Efficacy And Safety Of Green Laser Photocoagulation For Threshold Retinopathy Of Prematurity [eficácia E Segurança Da Fotocoagulação Com Laser Verde Na Retinopatia Da Prematuridade Limiar]

Purpose: To report the efficacy and safety of green laser photocoagulation for threshold retinopathy of prematurity (ROP). Methods: We reviewed the clinical records of the neonates who had undergone green laser photocoagulation for threshold ROP at the Federal University of Pernambuco in Brazil between January 2004 and January 2006. All procedures were conducted with local anesthetic drops. The neonates were monitored throughout the procedure by a neonatologist. A frequency-doubled solid state laser, diode-pumped, with 532 nm wavelength was used. The presence of tunica vasculosa lentis or cataract were excluded before laser treatment. The following preoperative data were obtained for each patient: age, birth weight and the grade of ROP. Postoperative data included complications associated with the laser treatment, grade of ROP and evaluation whether further surgery was necessary due to failure of laser photocoagulation. Results: Twenty-two neonates underwent photocoagulation with green laser for threshold ROP. A total of 31 eyes were included in the study. The mean gestational age was 30 ± 3 weeks and the mean birth weight was 1120 ± 490 g. Regression of the disease after laser therapy was observed in 30 eyes (96.7%). Despite treatment one eye presented stage 4A. Only 7 eyes required repetitive laser therapy. No adverse effects such as burning anterior segment tissues or bleeding in the anterior chamber occurred. No posterior segment side-effects were observed. Cataract formation was not observed at the last follow-up examination. Conclusions: Green laser photocoagulation remains an effective and safe alternative to red laser photocoagulation and to cryotherapy in the treatment of threshold ROP.7114951Childhood blindness prevention project launched (2002) Bull World Health Organ, 80 (8), p. 688(2007) Childhood blindness [text on the Internet], , http://www.who.int/blindness/causes/priority/en/index4.html, World Health Organization. Geneva: WHO[cited 2007 Oct 15]. Available from: URLHoyt, C.S., Good, W.V., The many challenges of childhood blindness (2001) Br J Ophthalmol, 85 (10), pp. 1145-1146Bashour, M., Menassa, J., Gerontis, C.C., (2007) Retinopathy of prematurity [text on the Internet], , http://www.emedicine.com/oph/topic413.htm, [cited Oct 15].Available from: URLPalmer, E.A., Hardy, R.J., Dobson, V., Phelps, D.L., Quinn, G.E., Summers, C.G., Krom, C.P., Tung, B., Cryotherapy for Retinopathy of Prematurity Cooperative Group. 15-year outcomes following threshold retinopathy of prematurity: final results from the multicenter trial of cryotherapy for retinopathy of prematurity (2005) Arch Ophthalmol, 123 (3), pp. 311-318Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial (2003) Arch Ophthalmol, 121 (12), pp. 1684-1694. , Early Treatment For Retinopathy Of Prematurity Cooperative GroupTrese, M.T., Retinopathy of prematurity (2006) Retina, pp. 2463-2476. , Ryan SJ, editor. 4th ed. Philadelphia: Elsevier-MosbyChristiansen, S.P., Bradford, J.D., Cataract in infants treated with argon laser photocoagulation for threshold retinopathy of prematurity (1995) Am J Ophthalmol, 119 (2), pp. 175-180Paysse, E.A., Miller, A., Brady McCreery, K.M., Coats, D.K., Acquired cataracts after diode laser photocoagulation for threshold retinopathy of prematurity (2002) Ophthalmology, 109 (9), pp. 1662-1665Connolly, B.P., Ng, E.Y., McNamara, J.A., Regillo, C.D., Vander, J.F., Tasman, W., A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years: part 2. Refractive outcome (2002) Ophthalmology, 109 (5), pp. 936-941Al-Ghamdi, A., Albiani, D.A., Hodge, W.G., Clarke, W.N., Myopia and astigmatism in retinopathy of prematurity after treatment with cryotherapy or laser photocoagulation (2004) Can J Ophthalmol, 39 (5), pp. 521-525Azad, R.V., Pasumala, L., Kumar, H., Talwar, D., Pal, R., Paul, V.K., Chandra, P., Prospective randomized evaluation of diode-laser and cryotherapy in prethreshold retinopathy of prematurity (2004) Clin Experiment Ophthalmol, 32 (3), pp. 251-254Penn, J.S., Rajaratnam, V.S., Collier, R.J., Clark, A.F., The effect of an angiostatic steroid on neovascularization in a rat model of retinopathy of prematurity (2001) Invest Ophthalmol Vis Sci, 42 (1), pp. 283-290Penn, J.S., Rajaratnam, V.S., Inhibition of retinal neovascularization by intravitreal injection of human rPAI-1 in a rat model of retinopathy of prematurity (2003) Invest Ophthalmol Vis Sci, 44 (12), pp. 5423-5429Chen, J., Hicks, D., Brantley-Sieders, D., Cheng, N., McCollum, G.W., Qi-Werdich, X., Penn, J., Inhibition of retinal neovascularization by soluble EphA2 receptor (2006) Exp Eye Res, 82 (4), pp. 664-673Wilkinson-Berka, J.L., Jones, D., Taylor, G., Jaworski, K., Kelly, D.J., Ludbrook, S.B., SB-267268, a nonpeptidic antagonist of alpha(v)beta3 and alpha(v)beta5 integrins, reduces angiogenesis and VEGF expression in a mouse model of retinopathy of prematurity (2006) Invest Ophthalmol Vis Sci, 47 (4), pp. 1600-1605Quinn, G.E., Dobson, V., Kivlin, J., Kaufman, L.M., Repka, M.X., Reynolds, J.D., Prevalence of myopia between 3 months and 5 1/2 years in preterm infants with and without retinopathy of prematurity. Cryotherapy for Retinopathy of Prematurity Cooperative Group (1998) Ophthalmology, 105 (7), pp. 1292-1300Axer-Siegel, R., Snir, M., Cotlear, D., Maayan, A., Frilling, R., Rosenbaltt, I., Diode laser treatment of posterior retinopathy of prematurity (2000) Br J Ophthalmol, 84 (12), pp. 1383-1386Kieselbach, G.F., Ramharter, A., Baldissera, I., Kralinger, M.T., Laser photocoagulation for retinopathy of prematurity: structural and functional outcome (2006) Acta Ophthalmol Scand, 84 (1), pp. 21-26Tanaka, S., Laser indirect ophthalmoscope photocoagulation in an incubator for the treatment of retinopathy of prematurity (1994) Ophthalmic Surg, 25 (1), pp. 48-50O'Neil, J.W., Hutchinson, A.K., Saunders, R.A., Wilson, M.E., Acquired cataracts after argon laser photocoagulation for retinopathy of prematurity (1998) J AAPOS, 2 (1), pp. 48-51Folk, J.C., Pulido, J.S., (1997) Laser photocoagulation of the retina and choroid: Ophthalmology monograph 11, , San Francisco: American Academy of Ophthalmolog