caa a22 4500 465794130 CHVBK 20180323112033.0 cr unu---uuuuu 170327e19900301xx s 000 0 eng 10.1007/BF02482617 doi (NATIONALLICENCE)springer-10.1007/BF02482617 The rationale for cryotherapy with a prophylactic scleral buckle for Zone I threshold retinopathy of prematurity [Elektronische Daten] [Helen Mintz-Hittner, Frank Kretzer] Our current surgical protocol for Zone I threshold retinopathy of prematurity (ROP) has evolved over 15 years and is rationalized by increasing knowledge of two pathologic processes of ROP: 1) angiogenic stimulation of spindle cells (clinically invisible) near the vitreal surface of the avascular retina; and 2) tractional forces of myofibroblasts [clinically visible as extraretinal fibrovascular proliferation (EFP)] in the vitreous overlying the vascular retina. These two pathologic processes occur concomitantly with normal anterior ocular growth with a constant optic disc-macular distance. Our current surgical protocol for Zone I threshold ROP. involves complex surgeries to achieve success defined as a macula which always remains anatomically attached, but which may be distorted or ectopic. This protocol requires cryotherapy in at least two sessions. The first is to the avascular retina to destroy spindle cells. The second is to the EFP to destroy myofibroblasts and to the shunt to eliminate the site of origin of myofibroblasts. The protocol also requires the concomitant placement of a prophylactic scleral buckle to allow formation of a new complete ora serrata while remnant myofibroblasts contract and while anterior ocular growth continues. Kluwer Academic Publishers, 1990 cryotherapy nationallicence myofibroblasts (tractional forces) nationallicence ocular growth nationallicence scleral buckling nationallicence spindle cells (angiogenic stimulation) nationallicence Zone I retinopathy of prematurity nationallicence Mintz-Hittner Helen Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut Kretzer Frank Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut Documenta Ophthalmologica Kluwer Academic Publishers 74/3(1990-03-01), 263-268 0012-4486 74:3<263 1990 74 10633 https://doi.org/10.1007/BF02482617 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02482617 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mintz-Hittner Helen Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Kretzer Frank Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut NATIONALLICENCE 773 0- Documenta Ophthalmologica Kluwer Academic Publishers 74/3(1990-03-01), 263-268 0012-4486 74:3<263 1990 74 10633 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer