Diode laser treatment of retinopathy of prematurity: Anatomical and refractive outcomes

Ruth Axer-Siegel*, Idit Maharshak, Moshe Snir, Ronit Friling, Rita Ehrlich, Ilana Sherf, Benjamin Shalev, Lea Sirota, Dov Weinberger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

70 Scopus citations

Abstract

PURPOSE: 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. CONCLUSION: 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.

Original languageEnglish
Pages (from-to)839-846
Number of pages8
JournalRetina
Volume28
Issue number6
DOIs
StatePublished - Jun 2008

Keywords

  • Diode laser photocoagulation
  • Retinopathy of prematurity

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