Diode laser photocoagulation for threshold retinopathy of prematurity. A randomized study

Area of Science:

• Ophthalmology
• Neonatal Care

Background:

• Peripheral cryotherapy for threshold retinopathy of prematurity (ROP) can cause apnea, bradycardia, and lid edema.
• Argon laser photocoagulation is an alternative with fewer adverse effects, but diode laser lesions are deeper, raising questions about efficacy.
• The impact of diode laser's deeper retinal lesions on ablative therapy outcomes for ROP remains unclear.

Purpose of the Study:

• To compare the safety and efficacy of diode laser therapy versus cryotherapy for threshold retinopathy of prematurity (ROP).
• To evaluate patient tolerance and procedural convenience of diode laser versus cryotherapy in ROP treatment.

Main Methods:

• A prospective, randomized protocol was used to treat one eye of each patient with threshold ROP using a diode laser and the other eye with cryotherapy.
• Infants with symmetric or asymmetric threshold ROP were included, with treatment randomization for asymmetric cases.
• Diode laser (814/815 nm) and cryotherapy were compared in 19 infants (33 eyes).

Main Results:

• Diode laser treatment was better tolerated and the apparatus more easily transported than cryotherapy.
• Apneic episodes requiring intubation occurred with cryotherapy but not diode laser sessions.
• While one eye in each treatment group progressed to stage 5 retinal detachment, diode laser treatment required fewer retreatments for persistent ROP.

Conclusions:

• Diode laser therapy is more convenient, technically easier, and better tolerated by patients compared to cryotherapy for threshold ROP.
• Diode laser peripheral retinal ablation appears to be as effective as cryotherapy for threshold ROP.
• Further studies are needed for statistical validation, but initial findings support diode laser as a viable alternative treatment for ROP.