Purpose

To determine the efficacy of scleral buckling in eyes with stage 4A and 4B retinopathy of prematurity (ROP).

Methods

Seven eyes of five premature infants underwent scleral buckling for stage 4 ROP in zone II. Five eyes had stage 4A ROP, and two eyes had stage 4B ROP. Six eyes had previous diode laser photocoagulation, and one eye had received an intravitreal ranibizumab injection. Scleral buckling was the procedure of choice due to lack of access to specialized pediatric vitrectomy instrumentation. Average age at surgery was 3.4 months. Postoperative anatomic retinal status, visual acuity outcome and refractive error were assessed.

Results

The scleral buckle was removed on average 8 months after surgery. Retinal reattachment was achieved in all seven eyes. At final follow-up one eye had macular ectopia and disc dragging, one eye had a macular traction fold and two eyes had optic disc pallor. Average myopic error after buckle removal was −7.5 D.

Conclusion

Scleral buckling can be performed safely and effectively in 4A and 4B stage ROP in critically ill infants, when access to specialized pediatric vitrectomy instrumentation is limited. This surgical technique may provide adequate relief of vitreoretinal traction with improved visual potential.

中文翻译：

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巩膜扣带术治疗危重新生儿早产儿 4A 和 4B 期视网膜病变

目的

确定巩膜扣带术对 4A 和 4B 期早产儿视网膜病变 (ROP) 眼的疗效。

方法

5 名早产儿的 7 只眼在 II 区进行了 4 期 ROP 的巩膜扣带术。五只眼有 4A 期 ROP，两只眼有 4B 期 ROP。六只眼睛之前接受过二极管激光光凝术，一只眼睛接受过玻璃体内雷珠单抗注射。由于缺乏专业的儿科玻璃体切割器械，巩膜扣带术是首选手术。手术平均年龄为 3.4 个月。评估术后解剖视网膜状态、视力结果和屈光不正。

结果

巩膜扣在手术后平均 8 个月被移除。所有七只眼睛都实现了视网膜复位。在最后的随访中，一只眼出现黄斑异位和视盘拖曳，一只眼出现黄斑牵引皱襞，两只眼出现视盘苍白。去除带扣后的平均近视误差为 -7.5 D。

结论

在 4A 和 4B 期 ROP 危重婴儿中，当使用专门的儿科玻璃体切割器械有限时，可以安全有效地进行巩膜扣带术。这种手术技术可以充分缓解玻璃体视网膜牵拉，并提高视觉潜力。