3 YEAR VISUAL OUTCOME FOR TREATED STAGE-3 RETINOPATHY OF PREMATURITY - CRYOTHERAPY VERSUS LASER

Backgroundlaims-In the management of retinopathy of prematurity (ROP), several studies have demonstrated laser photocoagulation to be as eff ective as cryotherapy in reducing the incidence of unfavourable struct ural outcome. However, few data are available on the functional outcom e. The 3 year visual acuity outcome of infants treated with laser or c ryotherapy in a neonatal unit is presented. Methods-The case notes of 34 infants (64 eyes) treated with cryotherapy, between 1989 and 1992, and 32 infants (59 eyes) treated with laser, between 1992 and 1995, we re reviewed. Results-In the cryotherapy group 69% of eyes had a favour able structural outcome. Of these structurally successful eyes 62.5%, 35.0%, and 33.3% of eyes had visual acuities within normal limits at t he 12 month, 24 month, and 36 month corrected age milestones respectiv ely. In the laser group 93% of eyes had a favourable structural outcom e. Of these structurally successful eyes 96.4%, 66.7%, and 59.5% of ey es had visual acuities within normal limits at the 12 month, 24 month, and 36 month corrected age milestones respectively. Conclusion-In the management of ROP, when laser photocoagulation induces a structurally successful result, the potential for normal visual acuity development at 3 years is high. Whether the poorer functional outcome of the eyes treated with cryotherapy is an artefact of the historical nature of t he study or as a result of an adverse effect of the destructive transc leral application is unknown.