gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Combination of cryotherapy and photocoagulation for the treatment of threshold retinopathy of prematurity

Meeting Abstract

  • corresponding author K. Senková - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • R. Autrata - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • M. Holouaová - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • J. Rehurek - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 141

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Veröffentlicht: 22. September 2004

© 2004 Senková et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Cryotherapy and transpupilary diode laser retinal photoablation are both effective in the treatment of retinopathy of prematurity (ROP). We evaluated the safety, efficiency, and effectiveness of combined cryotherapy and indirect diode laser photocoagulation to treat threshold ROP.

Methods

Medical charts of patients developing threshold ROP from January 1995 through December 2001 were retrospectively reviewed to identify those treated with combined cryotherapy and photocoagulation and followed up for at least 1year postoperatively. Diode laser Nidek DC 3300 was used to ablate posterior avascular retina, and cryotherapy was used for treatment of avascular anterior retina. Data reviewed included ocular and systemic complication rates, treatment duration, number of laser burns, functional outcome-visual acuity, structural outcome-most recent fundus examination, and cycloplegic refraction.

Results

In 34 patients, 61 eyes received combined treatment. Mean duration of treatment was 32±11 minutes/eye. A mean of 207±93 laser burns/eye and a mean of 15±7 cryocoagulations/eye were applied to achieve near-confluent ablation of the avascular retina. Functional outcome (visual acuity) was favorable (visual acuity better than 20/100) at last examination in 47 of 61 eyes (76.2%). Anatomic -structural outcome was favorable in 52 of 61 eyes (82.5%)at last examination. At 3years or later, 45 of 61 eyes (73.7%) measured were myopic (> 3 diopters), of which 18 (42.2%) were highly myopic (> 6 diopters). No intraoperative complications occurred.

Conclusions

Structural and functional outcomes after treating ROP with combined cryotherapy and diode laser photocoagulation appear comparable with results reported using either procedure alone. However, combined therapy may be safer by decreasing the number of laser applications and reducing the duration of surgery especiallly in eyes with very posterior ROP. This may reduce the number of complications. Further research on a larger cohort of patients is needed to confirm our results.