Connolly Brian P, Ng Eugene Y J, McNamara J Arch, Regillo Carl D, Vander James F, Tasman William
Wills Eye Hospital Retina Service, Philadelphia, Pennsylvania 19107, USA.
Ophthalmology. 2002 May;109(5):936-41. doi: 10.1016/s0161-6420(01)01015-6.
To compare the refractive outcome of eyes treated with cryotherapy for threshold retinopathy of prematurity (ROP) with eyes treated with laser photocoagulation.
Extended follow-up of a randomized controlled clinical trial.
One hundred eighteen eyes from 66 patients were randomly assigned to receive either cryotherapy or laser photocoagulation for threshold ROP. Twenty-five patients (44 eyes treated) were available for follow-up examination 10 years later.
Cycloplegic autorefraction or retinoscopy was performed. Immersion ultrasound biometry (A-scan) was also performed, and an autokeratometer was used for keratometry. If an A-scan could not be tolerated or the patient was not cooperative, a B-scan through-the-lid biometry was performed. Corneal thickness was measured using optical coherence tomography. MAIN AND SECONDARY OUTCOME MEASURES: Refractive error. In addition, anterior chamber depth, lens thickness, and axial length were measured. Central corneal thickness measurements and keratometric readings were also obtained.
Eyes treated with cryotherapy were significantly more myopic than those treated with laser photocoagulation. When comparing patients with bilateral treatment, the mean spherical equivalent (SE) of eyes treated with laser was -4.48 diopters (D) compared with a mean SE of -7.65 D for eyes treated with cryotherapy (n = 15 pairs of eyes, P = 0.019). Cryotherapy-treated eyes had a mean axial length of 21.7 mm versus 22.9 mm for laser-treated eyes (P = 0.024, n = 12 pairs of eyes). The anterior chamber depth and lens thickness averaged 2.86 mm and 4.33 mm, respectively, in the cryotherapy-treated eyes compared with 3.42 mm and 3.95 mm in the laser-treated eyes (P < 0.001, n = 12 pairs for both measurements). There were no statistical differences in anterior corneal curvature and central corneal thickness between the two treatment modalities. Crystalline lens power bore the strongest correlation to refractive outcomes in both laser-treated (r = 0.885, P < 0.001) and cryotherapy-treated eyes (r = 0.591, P = 0.026). Although keratometric readings were higher than normal values in these eyes, there was no correlation to the degree of myopia.
Laser-treated eyes were significantly less myopic than cyrotherapy-treated eyes. Lens power seemed to be the predominant factor contributing to the excess myopia.
比较接受冷冻疗法治疗阈值早产儿视网膜病变（ROP）的眼睛与接受激光光凝治疗的眼睛的屈光结果。
一项随机对照临床试验的延长随访。
66例患者的118只眼睛被随机分配接受冷冻疗法或激光光凝治疗阈值ROP。25例患者（44只接受治疗的眼睛）在10年后可进行随访检查。
进行睫状肌麻痹自动验光或检影验光。还进行了浸入式超声生物测量（A超），并使用自动角膜曲率计进行角膜曲率测量。如果无法耐受A超或患者不配合，则通过眼睑进行B超生物测量。使用光学相干断层扫描测量角膜厚度。主要和次要观察指标：屈光不正。此外，测量前房深度、晶状体厚度和眼轴长度。还获得了中央角膜厚度测量值和角膜曲率读数。
接受冷冻疗法治疗的眼睛比接受激光光凝治疗的眼睛近视程度明显更高。在比较双侧治疗的患者时，接受激光治疗的眼睛的平均球镜当量（SE）为-4.48屈光度（D），而接受冷冻疗法治疗的眼睛的平均SE为-7.65 D（n = 15对眼睛，P = 0.019）。接受冷冻疗法治疗的眼睛的平均眼轴长度为21.7 mm，而接受激光治疗的眼睛为22.9 mm（P = 0.024，n = 12对眼睛）。接受冷冻疗法治疗的眼睛的前房深度和晶状体厚度平均分别为2.86 mm和4.33 mm，而接受激光治疗的眼睛分别为3.42 mm和3.95 mm（P < 0.001，两项测量均为n = 12对）。两种治疗方式之间的角膜前曲率和中央角膜厚度没有统计学差异。在接受激光治疗（r = 0.885，P < 0.001）和接受冷冻疗法治疗的眼睛（r = 0.591，P = 0.026）中，晶状体屈光力与屈光结果的相关性最强。尽管这些眼睛的角膜曲率读数高于正常值，但与近视程度无关。
接受激光治疗的眼睛比接受冷冻疗法治疗的眼睛近视程度明显更低。晶状体屈光力似乎是导致近视过度的主要因素。
