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[Laser coagulation in the treatment of different-type retinopathy of prematures]
Insights
Laser coagulation effectively treats retinopathy of prematurity (ROP) in children. A combined laser technique improved stabilization rates in severe ROP cases, offering better outcomes.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Medical Laser Applications
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- ROP management often involves laser treatment to prevent severe visual loss.
- Different ROP subtypes and stages may respond variably to treatment.
Purpose of the Study:
- To evaluate the efficacy of laser coagulation using an 810 nm diode laser in children with retinopathy of prematurity.
- To compare the outcomes of transscleral, transpapillary, and combined coagulation methods.
- To determine the optimal timing and technique for laser treatment in different ROP stages.
Main Methods:
- Retinal laser coagulation was performed on 126 children (238 eyes) with ROP.
- Treatment modalities included transscleral, transpapillary, and combined laser coagulation.
- Patients were categorized into classical ROP (cROP) and fulminant ROP (fROP, plus-disease).
Main Results:
- Overall stabilization rates were 97.9% for cROP and 56.6% for fROP (plus-disease).
- In fROP, treatment was most effective in stages 1 and 2 (zones 1 and 2), with stabilization in 37% at stage 3.
- A combined laser coagulation method achieved a 75.8% stabilization rate in fROP (plus-disease).
Conclusions:
- Laser coagulation is effective for retinopathy of prematurity, with high success in cROP.
- A combined transscleral and transpupillary laser technique significantly improves outcomes in severe fROP (plus-disease).
- Early intervention in fROP (zones 1 and 2) yields better results than later-stage treatment.
Abstract:
Laser coagulation of the retina was made in 126 children (238 eyes) with retinopathy of prematures (RP) by an 810 nm diode laser ophthalmocoagulator. The methods of transscleral, transpapillary and combined coagulation were applied. As for children who needed coagulation, 39.9% of them had classical RP and 60.1%--fulminant RP (plus-disease). Stabilization in CRP was registered in 97.9% (the threshold process stage was an indication for surgery), and in FRP (plus disease) it was registered in 56.6%. The best effect from surgery in FRP was observed, when patient were operated on in FRP, stage 1 (process localization in zone 1) and stage 2 (process localization in zone 2), whereas, when the procedure was made at stage 3, the process was stabilized only in 37%. The authors elaborated a combined method of laser coagulation (including transscleral and transpupillary techniques), which brought up the rate of stabilization in FRP (plus-disease) to 75.8%. The results did not depend on a coagulation technique in CRP.
