Session Title: Vascular Diseases and Diabetic Retinopathy II
Session Date/Time: Friday 12/09/2014 | 11:00-13:00
Paper Time: 11:32
Venue: Boulevard C
First Author: : P.Volodin RUSSIA
Co Author(s): : I. Iablokova A. Borisova
One of the main trends in the treatment of active retinopathy of prematurity (ROP) is an early laser photocoagulation of avascular retina in the 'subthreshold' stage with 'plus'-disease, which significantly increases the level of requirements for precision and safety of laser surgery (ETROP,2003). Purpose – to evaluate the efficacy of optimized transpupillary pattern scanning laser photocoagulation for active stages of retinopathy of prematurity
The academician S.N. Fyodorov Federal State Institution IRTC “Eye Microsurgery' (Moscow, Russia)
The study involved 72 baby (142 eyes) in the active period of the retinopathy of prematurity (ROP) .The gestational ages at birth ranged from 25 to 32 weeks (mean 28,4±1,6 weeks). Birth weight - from 790 to 2250 g (mean 1120±118 g). 21 premature infants (41 eyes) were treated. Four babies (7 eyes) had 2 'subthreshold ' ROP with “plus-disease”, 6 children (12 eyes) - 3'subthreshold ' stage , 9 children ( 18 eyes) - 3'threshold' stage , and 2 babies (4 eyes) had aggressive posterior retinopathy of prematurity (AP -ROP) . Transpupillary slit-lamp delivered laser photocoagulation was performed on a scanning laser system «PASCAL Photocoagulator» (Optimedica, USA) with the use of different patterns (5x5, 4x4,3x3 and 2x2 dots). Laser parameters were established on the basis of fluence in a single pulse (0.7-1.1 J/cm2) at maximal spot diameter (400 microns) and minimal exposure of laser irradiation (0.02 sec.) and 0.25-0.5 φ spacing. Total amount of laser burns varied from 1250 to 2500.
Complete ROP regression was achieved in all 19 cases of premature infants with 'subthreshold ' stage, in 17 of 18 eyes – with 'threshold' ROP - (one eye required an additional laser) as a result of the optimized pattern laser treatment. Only one case with AP-ROP progressed after laser photocoagulation, necessitating early lens-sparing vitreous surgery.
The use of PASCAL technology in the early treatment of active retinopathy of prematurity can significantly improve the efficacy (up 97.6%) and at the same time reduce the risk of complications due to the optimization of parameters of laser energy, which helps to improve the anatomical and functional outcomes of ROP .