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Comparison of Ventilation Support During Laser Treatment of Retinopathy of Prematurity

Jason Peng1, Raghav Taneja2, Barry N Wasserman3,4

  • 1Cooper Medical School of Rowan University, Camden, NJ 08103, USA.

Children (Basel, Switzerland)
|March 28, 2026
PubMed

Insights

Elective intubation for retinopathy of prematurity (ROP) laser treatment in infants did not improve short-term outcomes and was linked to longer mechanical ventilation. Routine intubation may be unnecessary for most ROP surgeries.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Pediatric Surgery

Background:

  • Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
  • Laser treatment is a common intervention for ROP, sometimes involving intubation.
  • The necessity of elective intubation for ROP laser surgery is debated.

Purpose of the Study:

  • To compare respiratory outcomes in preterm infants undergoing ROP laser treatment with or without elective endotracheal tube (ETT) intubation.
  • To evaluate the impact of elective intubation on post-operative respiratory support and clinical outcomes.

Main Methods:

  • Retrospective cohort study of 91 preterm infants treated between 2010 and 2023.
  • Comparison of infants who received ROP laser treatment with (Hospital 2) or without (Hospital 1) elective ETT intubation.
  • Exclusion of infants intubated for unrelated reasons or treated solely with anti-VEGF injections.

Main Results:

  • The no-ETT group had shorter mechanical ventilation duration (0 vs. 1 day, p=0.005) but longer total respiratory support (108 vs. 4.5 days, p<0.001).
  • No significant differences in hospital length of stay or timing of surgery were observed between groups.
  • Over 90% of infants tolerated the procedure without elective intubation; emergent intubation occurred in 9.8%.

Conclusions:

  • Elective intubation for ROP laser surgery is associated with longer post-operative mechanical ventilation without clear short-term benefits.
  • Routine elective intubation appears unnecessary for most infants undergoing ROP laser treatment.
  • Clinical outcomes and comorbidities were similar, suggesting no advantage to routine elective intubation.

Keywords:
laser therapyneonatalrespiratory supportretinopathy of prematurityventilation

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