Connolly B P, McNamara J A, Sharma S, Regillo C D, Tasman W
Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
Ophthalmology. 1998 Sep;105(9):1628-31. doi: 10.1016/S0161-6420(98)99029-7.
The goal of this study was to determine whether there was a significant difference between the visual outcomes of eyes with threshold retinopathy of prematurity (ROP) treated with trans-scleral cryotherapy compared to those treated with laser photocoagulation.
Extended follow-up study of a prospective, randomized clinical trial.
Fifty-two patients with bilateral threshold ROP participated. Follow-up data were available for 25 of these patients.
Patients were randomized to receive cryotherapy in one eye and laser photocoagulation in the other eye.
The best-corrected visual acuity of each eye was measured. Best-corrected visual acuities of 20/50 or better were classified as "good" clinical outcomes, whereas those 20/60 or worse were considered "poor" outcomes. A secondary outcome of this study was the spherical equivalent (SE) of each eye's most recent refraction.
At an average follow-up point of 5.8 years (range, 4.3-7.6 years), the odds that an eye treated with laser had a good clinical outcome were 6.91 times greater than for eyes treated with cryotherapy (95% confidence interval, 1.70-28.0; n = 21). Additionally, the laser-treated eyes were less myopic with a mean SE of-3.05 diopters compared to a mean SE of -5.08 diopters for the cryotherapy-treated eyes (P = 0.0072, n = 23).
The authors' study suggests that laser photocoagulation for threshold ROP was more likely to result in a good clinical outcome with better final visual acuity and less myopia compared to cryotherapy treatment.
本研究的目的是确定与接受激光光凝治疗的早产儿阈值性视网膜病变（ROP）眼相比，接受经巩膜冷冻疗法治疗的ROP眼在视觉预后方面是否存在显著差异。
一项前瞻性随机临床试验的延长随访研究。
52例双侧阈值性ROP患者参与。其中25例患者有随访数据。
患者被随机分配，一只眼睛接受冷冻疗法，另一只眼睛接受激光光凝治疗。
测量每只眼睛的最佳矫正视力。最佳矫正视力为20/50或更好被分类为“良好”临床预后，而20/60或更差则被视为“不良”预后。本研究的次要观察指标是每只眼睛最近一次验光的等效球镜度（SE）。
在平均随访5.8年（范围4.3 - 7.6年）时，接受激光治疗的眼睛获得良好临床预后的几率比接受冷冻疗法治疗的眼睛高6.91倍（95%置信区间，1.70 - 28.0；n = 21）。此外，接受激光治疗的眼睛近视程度较低，平均SE为-3.05屈光度，而接受冷冻疗法治疗的眼睛平均SE为-5.08屈光度（P = 0.0072，n = 23）。
作者的研究表明，与冷冻疗法相比，阈值性ROP的激光光凝治疗更有可能获得良好的临床预后，最终视力更好且近视程度更低。
