Department of Ophthalmology, School of Medicine, University of California, Irvine, California, USA.
Ophthalmology. 2012 Apr;119(4):873-7. doi: 10.1016/j.ophtha.2012.01.003. Epub 2012 Mar 3.
To evaluate the role of cryotherapy in the current treatment of retinopathy of prematurity (ROP).
Literature searches of PubMed and the Cochrane Library were conducted on December 2, 2009, for articles published after 1984. The searches included all languages and retrieved 187 relevant citations. Thirteen articles were deemed relevant to the assessment question and were rated according to the strength of evidence. Four articles reported results from 2 large multicenter randomized clinical trials, and the remaining 9 articles reported results of 3 small randomized trials that directly compared cryotherapy and laser.
Neither of the multicenter randomized clinical trials was a direct comparison of cryotherapy with laser. These studies were used to evaluate the comparative trials based on treatment criteria, study populations, and clinical results. Higher percentages of poor structural and functional outcomes generally were seen in eyes treated with cryotherapy compared with eyes undergoing laser treatment. Higher rates of systemic complications and myopia also were identified after treatment with cryotherapy.
Despite a relative paucity of level I evidence directly comparing cryotherapy and laser treatment for threshold ROP, the literature suggests that neonatal facilities should gain access to laser technology and laser-trained ophthalmic staff to achieve better outcomes for treatment of the disease.
评估冷冻疗法在早产儿视网膜病变（ROP）治疗中的作用。
2009 年 12 月 2 日对 1984 年后发表的文献进行了PubMed 和 Cochrane 图书馆的文献检索，检索包括所有语言，并检索到 187 篇相关引文。有 13 篇文章与评估问题相关，并根据证据强度进行了评分。有 4 篇文章报告了 2 项大型多中心随机临床试验的结果，其余 9 篇文章报告了直接比较冷冻疗法和激光治疗的 3 项小型随机试验的结果。
这两项多中心随机临床试验均不是冷冻疗法与激光的直接比较。这些研究用于根据治疗标准、研究人群和临床结果评估比较试验。与接受激光治疗的眼睛相比，接受冷冻治疗的眼睛的结构和功能结局较差的比例通常更高。冷冻治疗后还发现全身并发症和近视的发生率更高。
尽管直接比较冷冻疗法和激光治疗阈值 ROP 的 I 级证据相对较少，但文献表明，新生儿医疗机构应获得激光技术和接受过激光培训的眼科工作人员，以实现更好的疾病治疗效果。
