[Eleven years experience in the management of retinopathy of prematurity in the Balearic Islands]. / Once años de experiencia en el manejo de la retinopatía del prematuro en las Islas Baleares.

PURPOSE: To evaluate the incidence and effectiveness of the treatment of Retinopathy of Prematurity (ROP) in preterm births in the Balearic Islands. MATERIALS AND METHODS: Protocol of prospective and consecutive study. We included preterm infants whose birth weights were under 1,501 g, or heavier infants requiring assisted oxygen therapy. Data for the 12 years between January 1992 and December 2003 were analyzed. We evaluated gestational age, birth weight, ROP stage and the effect of treatment following CRYO-ROP Study indications. A descriptive study was undertaken. RESULTS: We evaluated 446 babies. Average age and weight were 30.4 weeks and 1,178.4 g respectively. ROP was found in 93 infants (63.1%) weighing less than 1,000 g, in 50 (19.6%) weighing 1,000-1,500 g and in 5 (11.4%) weighing > 1,500 g. In regard to gestation, ROP was found in 27 (86.2%) babies born at < 27 weeks of gestation, in 87 (35.6%) born at 27-30 weeks of gestation and in 19 infants (12.7%) born at > 30 weeks gestation. There were 75 babies with stage III disease and 73.3% needed treatment. Retinal ablation was performed at 62.9 days. CONCLUSIONS: ROP incidence is inversely related to birth weight and gestational age. Three out of four babies who reached stage III disease needed treatment. The effectiveness of photocoagulation was over 90% when performed at 2 months of age.

[Ahmed drainage device implant. Our experience between 1995 and 2003]. / Implante de válvula de Ahmed. Nuestra experiencia 1995-2003.

PURPOSE: To evaluate the indications, results and complications of the Ahmed drainage device implanted between January 1995 and December 2003. MATERIALS AND METHODS: A retrospective study of 70 eyes in 65 patients. We analysed: the indications for surgery; the preoperative intraocular pressure (IOP), the postoperative IOP at 1 and 3 months, 1, 2 and 3 years after surgery; and the short and long term postoperative complications. We defined an absolute success as an IOP between 5 and 21 mmHg without glaucoma medications, relative success the same IOP levels whilst taking glaucoma medications and failure as an IOP of less than 5 and more than 22 mmHg. RESULTS: The most frequent indications for use of the drainage device were: neovascular glaucoma (45.7%), no response to other glaucoma surgery (20%), aphakic glaucoma (10%) and traumatic glaucoma (8.5%). Mean preoperative IOP was 39 mmHg. Mean postoperative IOP was: 19.7 mmHg (1 month), 21.6 mmHg (3 months), 19.6 mmHg (1 year), 18 mmHg (2 years) and 18.6 mmHg (3 years). The most frequent early complications were athalamia and hiphema. The most frequent late complications were tube or body valve extrusion and fibrotic reaction around the valve. CONCLUSIONS: Both the indications and success rates are similar to those previously reported. Visual acuity assessment is not of value in this group of patients because of their multiple associated ophthalmic pathologies.

Implante de válvula de Ahmed. Nuestra experiencia 1995-2003 / Ahmed drainage device implant. Our experience between 1995 and 2003

Objetivo: Evaluar las indicaciones y resultados de la cirugía de válvula de Ahmed de un plato, modelo S2, durante el período de enero de 1995 a diciembre de 2003. El período de seguimiento medio fue de 42 meses (rango 6 a 96).Material y métodos: Estudio retrospectivo de 70 ojos de 65 pacientes. Los datos recogidos fueron: indicaciones para el tratamiento quirúrgico, PIO preoperatoria, a 1 y 3 meses; 1, 2 y 3 años tras la cirugía; y complicaciones precoces y tardías del implante valvular.Se habla de éxito absoluto (PIO entre 5 y 21 mmHg sin tratamiento médico antiglaucomatoso), éxito relativo (PIO entre 5 y 21 mmHg con uno o más colirios antiglaucomatosos) y fracaso (PIO menor de 5 y mayor de 22 mmHg).Resultados: Las indicaciones más frecuentes fueron glaucoma neovascular (45,7%), glaucoma crónico simple refractario a otros tratamientos quirúrgicos (20%), glaucoma del afáquico (10%) y glaucoma traumático (8,5%).La PIO preoperatorio media fue de 39 mmHg y las PIO medias postoperatorias: a 1 mes 19,7 mmHg; a 3 meses 21,6 mmHg; a 1 año 19,6 mmHg; a 2 años 18 y a 3 años 18,6 mmHg.Las complicaciones precoces más frecuentes fueron atalamia e hipema. Las tardías: extrusión del tubo o cuerpo valvular y fibrosis perivalvular.Conclusiones: Tanto las indicaciones como los porcentajes de éxitos absoluto y relativos son equiparables a los publicados en la literatura.No es útil manejar la agudeza visual como parámetro de éxito o fracaso debido a la múltiple patología asociada, en la mayoría de los casos

Purpose: To evaluate the indications, results and complications of the Ahmed drainage device implanted between January 1995 and December 2003.Materials and methods: A retrospective study of 70 eyes in 65 patients. We analysed: the indications for surgery; the preoperative intraocular pressure (IOP), the postoperative IOP at 1 and 3 months, 1, 2 and 3 years after surgery; and the short and long term postoperative complications.We defined an absolute success as an IOP between 5 and 21 mmHg without glaucoma medications, relative success the same IOP levels whilst taking glaucoma medications and failure as an IOP of less than 5 and more than 22 mmHg.Results: The most frequent indications for use of the drainage device were: neovascular glaucoma (45.7%), no response to other glaucoma surgery (20%), aphakic glaucoma (10%) and traumatic glaucoma (8.5%).Mean preoperative IOP was 39 mmHg. Mean postoperative IOP was: 19.7 mmHg (1 month), 21.6 mmHg (3 months), 19.6 mmHg (1 year), 18 mmHg (2 years) and 18.6 mmHg (3 years).The most frequent early complications were athalamia and hiphema. The most frequent late complications were tube or body valve extrusion and fibrotic reaction around the valve.Conclusions: Both the indications and success rates are similar to those previously reported. Visual acuity assessment is not of value in this group of patients because of their multiple associated ophthalmic pathologies