Combined treatment with laser photocoagulation and cryotherapy for threshold retinopathy of prematurity

PURPOSE: To report the structural, functional, and refractive outcome, safety, and effectiveness of combined cryotherapy and diode laser indirect photocoagulation in the treatment of threshold retinopathy of prematurity (ROP). METHODS: Medical records of patients developing threshold ROP between 1995 and 2003 were reviewed to identify those with combined treatment and followed up for at least 4 years postoperatively. A total of 94 patients (172 eyes) received combined treatment. Data consisted of grade of ROP pre- and postoperatively, most recent fundus examination, birthweight, visual acuity, complications, and refraction. Diode laser was used to ablate posterior avascular retina, and cryotherapy was used for anterior retina. RESULTS: A total of 149 (87%) eyes responded to combined treatment and they had favorable anatomic outcome at last examination. In 131 eyes (76%), functional outcome was favorable (visual acuity better than 20/200) at last examination. Perioperative complications included hemorrhages in 26% of eyes, which resorbed spontaneously. Mean duration of treatment was 31 minutes/eye. At final visit (4 to 12 years), 115 eyes (66.8%) refracted were myopic, of which 26 (22.5%) had high myopia over -6 diopters. CONCLUSIONS: Combined cryotherapy and diode laser photocoagulation for ROP in our patients resulted in regression of threshold ROP with relatively successful structural and functional outcomes. Combined therapy may be faster and useful for eyes with very posterior ROP. This may decrease the number of complications occurring when excessive cryotherapy or laser photoablation must be used in zone 1 ROP.     

Large spot transpupillary thermotherapy: a quicker laser for treatment of high risk prethreshold retinopathy of prematurity - a randomized study

To compare structural and functional outcome and time efficiency between standard spot sized conventional pulsed mode diode laser and continuous mode large spot transpupillary thermotherapy (LS TTT) for treatment of high risk prethreshold retinopathy of prematurity (ROP). Ten eyes of five preterm babies having bilateral symmetrical high risk prethreshold ROP were included in this study. One eye of each baby was randomized to get either standard spot sized conventional pulsed mode diode laser or continuous mode LS TTT. There was no significant difference between structural or functional outcome in either group. The mean time taken for conventional diode laser was 20.07 minutes, while that for LS TTT was 12.3 minutes. LS TTT was 40% more time efficient than the conventional laser. It may be better suited for the very small fragile premature infants as it is quicker than the conventional laser.     

Combined use of cryotherapy and diode laser photocoagulation for the treatment of threshold retinopathy of prematurity.

PURPOSE: Cryotherapy and indirect laser retinal photoablation are both effective in the treatment of retinopathy of prematurity (ROP). We describe the safety, efficiency, and effectiveness of combined cryotherapy and diode laser photocoagulation to treat threshold ROP. METHODS: Records of patients developing threshold ROP from January 1, 1996 through December 31, 1998, were retrospectively reviewed to identify those treated with combined cryotherapy and photocoagulation and followed up for at least 45 days postoperatively. Diode laser was used to ablate posterior avascular retina, and cryotherapy was used for anterior retina. Data reviewed included ocular and systemic complication rates, treatment duration, number of laser burns, most recent fundus examination, visual acuity, and refraction. RESULTS: In 13 patients, 23 eyes received combined treatment. No intraoperative complications occurred. Mean duration of anesthesia and treatment was 35 +/- 8 minutes/eye. A mean of 117 +/- 84 laser burns/eye were applied. In 20 of 23 eyes (87.0%), anatomic outcome was favorable at last examination. In 13 of 16 eyes (81.3%), functional (visual acuity) outcome was favorable (visual acuity better than 20/200) at 1 year. At 6 months or later, 14 of 16 eyes (87.5%) measured were myopic, of which 5 (31.3%) were highly myopic (> 6 diopters). CONCLUSIONS: The effectiveness of treating ROP with combined cryotherapy and diode laser photocoagulation compares with that of either modality alone. By decreasing the number of laser applications, combined therapy may be faster and technically easier for eyes with very posterior ROP. This may decrease the number of complications seen when either excessive cryotherapy or laser retinal photoablation is used.     

