Cataract in infants treated with argon laser photocoagulation for threshold retinopathy of prematurity

Previous studies of lens opacities occurring after argon laser photocoagulation for retinopathy of prematurity indicate that the lens in these laser-treated eyes may be at risk for cataract. We studied the occurrence of permanent, visually significant cataracts in four infants after laser therapy for retinopathy of prematurity.

The records of 51 consecutive patients (100 eyes) treated only with argon laser photocoagulation for threshold retinopathy of prematurity at our institution were reviewed. Patient characteristics and treatment variables were compared between infants who developed cataracts and those who did not.

Complete opacification of the lens nucleus and cortex developed in six eyes of four patients between 19 and 99 days after laser therapy. An additional patient developed a transient, focal, anterior capsular, and subcapsular opacity in one eye that cleared by one month postoperatively. Eyes that developed permanent cataracts were noted to have a prominent anterior tunica vasculosa lentis at the time of treatment. After laser therapy, these eyes developed hyphema, shallowing of the anterior chamber, corneal edema, and progressive opacification of the lens. When compared with eyes that did not develop cataract, no statistically significant difference in number of burns, zone or clock hours of extraretinal proliferation, birth weight, gestational age, or age at treatment was found.

Cataract is a potential vision-threatening complication of argon laser photocoagulation that must be considered before choosing a treatment modality for infants with threshold retinopathy of prematurity.