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Surgical Treatment of Late Tractional Retinal Detachment Appearing on the Basis of Retinopathy of Prematurity

Publication at Second Faculty of Medicine |
2005

Abstract

Retinopathy of prematurity (ROP) is a proliferative retinopathy affecting predominantly immature children and children with low birth weight under 2500 g in 5-6 %. During 11 years we operated on 15 eyes of 15 patients aged 5-31 years, because of latě tractional retinal detachment (TRD) appearing on the basis of ROP.

The average follow-up period was 37.2 months; the minimal follow-up period was 1 year. In all patients, the personál medical history revealed the pre-term birth at the gestation age of 28-34 weeks.

The birth weight was in the range 850-1600 grams. According to the extend of vitreoretinal traction and type of retinal defect we indicated: a) primary cryosurgical proceduře (CP) with episcleral silicone implants.

The operation was indicated in 6 eyes: cerclage, segmental perilimbal plombage in the temporal half and puncture of the subretinal fluid; b) pars plana vitrectomy (PPV). In total in 9 eyes the PPV was indicated, in 5 eyes it was supplemented with relaxing retinotomy, and in 7 eyes with silicone oil (SO) implantátům.

Three eyes were re-operated by means of PPV with SO implantation. The finál anatomical success of the surgical treatment of the prognostic unfavorable TRD, including re-operations was achieved in 12 eyes (80 %), which we consider as a good one.

The visual acuity improved or remained the samé also in 12 eyes (80 %) and visual acuity 6/60 and better (20/200 or 0.1) in 8 out of 15 eyes (53 %).