Diode laser photocoagulation for retinopathy of prematurity--outcomes in one-year observation

PURPOSE: To evaluate structural and functional outcomes in one-year old patients, treated for retinopathy of prematurity (ROP) with transpupillary diode laser photocoagulation. MATERIALS AND METHODS: 58 children (116 eyes) 12 months old, after treatment for ROP with diode laser photocoagulation, were examined. Both, functional outcome (visual acuity--basing on the examination with Teller Acuity Card Procedure), and structural outcome were evaluated. The cycloplegic refraction was examined in all cases. RESULTS: We have found good functional outcome in 81.9%, and good structural outcomes in 96.5% of examined eyes. 64.6% of eyes had hyperopic refractive error, and 31% were myopic. CONCLUSIONS: Diode laser photocoagulation is an effective method of treatment for ROP.     

半导体与倍频Nd:YAG间接检眼镜激光治疗高危阈前期ROP的比较

目的 比较倍频Nd:YAG间接检眼镜激光(波长532 nm)、半导体间接检眼镜激光(波长810 nm)治疗高危阈前期早产儿视网膜病变(ROP)的效果.方法 回顾分析分别用半导体间接检眼镜激光、倍频Nd:YAG间接检眼镜激光治疗的20例40眼高危阈前期ROP的临床资料.患儿激光时的年龄(8.25±3.54)周,胎龄(30.25±1.65)周,出生体重(1 488.15±326.13)g,治疗时矫正胎龄(39.15±3.69)周.结果 19例(38眼)ROP回退,1例(2眼)病变进展为4期,其余病变均得到控制,无并发症出现.两种激光能量基本相同,激光点数的比较无统计学意义(t=0.735,P=0.471).结论 倍频Nd:YAG间接检眼镜激光和半导体间接检眼镜激光治疗高危阈前期早产儿视网膜病变同样有效.     

Diode laser photocoagulation to the vascular retina for progressively advancing retinopathy of prematurity.

AIMS--To estimate the effectiveness of diode laser photocoagulation of the retina posterior to the ridge in eyes with retinopathy of prematurity (ROP). METHODS--Diode laser photocoagulation was applied posterior to the fibrovascular ridge in stage 4a ROP in six eyes of four infants and in advancing stage 3+ in two eyes of one infant. Seven eyes had previously been unsuccessfully treated with diode laser photocoagulation anterior to the ridge. RESULTS--Six eyes of four children had total regression, two eyes of two children had flat maculae with residual peripheral tractional detachment and maintained vision. CONCLUSION--These preliminary results indicate that diode laser photocoagulation posterior to the ridge may be a useful treatment in late stage 3 and stage 4A ROP following failed laser treatment to the avascular retina in threshold stage 3 disease.     

早产儿视网膜病变激光光凝治疗效果及预后影响因素分析

目的:观察激光光凝术治疗阈值前Ⅰ型和阈值期早产儿视网膜病变(ROP)的临床效果,分析光凝术后病变进展的影响因素。方法:回顾分析激光光凝治疗ROP患者46例89眼,其中阈值前Ⅰ型57眼,阈值期32眼。采用810nm激光对周边视网膜无血管区进行光凝治疗。根据光凝术后结果分为病变消退组和进展组。随访视网膜解剖结构和ROP病变的变化,分析ROP病变部位、病变程度、光凝点数量、机械辅助呼吸、败血症、新生儿肺炎等因素与光凝术后病变进展的相关性。结果:ROP89眼经激光光凝治疗后病变完全消退79眼(89%),病变进展10眼(11%)。光凝治疗ROP病变消退组与进展组比较,出生胎龄、出生体重、首次光凝校正胎龄差异无统计学意义(P=0.668,0.495,0.143)。病变进展组的Ⅰ区病变、阈值病变、急性进展性后极部早产儿视网膜病变(AP-ROP)、光凝点数量均较病变消退组明显增加,差异有统计学意义(P=0.035,0.017,0.000,0.031)。Logistic回归分析结果显示,AP-ROP与光凝术后病变进展有关(P=0.001)。AP-ROP患眼光凝术后病变进展的可能性是非AP-ROP患眼的12.167倍(95%CI:2.733～54.154)。结论:激光光凝术能有效控制早期ROP的病变进展,使大部分阈值前Ⅰ型和阈值期ROP病变完全消退。急性进展性后极部早产儿视网膜病变光凝术后容易发生视网膜脱离,是影响光凝术后疗效的最主要因素。     

