CATARACT IN INFANTS TREATED WITH ARGON-LASER PHOTOCOAGULATION FOR THRESHOLD RETINOPATHY OF PREMATURITY

PURPOSE: Previous studies of lens opacities occurring after argon lase r photocoagulation for retinopathy of prematurity indicate that the le ns in these laser-treated eyes may be at risk for cataract. We studied the occurrence of permanent, visually significant cataracts in four i nfants after laser therapy for retinopathy of prematurity. METHODS: Th e records of 51 consecutive patients (100 eyes) treated only with argo n laser photocoagulation for threshold retinopathy of prematurity at o ur institution were reviewed, Patient characteristics and treatment va riables were compared between infants who developed cataracts and thos e who did not. RESULTS: Complete opacification of the lens nucleus and cortex developed in six eyes of four patients between 19 and 99 days after laser therapy, An additional patient developed a transient, foca l, anterior capsular, and subcapsular opacity in one eye that cleared by one month postoperatively. Eyes that developed permanent cataracts were noted to have a prominent anterior tunica vasculosa lentis at the time of treatment. After laser therapy, these eyes developed hyphema, shallowing of the anterior chamber, corneal edema, and progressive op acification of the lens. When compared with eyes that did not develop cataract, no statistically significant difference in number of burns, zone or clock hours of extraretinal proliferation, birth weight, gesta tional age, or age at treatment was found. CONCLUSIONS: Cataract is a potential vision-threatening complication of argon laser photocoagulat ion that must be considered before choosing a treatment modality for i nfants with threshold retinopathy of prematurity.