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[Diode laser coagulation of stage 3+ retinopathy of prematurity]
V Seiberth1, O Linderkamp, I Vardarli
1Universitäts-Augenklinik, Klinikum Mannheim.
Insights
Diode laser photocoagulation effectively treated stage 3+ retinopathy of prematurity (ROP) in premature infants, achieving a 98% success rate with minimal side effects. This laser treatment offers a safe and effective alternative to cryotherapy for ROP management.
Area of Science:
- Ophthalmology
- Neonatal care
- Medical technology
Context:
- Retinopathy of prematurity (ROP) is a significant cause of vision loss in premature infants.
- Traditional treatments like cryotherapy have limitations and adverse effects.
- Diode laser photocoagulation has emerged as a promising alternative.
Purpose:
- To evaluate the efficacy and safety of diode laser photocoagulation for stage 3+ ROP in very low birth weight infants.
- To compare the outcomes of laser treatment with cryotherapy.
Summary:
- A prospective study evaluated 50 eyes with stage 3+ ROP in 30 premature infants using diode laser photocoagulation (810 nm) via a laser indirect ophthalmoscope.
- A 98% success rate was achieved, with 46 eyes regressing after one treatment and two requiring a second session.
- Minor side effects included transient bleeding in 16% of eyes; no lenticular opacities or cataracts were observed.
Impact:
- Diode laser photocoagulation is an effective and safe treatment for stage 3+ ROP, demonstrating a high success rate and minimal adverse effects.
- This method is easy to administer and offers a viable alternative to cryotherapy, potentially improving visual outcomes for premature infants.
- The findings support the use of diode laser photocoagulation as a standard treatment in neonatal ophthalmology.
Background:
Laser photocoagulation in retinopathy of prematurity (ROP) appears to have fewer adverse effects and to be at least as effective as cryotherapy.
Methods:
To evaluate the efficacy and safety of diode laser photocoagulation we examined 50 eyes affected by stage 3+ ROP in 30 very low birth weight infants (gestational age 24-29 weeks, mean +/- SD 26.5 +/- 1.4 weeks; birth weight 480-1400 g, 898 +/- 208 g) in a prospective (uncontrolled) clinical study. Photocoagulation treatment was performed using a diode laser (810 nm) with a laser indirect ophthalmoscope delivery system. Follow-up ranged from 3 to 23 months (10.5 +/- 6.4 months).
Results:
In 46 (92%) of the 50 eyes ROP regressed after a single laser treatment and the outcome was a flat, attached retina. Two eyes (4%) had a second laser session and one other eye (2%) had additional retinal detachment surgery, resulting in the regression of ROP and a flat, attached retina. Thus, the success rate was 98% (49 out of 50 eyes). In 1 (2%) of the 50 eyes treatment failed and ROP progressed to stage 5, although additional retinal detachment surgery was performed. No adverse side effects of diode laser treatment were noted, except for a small amount of retinal/preretinal bleeding in the ridge in 8 eyes (16%) and slight postoperative anterior chamber bleeding in 1 eye (2%) with dense tunica vasculosa lentis. There were neither lenticular opacities nor cataract formation.
Conclusion:
Diode laser photo coagulation using the laser indirect ophthalmoscope for stage 3+ ROP was easy to administer. Laser treatment had only minor side effects and was at least as effective as cryotherapy.