Outcome of Diode Laser Photocoagulation for Threshold and Prethreshold Retinopathy of Prematurity

PURPOSE: To compare outcomes after diode laser photocoagulation between threshold and prethreshold retinopathy of prematurity (ROP). METHODS: The outcomes of 133 eyes of 80 infants who received laser treatment with diode laser were retrospectively evaluated. ROP stage was noted upon treatment. Of the eyes studied, 39 were classified as threshold and 94 were prethreshold, and these were further divided into type 1 (72 eyes) and type 2 (22 eyes). Outcomes among the groups were examined, as well as the effects of mean birth weight, gestational age, postconceptional age (PCA) at diagnosis, PCA at treatment, and the interval between diagnosis and treatment RESULTS: Three threshold eyes (7.7%) and 5 prethreshold eyes (5.3%) progressed to unfavorable outcomes. All 5 eyes with prethreshold disease were type 1. Mean birth weight and gestational age were not associated with prognosis. Unfavorable outcomes were related to lower PCA at diagnosis (p=0.022), lower PCA at treatment (p=0.008), and longer intervals between diagnosis and intervention (p=0.015), whereas neither birth weight nor gestational age significantly influenced outcomes. CONCLUSIONS: Unfavorable outcomes occurred in threshold and type 1 prethreshold ROP. Earlier treatment appeared to decrease the incidence of unfavorable outcomes.

Transscleral Diode Laser Photocoagulation for Retinopathy of Prematurity: Five Years' Experience

PURPOSES: We analysed the five-year outcomes and associated complications of transscleral diode laser photocoagulation (TSDLP), used to treat acute proliferative retinopathy of prematurity (ROP), to evaluate the efficacy and safety of this therapy. METHODS: We performed a retrospective analysis of the records of 163 eyes of 82 infants with acute ROP, who were treated with TSDLP by a single surgeon. Follow-up periods ranged from 15 to 278 weeks. RESULTS: The outcome was favorable in 158 eyes (96.9%) and unfavorable in 5 eyes (3.1%) of the 163 eyes that were treated. Vitreous hemorrhage was found to be an indicator of poor prognosis. Of the complications noted, symblepharon was observed in three eyes, hyphema was observed in four eyes, and a complicated cataract was observed in one eye. CONCLUSIONS: The results suggest that TSDLP is a safe and effective in the treatment of ROP. Vitreous hemorrhage should be regarded as a sign of poor prognosis.

Early Laser Treatment of Rush-Type Retinopathy of Prematurity

PURPOSE: We analyse the effect of the early laser treatment of rush-type ROP. METHODS: We performed a retrospective analysis of the records of 34 eyes of 17 premature infants with rush-type ROP, treated with diode indirect laser within 3 days after diagnosis and followed up for at least a year. RESULTS: Mean gestational age was 28+4 weeks, mean birth weight was 1182.9 gm and mean follow-up was 35.8 months. All patients were diagnosed with rush-type ROP at an average of 34+3 weeks and were treated with diode laser photocoagulation within an average of 1.6 days after diagnosis. The retinopathy regressed after photocoagulation in 25 eyes but regressed in 9 eyes so 8 of these eyes underwent secondary treatment. The outcome was favorable in 27 (79.4%) and unfavorable in 8 (20.6%) of the 34 treated eyes. The frequency of unfavorable outcome increased higher as acute stage at the time of treatment increased in severity. Especially in stage 3 threshold, the unfavorable outcome (33.3%) was significantly higher than that of stage 3 prethreshold (0%). CONCLUSIONS: In rush-type ROP, early treatment may be indicated regardless of the degree of EFP (extraretinal fibrovascular proliferation) because the outcome is poor by the time the stage at treatment has reached threshold.

A Comparison of Cryotherapy Versus Transscleral Diode Laser Photocoagulation for the Treatment of Retinopathy of Prematurity

PURPOSE: To determine whether transscleral diode laser photocoagulation is as effective as cryotherapy for the treatment of retinopathy of prematurity (ROP). METHODS: Thirty-six eyes of 18 infants with acute ROP were treated with cryotherapy and 32 eyes of another 16 infants with acute ROP were treated with transscleral diode laser photocoagulation. RESULTS: The transscleral diode laser photocoagulation group had 94% favorable outcome, whereas the cryotherapy group had 78% favorable outcome. CONCLUSIONS: The results suggest that transscleral diode laser photocoagulation is as effective as cryotherapy for the treatment of retinopathy of prematurity.

Comparison of Histologic Changes According to Treatment Method in Experimentally Perforated Rabbit Eyes

Perforation of the choroid and retina during strabismus surgery is fairly common and optimal management of global perforation is contoversial. The authorsinvestigated the histological changes of the rabbit eyes to compare the treatment effects of diode laser photocoagulation, cryotreatment, and nontreatment in experimentally perforated rabbit eyes.We perforated the globe of 6 pigmented rabbits (12 eyes)and treated four eyes with diode laser and four with cryotherapy and did not treat the remaining four.Proliferation of stromal cells and chorioretinal adhesion were seen in untreated eyes. The cryotherapy eyes revealed retinal destruction and pigment-laden cells in all retinal layers.The eyes treated by diode laser showed firm chorioretinal adhesion and relatively well preserved inner layers of retina.We concluded that directed diode laser photocoagulation was a safe and effective method of retinopexy to prevent the retinal detachment after globe perforation durng strabismus surgery.

