A comparison of laser photocoagulation with trans-scleral cryotherapy in the treatment of threshold retinopathy of prematurity

Ophthalmology. 1998 Sep;105(9):1628-31. doi: 10.1016/S0161-6420(98)99029-7.


Objective: The goal of this study was to determine whether there was a significant difference between the visual outcomes of eyes with threshold retinopathy of prematurity (ROP) treated with trans-scleral cryotherapy compared to those treated with laser photocoagulation.

Design: Extended follow-up study of a prospective, randomized clinical trial.

Participants: Fifty-two patients with bilateral threshold ROP participated. Follow-up data were available for 25 of these patients.

Intervention: Patients were randomized to receive cryotherapy in one eye and laser photocoagulation in the other eye.

Main outcome measures: The best-corrected visual acuity of each eye was measured. Best-corrected visual acuities of 20/50 or better were classified as "good" clinical outcomes, whereas those 20/60 or worse were considered "poor" outcomes. A secondary outcome of this study was the spherical equivalent (SE) of each eye's most recent refraction.

Result: At an average follow-up point of 5.8 years (range, 4.3-7.6 years), the odds that an eye treated with laser had a good clinical outcome were 6.91 times greater than for eyes treated with cryotherapy (95% confidence interval, 1.70-28.0; n = 21). Additionally, the laser-treated eyes were less myopic with a mean SE of-3.05 diopters compared to a mean SE of -5.08 diopters for the cryotherapy-treated eyes (P = 0.0072, n = 23).

Conclusion: The authors' study suggests that laser photocoagulation for threshold ROP was more likely to result in a good clinical outcome with better final visual acuity and less myopia compared to cryotherapy treatment.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Child
  • Child, Preschool
  • Cryosurgery*
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Laser Coagulation*
  • Male
  • Prospective Studies
  • Retinopathy of Prematurity / physiopathology
  • Retinopathy of Prematurity / surgery*
  • Treatment Outcome
  • Visual Acuity / physiology