Comparison of Refractive Error Changes in Retinopathy of Prematurity Patients Treated with Diode and Red Lasers

Abstract

Aim: To compare refractive error changes in retinopathy of prematurity (ROP) patients treated with diode and red lasers. Methods: A randomized double-masked clinical trial was performed, and infants with threshold or prethreshold type 1 ROP were assigned to red or diode laser groups. Gestational age, birth weight, pretreatment cycloplegic refraction, time of treatment, disease stage, zone and disease severity were recorded. Patients received either red or diode laser treatment and were regularly followed up for retina assessment and refraction. The information at month 12 of corrected age was considered for comparison. Results: One hundred and fifty eyes of 75 infants were enrolled in the study. Seventy-four eyes received diode and 76 red laser therapy. The mean gestational age and birth weight of the infants were 28.6 ± 3.2 weeks and 1,441 ± 491 g, respectively. The mean baseline refractive error was +2.3 ± 1.7 dpt. Posttreatment refraction showed a significant myopic shift (mean 2.6 ± 2.0 dpt) with significant difference between the two groups (p < 0.001). There was a greater myopic shift among children with zone I and diode laser treatment (mean 6.00 dpt) and a lesser shift among children with zone II and red laser treatment (mean 1.12 dpt). The linear regression model, using the generalized estimating equation method, showed that the type of laser used has a significant effect on myopic shift even after adjustment for other variables. Conclusion: Myopic shift in laser-treated ROP patients is related to the type of laser used and the involved zone. Red laser seems to cause less myopic shift than diode laser, and those with zone I involvement have a greater myopic shift than those with ROP in zone II.

Risk factors for myopia at 1-year corrected age following laser photocoagulation for retinopathy of prematurity

“…In our population, cataract occurred only in the 532 nm laser group (1 in 52 cases [2%]), although not so severe as to require lensectomy. However, an 808 nm laser has been reported to be more at risk of promoting myopic shift than a shorter wavelength laser [25]. In addition, several reports revealed that a 532 nm or 659 nm laser has therapeutic effects equal to those of an 808 nm laser [26,27].…”

Refractive Status in Children with Laser-Treated Retinopathy of Prematurity: Our Experience in Bulgaria

“…In our study, ROP treated children were with a mean birth weight of 928.9 g (SD ± 252.8g) and meant gestational age of 27.3 weeks (SD ± 1.78w). They are higher than those reported by studies where ROP screening guidelines were BW < 1250 g [5], [9] and lower than these discussed by many other authors with higher screening criteria [7], [11], [12], [13], [14].…”

Association between myopia progression and quantity of laser treatment for retinopathy of prematurity

“…During laser treatment for ROP, the entire area of avascular retina is ablated to reduce the drive for neovascularization. Posterior location of ROP, and thereby a larger area of avascular retina ablated during laser treatment, may correlate with a greater risk of myopia [8][9][10][11][12]. Precisely measuring the anterior-posterior location or the area of retina treated are difficult.…”

“…Precisely measuring the anterior-posterior location or the area of retina treated are difficult. Laser spot count may serve as a surrogate, and previous studies have correlated laser spot counts and zone of treatment with myopia [8][9][10][11][12]. However, these studies included data from multiple treating physicians, and therefore, the number of laser spots could have reflected variations in treatment density between physicians rather than the area of retina treated.…”