Authors
Kornilovsky I.M.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Backgraund. Surgical treatment methods for active ROP generally achieve relatively good anatomical results, but visual function can be poor, especially in advanced stages, despite technological advances in vitreoretinal surgery. However, there are still no standards for the choice of methods and timing of ROP surgery depending on the stage and type of disease progression.
Aim – to conduct a retrospective analysis of the results of vitreoretinal surgery in the active period of retinopathy of prematurity, followed by an assessment of the functional results in the cicatricial phase of the disease.
Materials and methods. This study was conducted in two stages. The first stage consisted of a retrospective analysis of the results of vitreoretinal surgery performed at the Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution from 2012 to 2024 in 89 children (89 eyes) with ROP in the active phase of the disease. The second stage included an assessment of the functional outcomes in the same 89 children (89 eyes) in the cicatricial phase of ROP using standard ophthalmological examination data (visometry, refractometry, perimetry, tonometry, ophthalmoscopy, B-scan).
Results. The retrospective study included a group of premature infants with a gestational age of 25-32 weeks and a birth weight of 700-1500 grams who underwent vitreoretinal surgery of varying extents depending on the severity of the pathological process. The most successful outcomes were observed in surgeries performed at stages 3 and 4a of active ROP, whereas the effectiveness of surgical treatment was significantly reduced at later stages (stages 4b and especially 5).
Analysis of data from the cicatricial period of ROP revealed significant differences in functional outcomes depending on the stage of the disease and the type of surgical intervention performed. In children over four years of age, significant visual acuity deficits were observed, especially in the groups operated on at later stages of ROP (stages 4b and 5).
Conclusions. The results of the study demonstrate that the final anatomical and functional outcome in each specific case depends on the surgical treatment method used during the active period of ROP to stabilize the pathological process, at what stage of the disease the treatment was carried out, the general condition of the child, the scope and timing of the surgical treatment, as well as the post-conceptual age at the time of its implementation.
Keywords: vitreoretinal surgery, retinopathy of prematurity, active period of retinopathy of prematurity, cicatricial retinopathy of prematurity, functional results.
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