倍频Nd:YAG激光治疗早产儿视网膜病变疗效分析

目的 评价倍频Nd:YAG间接检眼镜激光治疗早产儿视网膜病变(retinopathy of rematurity,ROP)的治疗效果,探讨其合理的治疗时机和模式.结果 对39例76只眼ROP患儿经倍频Nd:YAG间接检眼镜激光治疗后,71只眼病变完全退化,总治愈率93.42%.Ⅰ区病变的出生体重(1232±325)g出生胎龄(28.79±1.93)周与Ⅱ区病变(1333±264)g,(29.47±2.11)周的差异无统计学意义(P>0.05),而Ⅰ区病变的治疗时矫正胎龄(34.29±1.44)周明显小于Ⅱ区病变(36.00±2.03)周(P<0.05);Ⅰ区病变的激光斑数(1618±607)明显多于Ⅱ区病变(813±470)(P<0.05).结论 倍频Nd:YAG间接检眼镜激光治疗ROP早期病变是安全有效的.Ⅰ区腐变患儿阈值病变出现早,进展快,预后差.

Treatment outcome of retinopathy of prematurity by frequency-doubled Nd-YAG laser indirect photocoagulation

Objective To analyze the treatment efficacy of frequency-doubled Nd-YAG laser indirect photocoagulation for retinopathy of prematurity (ROP). Methods The clinical records in 39 preterm infants (76 eyes) treated by 532nm frequency-doubled Nd-YAG laser were retrospectively analyzed. Various risk factors were compared between the patients with zone Ⅰ ROP and zone Ⅱ ROP. Results Seventy-six eyes with ROP were cured via the laser photocoagulafion with the curative rate 93.42%. The mean birth weight, gestational age in 16 infants of zone Ⅰ ROP was 1232±325g, 28.79±1.93 weeks, and the data above mentioned had no significant difference in comparison with the 23 infants with zone Ⅱ disease group (1333±264g,29.47±2.11 weeks) (P >0.05 ). The corrected gestational at the time of operation with zone Ⅰ disease (34.29±1.44weeks ) was less than that zone Ⅱ disease group ( 36.00±2.03weeks ) (P <0.05 ). The laser spots of zone Ⅰ ROP (1618±607 ) were much more than that of zone Ⅱ ROP (813±470 )(P<0.05).Conclusions Patients with zone Ⅰ ROP always progress quickly and show a poor outcome. Frequency-doubled Nd-YAG laser retinal photocoagulation is a safe and effective procedure for treatment of zone Ⅰ and Ⅱ of ROP.