SURFACTANT PROPHYLAXIS AND RETINOPATHY OF PREMATURITY

Objective.-The use of exogenous surfactant has led to a decrease in mo rtality of low-birth-weight infants. In some instances, use of this dr ug has also led to a reduction in neonatal morbidity, such as respirat ory distress syndrome. This study was undertaken to determine whether prophylactic surfactant therapy has an effect on the incidence and sev erity of retinopathy of prematurity. Design.-The authors reviewed the findings of sequential prospective ophthalmologic examinations perform ed in two neonatal intensive care units that participated in randomize d trials of prophylactic exogenous mammalian surfactant. Patients.-The re were 43 patients in the control group (no prophylactic surfactant) and 43 patients in the prophylactic surfactant group. These groups did not differ on the basis of birth weight, gestational age, race, or ge nder. Results.-The incidence and severity of retinopathy of prematurit y did not vary between the control and surfactant-treated infants. Onl y birth weight appeared to be significantly related to the incidence a nd severity of retinopathy of prematurity. Conclusions.-These results suggest that the widespread use of prophylactic surfactant therapy wil l not change the incidence of retinopathy of prematurity in extremely low-birth-weight infants. However, the absolute number of affected pat ients will likely increase because of the decrease in mortality of ext remely low-birth-weight patients, the patients most at risk for retino pathy of prematurity.