UK retinopathy of prematurity treatment survey

BACKGROUND: Since the CRYO-ROP study showed the benefit of treating babies with ROP, a number of different treatment modalities have become available. Solid-state lasers have been extensively used in the treatment of ROP since their introduction some 10 years ago. Diode, argon and frequency-doubled YAG (FD-YAG) lasers have all been used to perform photocoagulation in ROP. We aimed to assess current treatment practices of ROP treatment in the UK.METHODS: A questionnaire survey was performed in June 2004 and sent to all consultants known to be involved in the treatment or screening of ROP patients. We asked about the number of patients treated in the last year, the treatment method, and whether there had been any serious complications.RESULTS: In all, 53 questionnaires were sent out, of which 42 were returned. Also, 30 respondents treated ROP. Of these 19 used transpupillary diode, 11 argon, and three FD-YAG. Cryotherapy and transscleral diode laser were used by two centres in particular cases. In all, 20 patients were treated with FD-YAG, 21 with argon laser, and 188 with diode laser. The number of burns per eye varied from 800 to 2500. Reported complications included hyphaema, retinal haemorrhage, and acute cataract formation; however, there was no significant difference in complications between different types of laser used.DISCUSSION: This survey of laser use in the treatment of ROP has shown that diode laser is now the most common mode of treatment in the UK. The incidence of complications was similar for centres using argon, diode, or FD-YAG laser.     

Therapeutic outcomes of cryotherapy versus transpupillary diode laser photocoagulation for threshold retinopathy of prematurity.

INTRODUCTION: We undertook this study to compare the clinical outcomes in patients treated for threshold retinopathy of prematurity (ROP) with transpupillary diode laser photocoagulation versus transscleral cryotherapy. METHODS: A retrospective chart review was performed of patients treated for threshold ROP at our institution between 1988 and 1997. Cryotherapy was used to treat patients before 1992, and diode laser was used thereafter. One hundred fifteen eyes of 63 patients underwent cryotherapy, and 130 eyes of 70 patients underwent laser treatment. Because strong concordance exists between fellow eyes treated for ROP, statistical analysis was done for right eye outcomes only. Demographics, short-term complications, and treatment parameters were compared on the entire cohort of patients. Structural outcomes were compared between a group of 79 cryotreated eyes (39 OD, 40 OS) and a group of 113 laser-treated eyes (56 OD, 57 OS). Mean cycloplegic refraction was compared between a group of 38 cryotreated eyes (18 OD, 20 OS) and a group of 90 laser-treated eyes (46 OD, 44 OS). Visual acuity for preverbal and nonverbal children was estimated and converted to a Snellen visual acuity equivalent. Geometric mean visual acuity was then compared between a group of 44 cryotreated eyes (22 OD, 22 OS) and a group of 92 laser-treated eyes (47 OD, 45 OS). Patients were included in each outcome analysis if adequate documentation was present in the patient record. RESULTS: Demographics and short-term complications were not significantly different between the 2 groups. In the statistical group, 22 of 39 right eyes (56.4%) in the cryotherapy group versus 49 of 56 right eyes (87.5%) in the laser group had resolution of ROP after treatment (P = .0008). Mean spherical equivalent cycloplegic refraction at 12 months of age and over the follow-up period was not significantly different between the cryotherapy and laser groups. Estimated geometric mean visual acuity in the cryotherapy group was 20/103 and in the laser group was 20/49 at 12 months of age (P= .0099). CONCLUSIONS: Diode laser photocoagulation was associated with a better long-term structural outcome and visual acuity compared with cryotherapy for the treatment of threshold ROP. Refractive error was not significantly different between the 2 groups over an equivalent follow-up period.     

Treating retinopathy of prematurity with laser diode photocoagulation

AIM: The purpose of the study was to assess the outcomes of the diode laser in the treatment of retinopathy of prematurity and to discuss the up-to-date possibilities of treating of active phase of this disease. MATERIAL AND METHODS: 96 children (185 eyes) treated with diode laser retinal photocoagulation for active stage 3 of ROP in our department in years 1996-2000. RESULTS: Favorable structural outcome was observed in 83.8% of treated eyes. In the remaining eyes the disease progressed despite of the treatment and falciform retinal fold (5.4%), partial retinal detachment (6.5%) and total retinal detachment (4.3%) developed. No serious complications were observed after the treatment. CONCLUSIONS: Diode laser retinal photocoagulation is a safe and effective procedure for treating active stage 3 of retinopathy of prematurity. It has been especially useful for treatment of changes in zone 1 and 2 of the disease. Diode laser photocoagulation is now the preferred method of treating active stage 3 of ROP in our department.     

