By PATRICIA ANSTETT

Born 14 weeks early, the only surviving baby of triplets, 4-month-old Riccardo Posarelli and his parents await the results of eye surgery that may save some of his waning vision.

It could be months or even years before they know whether the surgery done last month will help Riccardo. His family came to metro Detroit from Modena, Italy, south of Milan, because a medical team at Beaumont Hospital in Royal Oak is recognized as a world leader in breakthrough treatments for premature babies at risk of blindness.

Detroit may be known to the rest of the world as an auto capital, but in the field of pediatric ophthalmology, it attracts patients from around the globe for surgery and consultation for retinopathy of prematurity, a condition that can cause severe vision loss or blindness in babies born too early.

Dr. Michael Trese, the Beaumont retinal specialist who performed Riccardo's surgery, and his partner, Dr. Antonio Capone, helped develop procedures over the last 25 years that have made the condition treatable, improving the lives of thousands of children and saving as much as $1 million in their lifetimes in lost wages and medical costs, Trese said.

Riccardo's parents had to try it.

"They understand they have a chance other families never get," said Teresa Nascimbeni, president of the National Association of Immigrant Families, an organization of Italian women who volunteer to translate for some 200 Italian families who come to Beaumont each year for the surgery. She has helped Riccardo's parents communicate with the doctors during their stay in Michigan.

In the United States alone, retinopathy of prematurity occurs in an estimated 14,000 to 16,000 babies annually, a number that has declined with advancements in neonatal care, according to the National Eye Institute, part of the National Institutes of Health. About two-thirds of babies born under 2 3/4 pounds develop the disease, though it may not cause vision loss if found very early.

A single outpatient laser treatment, pioneered by Trese and others in the '80s and now available at many top centers, restores or improves vision in 90% of preemies, Trese said.

Trese and Capone also are leaders in vitrectomy surgery, to save vision in the other 10% of babies like Riccardo not helped by the laser treatments or cryosurgery, a freezing technique. Beaumont houses the world's only low-vision center for children, visited by families from 30 countries.

The Beaumont program is a strong example of what is known as medical tourism -- patients coming here from abroad, referred by top medical teams . Nearly 3 of 4 babies who come to Beaumont for the surgery are from outside Michigan, and half of those are from outside the United States.

The hospital's team has headed several key clinical studies into the condition, including one recently begun to see if injections of Avastin, a colon cancer drug, work to stop progression of the disease. A nonprofit Detroit-area group Trese founded in 1980, the Association for Retinopathy of Prematurity and Related Diseases, raises money for research into the causes and treatment of the disease.

In the one-hour operation, Trese slowly pushed and peeled back cloudy-looking scar tissue from Riccardo's retina. The tricky part is that the retina and scar tissue look so much alike. "It's like two pieces of wet toilet tissue," Trese explained. "You remove the top part without trying to harm the other."

Sometimes, the first signs of improvement can be seen when a baby sits near a window and responds to light. Riccardo will be lucky to get enough vision to see with the help of magnifiers and low-vision tools, Trese said before the child's surgery.

More at: Detroit Free Press