A comparison of laser photocoagulation with trans-scleral cryotherapy in the treatment of threshold retinopathy of prematurity.
OBJECTIVE
The goal of this study was to determine whether there was a significant difference between the visual outcomes of eyes with threshold retinopathy of prematurity (ROP) treated with trans-scleral cryotherapy compared to those treated with laser photocoagulation.


METHODS
Extended follow-up study of a prospective, randomized clinical trial.


METHODS
Fifty-two patients with bilateral threshold ROP participated. Follow-up data were available for 25 of these patients.


METHODS
Patients were randomized to receive cryotherapy in one eye and laser photocoagulation in the other eye.


METHODS
The best-corrected visual acuity of each eye was measured. Best-corrected visual acuities of 20/50 or better were classified as "good" clinical outcomes, whereas those 20/60 or worse were considered "poor" outcomes. A secondary outcome of this study was the spherical equivalent (SE) of each eye's most recent refraction.


RESULTS
At an average follow-up point of 5.8 years (range, 4.3-7.6 years), the odds that an eye treated with laser had a good clinical outcome were 6.91 times greater than for eyes treated with cryotherapy (95% confidence interval, 1.70-28.0; n = 21). Additionally, the laser-treated eyes were less myopic with a mean SE of-3.05 diopters compared to a mean SE of -5.08 diopters for the cryotherapy-treated eyes (P = 0.0072, n = 23).


CONCLUSIONS
The authors' study suggests that laser photocoagulation for threshold ROP was more likely to result in a good clinical outcome with better final visual acuity and less myopia compared to cryotherapy treatment.
Connolly
B P
BP
Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
McNamara
J A
JA
Sharma
S
S
Regillo
C D
CD
Tasman
W
W
D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D017075:Laser Coagulation; D008297:Male; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology