目的:观察使用计算机辅助双目间接检眼镜成像技术对早产儿视网膜病变(retinopathy of prematurity,ROP)进行表面麻醉下光凝手术的效果,探讨计算机辅助双目间接检眼镜成像技术条件下进行ROP光凝手术模式的应用价值。方法:回顾性研究,阈值前1期及阈值期ROP患儿58例116眼在术前、术中、术后分别使用计算机辅助的双目间接检眼镜成像技术对患儿视网膜进行检查,术前检查用于设计手术方案,术中检查用于检测病变区激光治疗的遗漏区,手术结束时用于记录手术效果。手术在实施心电监护后的表面麻醉下进行。随访3~12mo。结果:本组病例中术中使用计算机辅助双目间接检眼镜成像技术检查可及时发现36眼(31.0%)存在遗漏区,立即补充激光治疗。所有116眼一次激光治疗后ROP病变得到控制。随访结束时所有术眼均未出现视网膜不良结构。结论:表面麻醉条件下的早产儿视网膜光凝手术过程中,使用计算机辅助双目间接检眼镜成像技术进行眼底检查,可及时发现激光遗漏区,立即补充激光治疗后能够有效避免二次手术。

AIM:To observe and discuss the value of using computer-aided imaging technology of binocular indirect ophthalmoscopy in laser photocoagulation treatment for retinopathy of prematurity(ROP).METHODS:The clinical data of 58 patients 116 eyes with threshold ROP or prethreshold type I ROP were retrospectively analyzed.Ocular fundus was examined by computer-aided imaging technology of binocular indirect ophthalmoscopy before and after in every operation.Before operation results were used to design the surgery;in operation results were used to detect the missed area after laser photocoagulation,after operation results were for the operation effect recording.The surgery was implemented under surface anesthesia with electrocardio monitoring.The follow-up duration was 3-12 months.RESULTS:Missed area was found in thirty-six eyes(31.0%)by computer-aided imaging technology of binocular indirect ophthalmoscopy of laser photocoagulation.The missed area was at once supplemented during surgery.All the eyes which had undergone one time laser photocoagulation had good result after surgery and the disease was controlled.At the end of follow-up duration,there was no unfavorable retinal structural outcome.CONCLUSION:Computer-aided imaging technology of binocular indirect ophthalmoscopy of laser photocoagula-tion for ROP can find missed area effectively during the operation.Second-time surgery was avoided by supplement laser photocoagulation in time.

R779.63

中国广东省科学技术厅基金资助项目(No.83036);中国广州市科学技术局基金资助项目(No.2005Z1-E0102)