The Effect of Cryotherapy and Laser Photocoagulation for the Retinopathy of Prematurity

It has been generally accepted that cryotherapy is a effective therapy in structural outcome in management of threshold retinopathy of prematurity. Despited of this structural success, several potential complications have been termed ocular damage. The purpose of this study is to determine whether diode laser photocoagulation, which has fewer adverse effect and is easier to administe, is as effective as cryotherapy in treatment of prethreshold and threshold retinophthy of prematurity. Twenty-one eyes received diode laser retinal photocoagulation, ranging from 1090 to 1750 g birth weight, and sixty-two eyes received cryotherapy, from 1000 to 1680 g birth weight. The laser-treated eyes had 14.3% unfavorable outcome, and the eyes threated with cryotherapy is as effective as cryotherapy in the result suggests that diode laser therapy is as effective as cryotherapy in the treatment of prethreshold and threshold retinopathy of prematurity. Our study, however, showed that posterior retinopathy of prematurity in zone I was more aggressive than retinopathy of prematurity in zone II and had 42% unfavorable outcome. This result suggests that posterior retinopathy of prematurity requires a careful follow-up examination and and earlier surgical intervention than threshold retinopathy of prematurity.

Diode Laser Photocoagulation for Retinopathy of Prematurity

Diode laser photocoagulation with laser ophthalmoscope has been shown to be effective and safe for treatment of threshold ROP. The purpose of this study are to deternine whether diode laser photocoagulation is really effective in reducing the likelihood of unfavorable regults in threshold stage. The eyes of neonates with birthweight of 2,500g or less, gestational age of 37 weeks or less, or exposure to increased ambient oxygen between May 1994 and October 1995 were examined, 21 eyes of threshold level of ROP and 2 eyes of prethreshold stage received diode laser photocoagulation. Nineteen(83%) of the 23 eyes that underwent laser photocoagulation had a favorable respons. Retinopathy of prematurity, however progressed to stage 4 in 2 eyes and stage 5 in 2 eyes. Two eyes in stage 4 achieved retinal reattachment after retinal buckling operation, but two eyes in stage 5 did not achieved retina1 reattachment. Regarding complications, one eye had retinal hemorihagic spot and one had presumed Bruch's membrane rupture. All infants had been followed up for minimum of 6 months. The results suggest that diode laser photocoagulation is an effective method in treatment of ROP, technically easier to administer without significant complication.

Diode Laser Photocoagulation for Retinopathy of Prematurity

Diode laser photocoagulation with laser ophthalmoscope has been shown to be effective and safe for treatment of threshold ROP. The purpose of this study are to deternine whether diode laser photocoagulation is really effective in reducing the likelihood of unfavorable regults in threshold stage. The eyes of neonates with birthweight of 2,500g or less, gestational age of 37 weeks or less, or exposure to increased ambient oxygen between May 1994 and October 1995 were examined, 21 eyes of threshold level of ROP and 2 eyes of prethreshold stage received diode laser photocoagulation. Nineteen(83%) of the 23 eyes that underwent laser photocoagulation had a favorable respons. Retinopathy of prematurity, however progressed to stage 4 in 2 eyes and stage 5 in 2 eyes. Two eyes in stage 4 achieved retinal reattachment after retinal buckling operation, but two eyes in stage 5 did not achieved retina1 reattachment. Regarding complications, one eye had retinal hemorihagic spot and one had presumed Bruch's membrane rupture. All infants had been followed up for minimum of 6 months. The results suggest that diode laser photocoagulation is an effective method in treatment of ROP, technically easier to administer without significant complication.

The Study on Clinical Characteristics and Therapies of Stage 3+ Retinopathy of Prematurity

We diagnosed 48 babies as retinopathy of prematurity (ROP) among 438 premature infants from April 1995 to March 1996 in Gil General Hospital. Among 48 ROP babies, 16 (30 eyes) infants progressed to stage 3+ ROP. Mean birth weight was 1474.0 gm, mean gestational age was 29.7 weeks and mean oxygen inhalation duration was 471.2 hours. Among 30 eyes of stage 3+ ROP, 25 eyes progressed to threshold stage and 5 eyes regressed spontaneously. Ten eyes were treated with cryotherapy and 15 eyes with diode laser photocoagulation and the treatment depends on random selection. Four eyes progressed to stage 5 ROP in spite of photocoagulation and encircling scleral buckling. Favorable outcome was achieved in all eyes treated with cryotherapy, and in 73. 3% of eyes laser-treated.