Comparison of cryotherapy and laser photocoagulation in stage III retinopathy of prematurity.

Both cryotherapy and laser photocoagulation have been advocated for the treatment of stage III retinopathy of prematurity (ROP). In this retrospective study, we looked at which treatment was more effective and caused fewer complications. The outcomes of 23 patients (45 eyes) with stage III ROP treated with transconjunctival cryotherapy or indirect diode laser photocoagulation were reviewed. Group 1 (10 patients, 20 eyes) received cryotherapy and group 2 (13 patients, 25 eyes) received photocoagulation. In group 1, all had progressive ROP and one patient had bilateral neovascularization involving zone I. After treatment, 17 eyes had regression of ROP with good anatomic results, one eye had regression of the disease with mild to moderate macular ectopia and vessel traction, and two eyes (one patient) with zone I involvement advanced to stage V in 2 weeks. In group 2, 12 patients had threshold ROP, two had neovascularization involving zone I, and one patient had prethreshold zone I ROP. After treatment, 24 eyes had regression of ROP with good anatomic results and one eye had mild ectopic macula. Two eyes received two sessions of treatment. The results suggest that photocoagulation is at least as effective as cryotherapy and may be a favorable alternative for zone I ROP.