A COMPARISON OF LASER PHOTOCOAGULATION WITH TRANSSCLERAL CRYOTHERAPY IN THE TREATMENT OF THRESHOLD RETINOPATHY OF PREMATURITY

Objective: The goal of this study was to determine whether there was a significant difference between the visual outcomes of eyes with thres hold retinopathy of prematurity (ROP) treated with trans-scleral cryot herapy compared to those treated with laser photocoagulation. Design: Extended follow-up study of a prospective, randomized clinical trial. Participants: Fifty-two patients with bilateral threshold ROP particip ated. Follow-up data were available for 25 of these patients. Interven tion: Patients were randomized to receive cryotherapy in one eye and l aser photocoagulation in the other eye. Main Outcome Measures: The bes t-corrected visual acuity of each eye was measured. Best-corrected vis ual acuities of 20/50 or better were classified as ''good'' clinical o utcomes, whereas those 20/60 or worse were considered ''poor'' outcome s. A secondary outcome of this study was the spherical equivalent (SE) of each eye's most recent refraction. Result: At an average follow-up point of 5.8 years (range, 4.3-7.6 years), the odds that an eye treat ed with laser had a good clinical outcome were 6.91 times greater than for eyes treated with cryotherapy (95% confidence interval, 1.70-28.0 ; n = 21). Additionally, the laser-treated eyes were less myopic with a mean SE of -3.05 diopters compared to a mean SE of -5.08 diopters fo r the cryotherapy-treated eyes (P = 0.0072, n = 23). Conclusion: The a uthors' study suggests that laser photocoagulation for threshold ROP w as more likely to result in a good clinical outcome with better final visual acuity and less myopia compared to cryotherapy treatment.