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document
Diode laser photocoagulation for threshold retinopathy of prematurity . A randomized study . BACKGROUND Although peripheral cryotherapy decreases the incidence of unfavorable anatomic outcomes in threshold retinopathy of prematurity ( ROP ) , apnea , bradycardia , and lid edema can occur . Argon laser indirect ophthalmoscope photocoagulation has been used as an alternative to cryotherapy , with fewer adverse effects . Retinal lesions placed with diode lasers are deeper than similar argon laser lesions , and it is not known whether this difference could influence the response to ablative therapy . METHODS Patients were enrolled under a prospective , randomized protocol . One eye of each patient with symmetric , threshold ROP was treated with an 814/815 nm diode laser , while the other eye was treated with cryotherapy . Patients with asymmetric diseases also were randomized for treatment in the threshold eye . RESULTS Nineteen infants ( 33 eyes ) were treated , ranging from 485 to 863 g birth weight ( 23 to 27 weeks gestational age ) ; 18 patients ( 32 eyes ) were followed for 3 months or longer . Four patients ( 8 eyes ) had bilateral zone 1 disease . Postconceptional age was 36 to 45 weeks at the time of treatment . The diode laser treatment was better tolerated than cryotherapy , and the treatment apparatus was more easily transported . Apneic episodes requiring intubation resulted from two cryotherapy sessions but no diode laser sessions . Five cryotherapy-treated eyes required retreatment because of persistent disease with adjacent skip areas . In the group followed for 3 to 15 months , 1 cryotherapy-treated eye and 1 diode laser-treated eye progressed to stage 5 retinal detachment . CONCLUSION Compared with cryotherapy , the diode laser was more convenient , technically easier to administer , and better tolerated by the patient . Although the number of patients was too small for meaningful statistical analysis of outcome , diode laser peripheral retinal ablation appeared to be as effective as cryotherapy for the treatment of threshold ROP .
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Intervention_Physical
Diode laser photocoagulation
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Intervention_Physical
peripheral cryotherapy
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Intervention_Physical
Argon laser indirect ophthalmoscope photocoagulation
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Intervention_Physical
cryotherapy
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Intervention_Physical
diode lasers
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Intervention_Physical
argon laser
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Intervention_Physical
ablative therapy
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Intervention_Physical
diode laser
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Intervention_Physical
cryotherapy
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Intervention_Physical
diode laser
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Intervention_Physical
cryotherapy
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Intervention_Physical
cryotherapy
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Intervention_Physical
diode laser
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Intervention_Physical
cryotherapy-treated
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Intervention_Physical
cryotherapy-treated
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Intervention_Physical
laser-treated
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Intervention_Physical
cryotherapy
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Intervention_Physical
diode laser
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Intervention_Physical
diode laser peripheral retinal ablation
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Intervention_Physical
cryotherapy
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Outcome_Adverse-effects
adverse effects
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Outcome_Other
response
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Outcome_Other
tolerated
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Outcome_Physical
Apneic episodes requiring intubation
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Outcome_Other
retreatment
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Outcome_Physical
stage 5 retinal detachment
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Participant_Condition
threshold retinopathy of prematurity
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Participant_Condition
retinopathy of prematurity
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Participant_Condition
ROP
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Participant_Sample-size
Nineteen infants ( 33 eyes )
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Participant_Sample-size
18 patients ( 32 eyes )
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Participant_Sample-size
Four patients ( 8 eyes )
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Participant_Age
36 to 45 weeks