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Published on: December 4, 2007
[Laser photocoagulation in retinopathy of prematurity--preliminary results]
Simona Tălu1, Gabriela Zaharie, Cristina Vlăduţiu
1Clinica de Oftalmologie, Spitalul Clinic Judetean Cluj-Napoca.
Purpose:
The present study aims to reveal, on one hand, the efficiency of the laser photocoagulation in the Retinopathy of Prematurity (ROP) and, on the other one, to answer two questions: 1. Why do some ROPs still go wrong, in spite of laser therapy? 2. What can we do about it?
Material/Method:
A retrospective study has been performed, including the 21 prematurely newborns that have been treated by laser photocoagulation, for ROP, in Cluj-Napoca, between April 2006-September 2007. The photocoagulation has been carried out with a diode laser fixed on an indirect ophthalmoscope, under sedation, in the Neonatology Department of the County Clinical Hospital from Cluj.
Results:
Globally, the results of the laser treatment are the following: favourable outcome (regression of ROP)--in 32 eyes (84.21%) and unfavourable outcome--in 6 eyes (15.79%). Laser photocoagulation has been performed in 29 eyes in stage III zone 2 and produced the regression of ROP in 27 of them (93. 10%). ROP zone I has been identified and treated in 3 cases, of which-two had a favourable evolution (66.66%), and one has progressed to stage IV (33.33%). ROP in stage IVa has been identified in 3 cases (5 eyes). The laser photocoagulation has been possible only in 3 eyes, with favourable evolution in one eye (33.33%) and unfavourable, in 2 eyes (66.66%).
Discussion:
The results of the treatment are analyzed according to two parameters: the objective situation prior to laser photocoagulation (stage and zone of ROP) and the moment of the treatment (postconceptional and postnatal age).
Conclusions:
1. The laser photocoagulation has been performed at the right moment, in 17 of the 21 treated cases (80.95%). 2. The indirect laser photocoagulation produced the regression of ROP in 15 of the 17 cases that were treated at the right moment (88.22%). 3. The indirect laser photocoagulation has been possible in 4 of the 7 eyes that arrived too late for the treatment and produced the regression of ROP in 3 of them (42.85%). 4. If it is not sustained by a correct screening, performed at the right moment, the laser photocoagulation cannot maximally validate its healing potential in ROP