The Comparison of Anterior Segment Parameters in School-Aged Children with Laser-Treated Retinopathy of Prematurity, Untreated Preterm Birth, and Full-Term Birth.

Background/

Objectives

To compare long-term refractive and anterior segment outcomes among preterm infants with retinopathy of prematurity (ROP) who underwent laser photocoagulation (LP), untreated preterm infants, and term-born controls.

Methods

This study included 285 eyes of 144 patients aged 6-10 years, categorized into three groups: LP-treated type 1 ROP (Group 1), untreated preterms without type 1 ROP (Group 2), and full-term controls (Group 3). Data were collected, including birth weight (BW), gestational age (GA), ROP status, LP parameters (if required), as well as all ophthalmologic findings. Corneal tomography assessed keratometry, corneal thickness, corneal volume, anterior chamber metrics, and keratoconus indices. Optical biometry evaluated axial length (AL), keratometry, astigmatism (Ast), and anterior chamber depth (ACD). Cycloplegic autorefractometry measured spherical equivalent (SE), astigmatism (KAst), and keratometry.

Results

Among 144 patients (63 female, 43.8%), the mean age was 8.7 ± 1.2 years, with a median GA of 34 weeks and BW of 2165 g. Significant differences were observed in corneal tomography parameters (Kh, Kv, Km, Kmax, astigmatism, and thickness metrics, p < 0.001), keratoconus indices (p < 0.001), optical biometry (AL, lens power, and ACD, p < 0.001), and cycloplegic autorefractometry (astigmatism and keratometry, p < 0.001) among the three groups. Refractive errors, including myopia and astigmatism, were most pronounced in laser-treated ROP cases (p < 0.036 and p < 0.001, respectively).

Conclusions

Children with laser-treated ROP had steeper and thinner corneas, higher posterior astigmatism, and shallower ACD than preterm and term-born children. These findings likely reflect developmental anterior segment differences related to prematurity and treatment-requiring ROP, supporting careful long-term ophthalmologic follow-up.