早产儿视网膜病变全视网膜脱离的玻璃体视网膜手术治疗预后

目的：评价玻璃体视网膜手术治疗早产儿视网膜病变(ROP)视网膜全脱离的临床效果。方法:回顾分析接受玻璃体视网膜手术治疗的56例5期（视网膜全脱离）ROP患儿73只眼的临床资料。手术时患儿年龄为3～84个月，平均年龄(13.02±14.64)个月，出生胎龄为25～36周，平均胎龄(29.5±2.22)周；出生体重为900～2500 g，平均体重(1400.19 ±300.05) g；吸氧时间为2～90 d，平均吸氧时间为(20.53±18.91) d。手术包括开放玻璃体切割手术和闭合晶状体切除、玻璃体切割手术。视网膜解剖复位的标准以黄斑复位为视网膜复位成功，视网膜复位黄斑脱离为部分成功，视网膜未复位为手术失败。结果:手术后10只眼视网膜复位成功，占13.69%；20只眼视网膜复位部分成功，占27.39%；43只眼视网膜复位失败 ，占58.9%。手术后视力为手动者9只眼，占12.33%；条栅视力＞0.004者6只眼,占8.21% 。结论:ROP 视网膜全脱离的玻璃体视网膜手术治疗手术难度较大，手术后仅少数患儿视网膜复位成功 ，部分患儿视功能有一定恢复。

Prognosis after vitreoretinal surgery for retinal detachment in patients with retinopathy of prematurity

Objective:To evaluate the clinical effects of vitrectomy on total retinal detachment in patients with retinopathy of prematurity (ROP). Methods:The clinical data of 73 eyes of 56 patients with total retinal detachment in ROP (stage 5) who had undergone vitrectomy were retrospectively analyzed. The age o f the patients when underwent the surgery was 3 84 months old with the average o f (13.02±14.64) months. The gestation age ranged from 25 to 36 weeks with the average of (29.5±2.22) weeks; the birth weight ranged from 900 to 2500 g wit h th e average of (1400.19±300.05) g; the oxygen inhaling time ranged from 2 to 9 0 days with the average of (20.53±18.91) days. The surgery included open vitr ectom y, closed lens extraction, and vitrectomy. The anatomical outcomes of retinal re attachment were categorized as success: macular reattachment; partial success: macular detachment; and failure: total retinal detachment.Results:After the operation, the anatomical outcome was succeed in 10 eyes (13.69%), partially succeed in 20 eyes (27.39%), and failed in 43 eyes (58.9%). The visual acuity was hand moving in 9 eyes (12.33%), and the grating acuity was better than 0.004 in 6 e yes (8.21%) after the surgery.Conclusions:The procedures of vitrectomy for retinal detachment in ROP is difficult, and the prognosis of the operative therapy is poor. After t he operation, only a few patients get retinal reattachment, and few have certain extent recovery of the visual acuity.