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Refractive errors after cryotherapy in retinopathy of prematurity
V Seiberth1, M C Knorz, R Trinkmann
1Department of Ophthalmology, Mannheim Medical Center, Faculty of Clinical Medicine, University of Heidelberg, FRG.
Insights
Cryocoagulation treatment for retinopathy of prematurity in premature infants resulted in a high prevalence of refractive errors, including hyperopia and myopia. Repeated cryocoagulation for severe cases correlated with pronounced myopia.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Cryocoagulation has been a traditional treatment for ROP, but its long-term effects on refractive development are crucial to understand.
Purpose of the Study:
- To evaluate the refractive outcomes in premature infants treated for acute retinopathy of prematurity using cryocoagulation.
- To assess the influence of cryocoagulation on refractive errors and anisometropia.
Main Methods:
- Retrospective follow-up study of 14 premature infants (birth weight 900-1,630 g) treated with cryocoagulation between 1976 and 1984.
- Refractive power was determined for 20 eyes up to 2-7 years of age.
- Comparison of refractive errors between treated and untreated eyes in cases where only one eye received cryotherapy.
Main Results:
- The average refractive power was -1.5 +/- 4.1 diopters.
- 60.0% of eyes were hyperopic (+1.3 +/- 0.4 dptr), and 40.0% were myopic (-5.7 +/- 3.6 dptr).
- Eyes treated multiple times for severe ROP showed pronounced myopia (>7.0 dptr).
- Cryocoagulation in one eye did not significantly affect refractive errors compared to the untreated eye (average anisometropia +0.4 +/- 0.4 dptr).
Conclusions:
- Cryocoagulation for retinopathy of prematurity is associated with a high incidence of refractive errors, particularly myopia in severe cases.
- While cryocoagulation itself may not cause significant anisometropia, the treatment can lead to substantial refractive deviations in the long term.
Abstract:
Because of acute retinopathy of prematurity 14 premature infants (900-1,630 g birth weight) were treated with cryocoagulation (10 children, both eyes; 4 only one eye) between 1976 and 1984 and were followed up until they were 2-7 years of age. The average refractive power of 20 eyes (those in which refraction could be determined) was -1.5 +/- 4.1 dptr. Twelve eyes (60.0%) were hyperopic (average: +1.3 +/- 0.4 dptr), and 8 eyes (40.0%) were myopic (average: -5.7 +/- 3.6 dptr). Three eyes in which cryocoagulation was done twice or three times because of a severe course developed pronounced myopia (greater than 7.0 dptr). When comparing both eyes of 4 children in whom cryotherapy had been carried out in only one eye, cryotherapy was found to have no influence on refractive errors (average anisometropia +0.4 +/- 0.4 dptr).