Diode laser treatment of posterior retinopathy of prematurity

AIMS: To study the efficacy of infrared diode laser for the treatment of posterior retinopathy of prematurity (ROP). METHODS: 48 eyes of 25 premature babies (mean birth weight 779 (SD 127.7) g; mean gestational age 25.5 (SD 1.47) weeks) with threshold ROP in zone I and posterior zone II were treated by the indirect infrared (810 nm) diode laser. Confluent burns were applied to the avascular retina. In 18 eyes, an additional row of laser burns was added posterior to the ridge. RESULTS: Favourable anatomical results were noted in 41 eyes (85.4%). ROP stage 5 developed in two eyes, ROP stage 4A developed in four eyes, and ROP stage 4B in one eye. Three of the eyes with stage 4A eyes were successfully buckled; the fourth was not operated on and remained demarcated by laser scars. No complications were noted. CONCLUSION: In this series, the diode laser was found to be a safe and effective treatment for posterior ROP.     

Long term functional and structural outcomes of laser therapy for retinopathy of prematurity

AIMS: To assess the long term functional and structural outcomes of premature babies who received diode laser photocoagulation for threshold retinopathy of prematurity (ROP). METHODS: 25 patients (43 eyes) treated with laser were recalled for assessment at a mean follow up of 11 years. A further seven patients (14 eyes) with subthreshold ROP, which had regressed spontaneously without laser treatment, were also examined. All children underwent distance acuity, near acuity, contrast sensitivity (CS), and colour vision assessments followed by a dilated fundal examination and cycloplegic autorefraction. RESULTS: The laser treated eyes had a mean distance visual acuity of 0.37 logMAR, a mean near visual acuity of 0.39 logMAR, a mean contrast sensitivity of 1.49 log CS units, and a mean spherical equivalent of -2.10D. An unfavourable distance visual acuity outcome occurred in five eyes (13.5%). An unfavourable near visual acuity outcome was also noted in the five eyes (13.5%) with poor distance visual outcome. 7% had an unfavourable structural outcome. On comparison with the control group, there was no significant difference in near acuity, CS, refraction, or colour vision between the two groups. However, there was a statistically significant difference in terms of distance visual acuity (p = 0.03). CONCLUSIONS: Laser treated eyes with favourable structural outcome have a good visual outcome. The results show a long term benefit from diode laser photocoagulation in preserving distance and near vision in eyes with threshold ROP.     

Laser photocoagulation for retinopathy of prematurity: structural and functional outcome

BACKGROUND: To report the structural and refractive outcome after laser photocoagulation for retinopathy of prematurity (ROP). METHODS: Nineteen consecutive patients who had undergone photocoagulation for ROP between 1997 and 2002 at our clinic were examined for this non-comparative, consecutive, interventional, retrospective case series. A total of 37 eyes received either transscleral or transpupillary laser treatment. Data consisted of grade of ROP pre- and postoperatively, birth weight, perioperative and postoperative complications and refraction. Based on indirect ophthalmoscopy, independent observers graded the extent of ROP and determined the postoperative refraction by retinoscopy. RESULTS: A total of 97% of all eyes responded to laser treatment with regression of ROP. Only one eye out of 37 progressed to stage IV B despite photocoagulation and therefore an encircling procedure was performed. After further progression a vitrectomy was carried out. Perioperative complications included haemorrhages in 22% that resorbed spontaneously and cataract formation in one eye (3%). Postoperative refractive errors at mean ages of 23 +/- 12 months and 45 +/- 14 months were evaluated in 15/19 patients (79%). The spherical equivalents ranged between -8 D and +6 D at the first examination and between -12 D and +7 D at the second examination. In all only 14% of the refracted eyes were myopic. CONCLUSIONS: Photocoagulation for ROP in our patients resulted in regression of threshold ROP. In addition, the analyses of the refractive outcomes demonstrated a predominance of hypermetropia in our patients.     

Diode laser photocoagulation for retinopathy of prematurity: a histopathologic study

Laser photocoagulation has largely supplanted cryotherapy as an effective treatment for retinopathy of prematurity. This case describes the ocular histopathologic findings of a pair of eyes in a severely premature male infant treated with diode laser photocoagulation for bilateral stage 3 retinopathy of prematurity (ROP) for 360 degrees in zone 1 with severe plus disease. The right eye responded to treatment; the left eye developed persistent vitreous hemorrhage and total retinal detachment. The histopathologic examination of laser burns in the right eye disclosed segmental areas of chorioretinal scarring with retinal atrophy and gliosis, loss of RPE and extensive atrophy of the choroid and its vasculature, which involved both the choriocapillaris and larger vessels. The left eye had iris neovascularization, a chronic organized vitreous hemorrhage and a totally detached retina. The histopathologic findings in an eye of a premature infant with threshold ROP treated with diode laser photocoagulation resembled those reported after transsceral cryotherapy. Diode laser photocoagulation may produce less severe chorioretinal damage.     

