Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes.
OBJECTIVE
To examine the anatomical and refractive outcomes of infrared diode laser photocoagulation (DLPC) for the treatment of threshold retinopathy of prematurity (ROP).


METHODS
The charts of all consecutive premature neonates with ROP treated by DLPC at our tertiary center from December 1, 1996, to December 31, 2004, were reviewed.


RESULTS
The group included 100 neonates (194 eyes) with a mean birth weight +/- SD of 833.9 +/- 250.3 g and a mean gestational age +/- SD of 26 +/- 1.9 weeks. Sixty-two percent of neonates had zone I or posterior zone II ROP. Each eye received a mean +/- SD of 1,740 +/- 990 laser applications, and 21% of eyes received an additional 1 to 2 rows posterior to the ridge. Neonates treated after December 2003 (cutoff date of the Early Treatment of Retinopathy of Prematurity study) underwent a significantly greater number of laser applications (mean +/- SD, 2,286 +/- 1,087) than did neonates treated earlier. Anatomical results of laser treatment were favorable for 179 eyes (92.3%) at a mean follow-up +/- SD of 33.6 +/- 27.2 months. After vitreoretinal surgery, partial or total retinal detachment was documented for 2.5% of patients who received posterior-to-the-ridge laser treatment and 3.8% of patients treated only on the avascular retina. Refractive data were available for 134 eyes: 55.2% had myopia of -5 diopters (31.3%) or greater (23.9%). Strabismus was found in 21 (28.8%) of 73 neonates tested. Gestational age was correlated with corrected age at treatment, zone of ROP, number of laser applications, and spherical equivalent. Snellen visual acuity of 6/12 or more occurred in 17 of 24 patients who complied with testing.


CONCLUSIONS
DLPC is a safe and effective treatment for ROP. Neonates of lower gestational age and birth weight require earlier and more aggressive laser treatment and may have a higher refractive error.
Department of Ophthalmology, Rabin Medical Center, Tel Aviv, Israel. seegs@netvision.net.il
Ruth
R
Axer-Siegel
Idit
I
Maharshak
Moshe
M
Snir
Ronit
R
Friling
Rita
R
Ehrlich
Ilana
I
Sherf
Benjamin
B
Shalev
Lea
L
Sirota
Dov
D
Weinberger
D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D017075:Laser Coagulation; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology*; D012160:Retina / Q000503:physiopathology; D012178:Retinopathy of Prematurity / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*