Laser photocoagulation for retinopathy of prematurity: structural and functional outcome

To report the structural and refractive outcome after laser photocoagulation for retinopathy of prematurity (ROP).

Nineteen consecutive patients who had undergone photocoagulation for ROP between 1997 and 2002 at our clinic were examined for this non-comparative, consecutive, interventional, retrospective case series. A total of 37 eyes received either transscleral or transpupillary laser treatment. Data consisted of grade of ROP pre- and postoperatively, birth weight, perioperative and postoperative complications and refraction. Based on indirect ophthalmoscopy, independent observers graded the extent of ROP and determined the postoperative refraction by retinoscopy.

A total of 97% of all eyes responded to laser treatment with regression of ROP. Only one eye out of 37 progressed to stage IV B despite photocoagulation and therefore an encircling procedure was performed. After further progression a vitrectomy was carried out. Perioperative complications included haemorrhages in 22% that resorbed spontaneously and cataract formation in one eye (3%). Postoperative refractive errors at mean ages of 23 +/- 12 months and 45 +/- 14 months were evaluated in 15/19 patients (79%). The spherical equivalents ranged between -8 D and +6 D at the first examination and between -12 D and +7 D at the second examination. In all only 14% of the refracted eyes were myopic.

Photocoagulation for ROP in our patients resulted in regression of threshold ROP. In addition, the analyses of the refractive outcomes demonstrated a predominance of hypermetropia in our patients.