RETINOPATHY OF PREMATURITY IN A CONTROLLED TRIAL OF PROPHYLACTIC SURFACTANT TREATMENT

Aims-To investigate the incidence of acute and cicatricial retinopathy of prematurity (ROP) in a cohort of premature neonates entered into a randomised, multicentre trial of prophylactic exogenous surfactant fo r respiratory distress syndrome (RDS) compared with controls receiving surfactant only if severe RDS developed. Methods-The incidence of acu te and cicatricial ROP was assessed in 304 neonates born at less than 30 weeks' gestation in a geographically defined population of approxim ately three million. Results-There was a trend towards improved surviv al in the group receiving prophylactic surfactant with 102/151 (67.5%) surviving compared with 82/141 controls (58.2%, p=0.12). The prophyla ctic surfactant group would be expected to have an increased risk of R OP due to improved survival, particularly of the most premature infant s. However, there was no statistically significant difference in the i ncidence of acute ROP between the two groups and the incidence of cica tricial ROP was lower in the group receiving prophylactic surfactant ( 4/100 survivors, 4.0%) compared with neonates receiving rescue surfact ant as required (6/81, 7.4%). This difference did not reach statistica l significance (p=0.35). Conclusion-The trend for a lower incidence of cicatricial ROP in those neonates treated with prophylactic surfactan t compared with the rescue surfactant group, despite improved survival , suggests that the use of prophylactic surfactant also had a benefici al effect on the development of cicatricial ROP.