[Laser photocoagulation in retinopathy of prematurity--preliminary results].

PURPOSE: The present study aims to reveal, on one hand, the efficiency of the laser photocoagulation in the Retinopathy of Prematurity (ROP) and, on the other one, to answer two questions: 1. Why do some ROPs still go wrong, in spite of laser therapy? 2. What can we do about it?

MATERIAL/METHOD: A retrospective study has been performed, including the 21 prematurely newborns that have been treated by laser photocoagulation, for ROP, in Cluj-Napoca, between April 2006-September 2007. The photocoagulation has been carried out with a diode laser fixed on an indirect ophthalmoscope, under sedation, in the Neonatology Department of the County Clinical Hospital from Cluj.

RESULTS

Globally, the results of the laser treatment are the following: favourable outcome (regression of ROP)--in 32 eyes (84.21%) and unfavourable outcome--in 6 eyes (15.79%). Laser photocoagulation has been performed in 29 eyes in stage III zone 2 and produced the regression of ROP in 27 of them (93. 10%). ROP zone I has been identified and treated in 3 cases, of which-two had a favourable evolution (66.66%), and one has progressed to stage IV (33.33%). ROP in stage IVa has been identified in 3 cases (5 eyes). The laser photocoagulation has been possible only in 3 eyes, with favourable evolution in one eye (33.33%) and unfavourable, in 2 eyes (66.66%).

DISCUSSION: The results of the treatment are analyzed according to two parameters: the objective situation prior to laser photocoagulation (stage and zone of ROP) and the moment of the treatment (postconceptional and postnatal age).

CONCLUSIONS

1. The laser photocoagulation has been performed at the right moment, in 17 of the 21 treated cases (80.95%). 2. The indirect laser photocoagulation produced the regression of ROP in 15 of the 17 cases that were treated at the right moment (88.22%). 3. The indirect laser photocoagulation has been possible in 4 of the 7 eyes that arrived too late for the treatment and produced the regression of ROP in 3 of them (42.85%). 4. If it is not sustained by a correct screening, performed at the right moment, the laser photocoagulation cannot maximally validate its healing potential in ROP