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  Česky / Czech version Čs. Oftal., 58, 2002, No. 1, p. 30-35
 
Cryotherapy and Photocoagulation in the Treatment of Retinopathy of Prematurity 
Autrata R., Holoušová M., Řehůřek J. 

Dětská oční klinika DN FNB a LF MU, Brno, přednosta prof. MUDr. J. Řehůřek, CSc.
 


Summary:

       In a retrospective clinical trial is compared efficacy of transscleral cryotherapy versus diode laser photocoagulation in the treatment of threshold stage 3 retinopathy of prematurity (ROP) in zone II-III. 40 eyes were treated with cryotherapy and 32 eyes were treated with diode laser photocoagulation. All children have been followed up for 5 to 9 years after treatment. The long-term best-corrected visual acuity (BCVA) and refractive errors were evaluated. BCVA from 6/6 to 6/18 in last examination had 53% of eyes with cryotherapy and 56% of eyes with photocoagulation. The difference was not statistically significant (P= 0.094). Myopia over -6.0 D were at 32.5% of eyes with cryotherapy and at 22% of eyes with photocoagulation. This difference was statistically significant (P<0.05). In the second part of this study is evaluated the long-term visual acuity and structural outcome in Zone 1 ROP (Very posterior Zone 1 disease, rush disease). 20 eyes with cryotherapy and 24 eyes with photocoagulation of this severe form ROP were followed up for 5 to 11 years. BCVA of 6/36 and better had 30% eyes of cryotherapy and 37.5% eyes of laser photocoagulation (P<0.05). Unfavourable structural fundus outcomes had 55% eyes of cryotherapy and 33% eyes of photocoagulation (P<0.05). These differences were statistically significant. Our results support the long-term efficacy and safety of cryotherapy and diode laser photocoagulation in the treatment of threshold 3 stage ROP. Visual acuity results suggest that diode laser photocoagulation is as effective as cryotherapy in treatment of this ROP stage. In the group of posterior Zone 1 ROP was achieved better visual acuity results and reduced unfavourable structural outcomes with diode laser photocoagulation as compared to cryotherapy.

        Key words: retinopathy of prematurity, cryotherapy,diodelaserphotocoagulation
       

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