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.