Cryotherapy for stage 3+ retinopathy of prematurity: visual and anatomic results

Fifty eyes of 25 preterm infants with stage 3+ retinopathy of prematurity (ROP) and 180 degrees to 360 degrees of preretinal neovascularization were treated with cryotherapy to ablate the peripheral zone of avascular retina. All neovascularization regressed. Eleven eyes developed traction detachments, eight of which were successfully reattached with scleral buckling surgery. With follow-up of 6 to 70 months (mean, 29 months), visual acuity was 20/30 to 20/60 in 11 of 16 eyes (69%) of eight children old enough to be tested, and 20/100 to 20/200 in three of these eyes. Thus, vision was 20/200 or better in 14 of 16 eyes (87.5%). Visual behavior was normal for their age in 16 infants too young to test. One child developed bilateral inoperable detachments. We conclude that cryotherapy safely resolves stage 3+ ROP with excellent visual results.