Trans-scleral diode laser coagulation for therapy of acute retinopathia praematurorum

BACKGROUND: Lens opacities were noted in single cases after transpupillar laser photocoagulation in retinopathy of prematurity (ROP) using the laser indirect ophthalmoscope. The diode laser with its wavelength in the near infrared (810 nm) makes lens sparing transscleral retinal coagulation possible. PATIENTS AND METHODS: In a controlled clinical study 60 eyes of 30 very low birth weight infants (gestational age 23-31 weeks, mean 26.6 +/- 1.8 weeks; birth weight 510-1200 g, 856 +/- 170 g) with threshold ROP were treated with diode laser photocoagulation. One eye of each infant was coagulated transsclerally while the fellow eye had transpapillary coagulation using the laser indirect ophthalmoscope. Follow-up ranged from 2 to 38 months (19 +/- 11 months). RESULTS: In 29 (97%) out of 30 eyes treated transsclerally and in 30 (100%) out of 30 eyes treated transpapillary the outcome was a flat, attached retina. Three eyes had a second laser treatment and 2 eyes had additional retinal detachment surgery. One eye (3%) with zone I disease failed after transscleral laser treatment and additional retinal detachment surgery with partially detached retina (stage 4 B) No adverse side effects as a result of laser treatment were noted except for a small amount of retinal/preretinal bleeding in the ridge and a vitreous bleeding. There were no adverse side effects (e.g., bleeding, cataract formation) in the anterior segments of the eyes. CONCLUSION: Transscleral diode laser coagulation for treatment of threshold ROP proved to be as effective as transpapillary diode laser photocoagulation. Only minor side effects were noticed. Transscleral diode laser photocoagulation is an advantageous treatment method in eyes with preexisting risk of cataract formation in transpapillary laser treatment.     

早产儿视网膜病变激光光凝术后角膜地形图状况

目的：:观察早产儿视网膜病变（ROP）激光光凝术后儿童角膜地形图的改变。方法：:病例对照研究。收集2015年9月至2018年4月于深圳市眼科医院行激光光凝术后的ROP儿童25例（50眼）为ROP组,同时收集年龄匹配的足月儿童23例（46眼）为对照组。2组儿童均行最佳矫正视力（BCVA）检查,统计分析时转换为LogMAR...     

The Early Treatment for Retinopathy Of Prematurity Study: structural findings at age 2 years

OBJECTIVE: To determine whether earlier treatment of high-risk, prethreshold retinopathy of prematurity (ROP) improves retinal structural outcome at 2 years of age. METHODS: Infants with bilateral high-risk prethreshold ROP had one eye randomly assigned to treatment with peripheral retinal ablation. The fellow eye was managed conventionally, and either treated at threshold ROP or observed if threshold was never reached. In patients with asymmetrical disease, the high-risk, prethreshold eye was randomised to earlier treatment or to conventional management. At 2 years of age, children were examined comprehensively by certified ophthalmologists to determine structural outcomes for their eyes. For the purposes of this study, an unfavourable structural outcome was defined as (1) a posterior retinal fold involving the macula, (2) a retinal detachment involving the macula or (3) retrolental tissue or "mass" obscuring the view of the posterior pole. Results of the 2-year examination were compared with those from the 9 months examination. RESULTS: Data were available on 339 of 374 (90.6%) surviving children. Unfavourable structural outcomes were reduced from 15.4% in conventionally managed eyes to 9.1% in earlier-treated eyes (p = 0.002) at 2 years of age. Ophthalmic side effects (excluding retinal structure) from the ROP or its treatment were similar in the earlier-treated eyes and the conventionally managed eyes. CONCLUSION: The benefit of earlier treatment of high-risk prethreshold ROP on retinal structure endures to 2 years of age, and is not counterbalanced by any known side effect caused by earlier intervention. Earlier treatment improves the chance for long-term favourable retinal structural outcome in eyes with high-risk prethreshold ROP. Long-term follow-up is planned to determine structural and functional outcomes at 6 years of age.     

