[Diode laser coagulation of stage 3+ retinopathy of prematurity].

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.