Clinical outcome of confluent laser photoablation for retinopathy of prematurity. Fallaha N, Lynn MJ, Aaberg TM Jr, Lambert SR. Journal of AAPOS 2002;6:81–85

Abstract

During the past decade, laser photocoagulation has supplanted cryotherapy as the standard treatment for threshhold retinopathy of prematurity (ROP). The authors retrospectively studied 91 eyes (47 patients) treated with confluent diode laser photoablation. A mean of 1943 ± 912 laser burns were administered in a confluent pattern. Four main outcomes were evaluated: (1) rate of progression, (2) frequency of laser retreatment, (3) postoperative complications, and (4) postoperative refractive error. Progression to stage 4 or 5 disease occurred in 13 (44.8%) of 29 eyes with zone I and posterior zone II and in 2 (3.9%) of 51 eyes with anterior zone II (P = .01). Eyes with anterior zone II ROP that received more than or equal to 2000 burns progressed more than those that received fewer than 2000 burns. Only 1 (1%) eye needed retreatment. Postoperative complications included corneal edema (2.3%), anterior segment ischemia (2.3%), vitreous hemorrhage (7.9%), posterior synechia (2.3%), cataract (4.9%), and macular ectopia (12%). The mean spherical equivalent at the last follow-up was −4.52 ± 5.63 D. While confluent treatment has almost completely eliminated supplemental treatment, it was associated with a similar rate of progression and complications as previous reports with other patterns (scatter, near-confluent) of laser treatment.—Michael D. Wagoner