Intravitreal pegaptanib combined with diode laser therapy for stage 3+ retinopathy of prematurity in zone I and posterior zone II

Purpose. To investigate efficacy of intravitreal injection of pegaptanib and laser photocoagulation for treatment of stage 3+ retinopathy of prematurity (ROP) affecting zone I and posterior zone II, and to compare the results in terms of regression, development of peripheral retinal vessels, and final structural outcome with conventional laser photocoagulation or combined with cryotherapy. Methods. In a prospective comparative study, 152 eyes with zone I, II posterior ROP 3+ (76 premature rabies), from 2009 to 2011, were included. Patients were randomly assigned to receive intravitreal pegaptanib (Macugen? 0.3 mg = 0.02 mL, Pfizer) with conventional diode laser photocoagulation in group 1 (68 eyes of 34 infants) or only laser therapy combined with cryotherapy in group 2 (84 eyes of 42 infants), bilaterally. The primary outcome of treatment success was defined as absence of recurrence of stage 3+ ROP. The mean follow-up after treatment was 19.3 months in group 1 and 21.5 months in group 2. Results. Final favorable anatomic outcome and stable regression of ROP at last control examination was noted in 89.7% of eyes in group 1 and 60.8 % of eyes in group 2. Regression of plus disease and peripheral retinal vessels development appeared significantly more rapidly in group 1. No recurrence of neovascularization (stage 3+ ROP) was identified in 85.4% of patients in group 1 and 50% of patients in group 2. Conclusions. Results of this study support the administration of intravitreal pegaptanib as useful therapy in the management of stage 3+ ROP.     

Acquired cataracts after argon laser photocoagulation for retinopathy of prematurity.

PURPOSE: Our purpose was to determine the incidence of cataract after argon laser photocoagulation of the retina in infants with retinopathy of prematurity (ROP). METHODS: We reviewed medical records of 189 consecutive infants undergoing argon laser photocoagulation for acute ROP between 1993 and 1996. Birth weight, estimated gestational age at birth, chronologic and postconceptional ages at the time of treatment, ROP outcome, and the postoperative occurrence of cataract were recorded. RESULTS: A total of 374 eyes in 189 infants were treated for threshold ROP. Mean birth weight was 916 gm (range 480 to 2500 gm), mean postconception age at birth was 26.4 weeks (range 23.5 to 34 weeks), and mean postconception age at surgery was 36.2 weeks (range 33 to 47 weeks). A favorable anatomic outcome occurred in 90% of eyes. However, severe macular traction, macular fold, or retinal detachment developed in 10% of eyes. A total of four eyes (1%) had cataracts. Laser-induced cataracts were diagnosed in only two eyes. A third eye had a posterior subcapsular cataract that may or may not have resulted from the laser treatment. In a fourth patient a unilateral punctate opacity judged to be visually insignificant was noted at surgery but it was not progressive. All patients who had cataracts had a persistent tunica vasculosa lentis; however, there was no statistically significant difference in the incidence of cataract formation in eyes with persistent tunica vasculosa lentis compared with eyes without it (p = 0.057). CONCLUSION: Argon laser photocoagulation remains an effective alternative to transscleral cryotherapy in the treatment of threshold ROP. The incidence of cataract formation is approximately 1% and may be more likely to occur when persistent hyaloidal vessels are present on the lens.     

Diode laser photocoagulation for stage 3+ retinopathy of prematurity

Background: Laser photocoagulation in retinopathy of prematurity (ROP) appears to have fewer adverse effects than cryotherapy and seems to be at least as effective. Methods: To evaluate the efficacy and safety of diode laser photocoagulation, we included 42 eyes with stage 3+ ROP of 24 preterm infants (gestational age 24–29 weeks, mean ± SD 26.6 ± 1.3 weeks; birth weight 480–1400 g, 896 ± 196 g) in a prospective 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 16 months (8.8 ± 4.0 months). Results: In 39 (93%) of 42 eyes ROP regressed after a single laser treatment and the outcome was a flat, attached retina. One eye (2%) had a second laser session and another eye (2%) had additional retinal detachment surgery, resulting in the regression of ROP and a flat, attached retina. Thus, the success rate was 41 (98%) out of 42 eyes. In one (2%) of the 42 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 noticed except for a small amount of retinal/preretinal bleeding in the ridge in five eyes (12%) and a small postoperative anterior chamber hemorrhage in one eye (2%) with dense tunica vasculosa lentis. Neither lenticular opacities nor cataract formation were encountered. Conclusion: Diode laser photocoagulation for stage 3+ ROP showed only minor side effects and was at least as effective as cryotherapy treatment.