Objective To observe the application and effectiveness of bevacizumab intravitreal injection as adjunctive treatment for laser coagulation to treat retinopathy of prematurity (ROP). MethodsFrom March 2008 to October 2010, 17 infants (31 eyes) with ROP received bevacizumab intravitreal injection and were analyzed. Ten infants were male (18 eyes) and 7 were female (13 eyes).Their gestational age was from 24.7 to 31.0 weeks, with a mean of (28.2±1.9) weeks. Their birth weight was from 750 to 1600 grams, with a mean of (1150±264) grams. The indications for treatment included poor papillary dilation and refractive media opacity precluding complete laser coagulation and that ROP could not be controlled after complete laser coagulation treatment. The duration of followup was 1.4 to 40.8 months, with a mean of (20.8±13.2) months. It was noted whether the diseases were completely controlled or not, unfavourable structural outcome occurred or not and if there were complications regarding treatment. Results During the follow-up of all 31 eyes, ROP of 27 eyes (87.0%) was controlled by bevacizumab intravitreal injection as adjunctive treatment for laser coagulation. Increasing neovascularization and traction retinal detachment occurred in 2 eyes (6.5%). These 2 eyes underwent vitreoretinal surgery. The posterior retinal structure returned to normal in 1 eye and posterior vitreoretinal traction occurred in 1 eye. After bevacizumab intravitreal injection ROP continued progressing and traction retina detachment occurred in 2 eyes. The overall health of this infant remained good during and after operation. No systemic adverse drug reactions were found. No endophthalmitis occurred. No ocular complications such as corneal burn, cataract, and anterior segmental ischemia were found. Conclusions During the follow-up，the effectiveness of bevacizumab intravitreal injection as adjunctive treatment for laser coagulation to treat ROP was positive. No complications regarding the treatment were found.
ObjectiveTo evaluate the safety and efficacy of 27G micro-incision vitrectomy surgery (MIVS) combined with intravitreal injection of ranibizumab (IVR) in the treatment of retinopathy of prematurity (ROP) with early intervention failure.MethodsRetrospective case series was performed. Fourteen eyes (11 infants) with ROP who underwent 27G MIVS combined with IVR were included from March 2016 to January 2018 in Shenzhen Eye Hospital. Among them, there were 5 males with 7 eyes, 6 females with 7 eyes. The average gestational age of the infants was 28.12±0.90 weeks; the average birth weight was 1 023.64±200.96 g. Before the early clinical intervention, 1 infant (2 eyes) had ROP in zone Ⅰstage 3 with plus disease, 8 infants (10 eyes) had ROP in zone Ⅱ stage 3 with plus disease, and 2 infants had ROP in aggressive posterior ROP. Six eyes underwent laser photocoagulation, while 8 eyes received laser therapy combined with IVR. Six eyes of stage 4A ROP and 8 eyes in stage 4B. Retinal detachment was detected with a mean of 10.44±9.21 weeks. At the time of surgery, the average post-conceptional age was 48.02±8.09 weeks. All the affected eyes were treated with standard sclera with three incisions 27G MIVS. During the operation, only local vitrectomy was performed to release and clear fibroascular proliferation in the optic disc, anterior macular area and pericristal area. After surgery, 10 mg/ml of ranibizumab 0.03 ml was injected into the vitreous cavity. The average follow-up time was 23.36±8.34 months. The primary objectives were the condition of retinal reset, ROP progression control and complications.ResultsAll patients had uneventful surgeries with an average duration of 32.86±9.35 mins. Of the 14 eyes, 12 eyes (85.71%) were controlled, 8 eyes (57.14%) had a good rearrangement of macular structure, while 4 eyes with macular traction. Two eyes had ROP progression, recurrence of retinal detachment, posterior synechia. Complicated cataract was in 1 eye. Proliferative vitreoretinopathy and retinal detachment was in 1 eye after 7 months the operation.Conclusion27G MIVS combined with IVR is a safe and effective treatment for ROP with early clinical intervention failure.