5-18.5mo）。手术后,所有患者前房均正常.14只眼睛有清晰的角膜。3眼青光眼的眼压通过药物控制。两只眼睛有视力。视网膜在3只眼中重新附着，在11只眼中部分附着。视力范围从无光感知到手部运动。
结论：分期性晶状体切除术和玻璃体切除术可以阻止进展为进一步的并发症，并在有角膜混浊的5C期ROP患者中保留一些有用的视力。晶状体切除术越早，预后越好。
