Diode Laser Photocoagulation for Retinopathy of Prematurity - Six Years Experience

早產兒視網膜病變之二極體雷射光凝固治療－六年之經驗

10.6440/TZUCMJ.199712.0265

何昭德(Jau-Der HO)；楊中美(Chung-May Yang)；何子昌(Tzyy-Chang Ho)；陳慕師(Muh-Shy Chen)；鄒國英(Kuo-Ying Tsou)；柯嘉音(Ka-Em Kua)

早產兒視網膜病變 ； 二極體雷射光凝固治療 ； 冷凍治療 ； retinopathy of prematurity ； diode laser photocoagulation ； cryotherapy

慈濟醫學雜誌

9卷4期（1997 / 12 / 01）

265 - 272

英文

早產兒視網膜病變是一種可能導致早產兒眼盲之疾病，冷凍治療已被證實可以少因早產兒視網膜病變導致之視力喪失的情形。近來對於早產兒視網膜病變治療，有學者建議雷射光凝固治療可能優於冷凍治療。本研究將評估以二極體雷射光凝固治療早產兒視網膜病變之效果。自1991年1月至1996年6月，共有32位早產兒的60隻眼睛接受二極體雷射光凝固治療。出生週數自24週至32週，出生體自638克至1470克，施行雷射時的受孕後週數為31週至44週。在雷射治療時，13位早產兒接受包括氣管插管之全身麻醉，而另外19位則施以靜脈內注射鎮靜劑及局部點眼麻醉。治療後之追蹤均在3個月以上。53隻眼睛(88.3%)於第一次雷射治療後早產兒視網膜病變消退，而有2隻眼睛(3.4%)則在兩次雷射治療後網膜病變才消退。5隻眼睛(8.3%)在接受雷射治療後，仍惡化至早產兒視網膜病變第4期或第5期。所有眼睛在接受雷射治後均只有輕微之發炎反應。本研究顯示對於早產兒視網膜病變使用二極體雷射光凝固治療是有效的。(慈濟醫學1997:9:265-272)

In this study, we evaluate the surgical results of diode laser photocoagulation in the treatment of ROP. From January 1991 to June 1996, 60 eyes of 32 infants were treated with diode laser photocoagulation for progressive stage 3 ROP. The gestational age ranged from 24to 32 weeks. The birth body weight ranged from 638 to 1470 g. Post conceptional age was 31 to 44 weeks at the time of the treatment. General anesthesia was used in 13 infants, while the other 19 infants received intravenous sedation and topical anesthesia. Diode laser was applied to all the avascular area of the retina. Patients were followed for at least 3 months after the laser treatment. Fifty-three eyese (88.3%)showed regression of ROP after one session of the treatment. ROP in two eyes regressed after the second session of the treatment. Five eyes (8.3%) progressed to retinal detachment. Minimal intraocular inflammation was noted after the treatment. Our findings suggest the usefulness of diode laser photocoagulation in the treatment of ROP. (Tzu Chi Med J 1997;9:265-272)