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[Cryocoagulation in the treatment of retinopathy of prematurity]
H Lomícková1, A Zobanová, M Odehnal
1Dĕtská ocní klinika FDL UK, Praha.
Insights
Cryotherapy for retinopathy of prematurity significantly reduces severe visual impairment. This treatment, cryocoagulation, halved the rate of blindness in premature infants compared to untreated eyes.
Area of Science:
- Ophthalmology
- Neonatal care
- Pediatric surgery
Context:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Early intervention is crucial for managing ROP and preventing severe visual outcomes.
- Cryocoagulation has been a standard treatment for ROP.
Purpose:
- To evaluate the efficacy of cryotherapy in treating retinopathy of prematurity.
- To compare visual outcomes in premature infants treated with cryocoagulation versus those who were not.
- To assess the long-term cicatricial phase findings and visual acuity after cryotherapy.
Summary:
- Cryocoagulation was performed on 130 eyes of 93 premature infants between 1984-1988.
- 102 eyes treated in stage 3a were compared to 90 untreated eyes.
- Treated eyes showed significantly better outcomes: 51% in cicatricial stages I-II with good vision, versus 4.4% in untreated eyes.
Impact:
- Cryotherapy reduced adverse outcomes (blindness) by half compared to untreated eyes (31.4% vs. 66.7%).
- This highlights the effectiveness of cryocoagulation in preserving vision for premature infants with ROP.
- The findings support the continued use of cryotherapy as a vital treatment for retinopathy of prematurity.
Abstract:
The authors give an account on cryotherapy of retinopathies in the premature--130 eyes of 93 children treated during 1984-1988. Almost in all children cryocoagulation was made, using a transconjunctival approach, in the avascular periphery of the retina under local instillation anaesthesia. Twenty-eight eyes were coagulated already in stage 2 of the proliferative phase (along with the other more severely affected eye), the results being very satisfactory. In this stage, however, spontaneous regression cannot be ruled out. This is the reason why only 102 eyes were evaluated in detail, i.e. those coagulated in stage 3a and the latter were compared with findings in 90 eyes equally affected where cryocoagulation was not performed. In the group after coagulation 51% of the eyes had findings in stage I and II of the cicatricial phase with good and very good vision, in 17.6% the final finding is stage III with vision in the zone of visual debility and 31.4% of the eyes with findings stage IV and V are blind. In the group without coagulation there were 4.4% eyes in stage I and II, 28.9% eyes in stage III and 66.7% in stages IV and V. In eyes after coagulation the percentage of adverse results (31.4%) is by one half lower than in untreated eyes (66.7%).