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Diode laser photocoagulation for threshold retinopathy of prematurity in eyes with tunica vasculosa lentis
V Seiberth1, O Linderkamp, I Vardarli
1Department of Ophthalmology, Klinikum Mannheim, Faculty for Clinical Medicine, University of Heidelberg, Germany.
Insights
Diode laser treatment for retinopathy of prematurity in infants with tunica vasculosa lentis is safe. This method effectively treated ROP without causing significant adverse effects like cataracts.
Area of Science:
- Ophthalmology
- Neonatal Care
- Medical Technology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- The presence of tunica vasculosa lentis can complicate ROP treatment.
- Diode laser photocoagulation is a standard treatment for ROP.
Purpose of the Study:
- To evaluate the safety and efficacy of diode laser photocoagulation for threshold ROP in eyes with tunica vasculosa lentis.
- To identify potential side effects of this treatment in this specific patient population.
Main Methods:
- A prospective study treated 14 eyes of 7 preterm infants with threshold ROP and tunica vasculosa lentis.
- Diode laser indirect ophthalmoscopy was used for photocoagulation.
- Adverse treatment effects were monitored via anterior segment examination for 7-17 months.
Main Results:
- The tunica vasculosa lentis did not impede laser photocoagulation in any treated eyes.
- ROP regressed in all 14 eyes, resulting in flat, attached retinas.
- One eye (7%) experienced minor postoperative anterior chamber bleeding; no lenticular opacities or cataracts formed.
Conclusions:
- Diode laser photocoagulation is a safe and effective treatment for threshold ROP in eyes with tunica vasculosa lentis.
- The laser energy levels used did not induce lens opacities or cataracts.
- Further studies with larger cohorts and longer follow-up are warranted.
Purpose:
To determine possible side effects of diode laser photocoagulation for threshold retinopathy of prematurity in eyes with tunica vasculosa lentis.
Methods:
In a prospective clinical study, threshold retinopathy of prematurity was treated in 14 eyes of seven consecutive preterm infants with tunica vasculosa lentis (birth weight, 480 to 980 g; mean +/- S.D., 777 +/- 175 g; gestational age, 24 to 27 weeks; mean +/- S.D., 25.7 +/- 0.9 weeks) by using the diode laser indirect ophthalmoscope. Main outcome measure was the incidence of adverse treatment effects. Follow-up included anterior segment examination with a hand-held slit lamp and ranged from seven to 17 months (12.6 +/- 3.5 months).
Results:
The tunica vasculosa lentis did not interfere with photocoagulation in any of the 14 eyes. Laser power ranged from 200 to 400 mW (260 +/- 52 mW). Duration of a single spot was 200 msec. Number of burns ranged from 1,060 to 2,132 (1,556 +/- 315). Retinopathy of prematurity regressed in all eyes, and the outcome was a flat, attached retina. A small amount of postoperative anterior chamber bleeding was noticed in one eye (7% of the eyes, 14% of the patients). There were neither lenticular opacities nor cataract formation.
Conclusion:
Diode laser photocoagulation with the laser indirect ophthalmoscope can be used safely in eyes with tunica vasculosa lentis. At the laser energy levels used in our study, no transient lens opacities or cataract formation occurred. However, the results of this study are limited by a relatively small number of patients and a relatively short follow-up.