First Author: O.Kolenko RUSSIA
Co Author(s): V. Egorov E. Sorokin M. Pshenichnov
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To compare the duration of the operation with the use of various technologies of laser coagulation of the retina for the treatment of threshold stages of retinopathy of prematurity (ROP)
The research was performed in the State Institution Eye Microsurgery Complex named after academician S.N. Fyodorov, Khabarovsk, Russia
Dynamic monitoring of 106 children with threshold stages of ROP (198 eyes) was carried out. The 1st group consisted of 15 children whom laser coagulation was performed with a head-on ophthalmoscope and a diode laser (Iridex Oculight Slx, wavelength 810 nm). The 2nd group included 30 children whom laser coagulation was carried out using a diode laser adapted to a slit lamp (VisuLAS 532 'Carl Zeiss'). In the 3rd group (61 children) VALON technology was applied, which allows to apply simultaneously from 4 to 25 coagulants, in the form of square patterns.
In the 1st group, the duration of the operation varied from 30 to 48 minutes in one eye, depending on the area of the avascular retina. Moreover, in all cases we encountered great difficulties in carrying out adequate laser coagulation. As a result of the treatment, up to 20-30% of the avascular retina remained intact. 7 of 15 children underwent respiratory arrest during the operation, which required urgent intubation of the trachea and resuscitation; 2 children had a short-term cardiac arrest, which was immediately restored through resuscitation. In the 2nd group, the duration of the operation under anesthesia ranged from 18 to 31 minutes per eye, an average of 24±4.1 minutes. In the 3rd group, the duration of the operation on one eye was 11 to 25 minutes, averaging 17±5.3 minutes.
The use of pattern laser coagulation is the most optimal technology for treating children with ROP. A significant reduction in the operation time (17±5.3 minutes with the use of the pattern technology versus 36±4.2 minutes with the head optic ophthalmoscope) reduces the risk of complications of mask anesthesia.