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Impressum
Diode Laser Photocoagulation in Retinopathy of Prematurity Stages 3+ and 4+ over a 10-year period
Seiberth V., Woldt C.
Klinik für Augenheilkunde, Marienhospital Osnabrück, D-49074 Osnabrück
Background: In the late decade laser photocoagulation has surpassed
the former goldstandard cryocoagulation in retinopathy of prematurity
(ROP) treatment. We report our 10-year experience with diode laser photocoagulation
in acute ROP stages 3+ and 4+ (International Classifiction 1984).
Methods: To evaluate the efficacy and safety of diode laser photocoagulation
we included 172 eyes with stage 3+ and stage 4+ ROP of 88 very low birth
weight infants (gestational age 24 to 31 weeks, mean ± SD 26.4
± 1.7 weeks; birth weight 430 to 1400 g, 842 ± 207 g) in
a prospective clinical study between 1992 and 2001. Photocoagulation treatment
was performed transpupillarly (142 eye) or transsclerally (30 eyes) using
a diode laser (wavelength 810 nm). Seven eyes (4.1 %) had additional retinal
detachment surgery using an encircling band. Follow-up ranged from 2 to
74 months.
Results: In 158 (91.9 %) of the 172 eyes the retina was attached
without dragging or with mild dragging after laser coagulation and additional
retinal detachment surgery. Of 164 eyes treated in stage 3+ 152 (92.7
%) ended with attached retina , 6 eyes in stage 4 and 6 eyes in stage
5 ROP. Of the 8 eyes treated in stage 4+ 6 eyes ended with attached retina,
2 eyes in stage 4 and none in stage 5 ROP. No adverse side effects as
a result of diode laser treatment were noticed except for a small amount
of retinal/preretinal bleeding in the ridge in 48 eyes (27.9 %) and a
small postoperative anterior chamber bleeding in two eyes (1.2 %) with
tunica vasculosa lentis. There were neither lenticular opacities nor was
there cataract formation or any severe anterior segment complication.
Conclusion: Diode laser photocoagulation is an effective treatment
for stage 3+ ROP. In stage 4+ ROP diode laser treatment is less effective.
There were no severe side effects due to coagulation treatment.