EPOS
European Paediatric Ophthalmological Society
Abstract Preview
15 The treatment of retinopathy of prematurity by transscleral and by transpupillar diode laser in the neonatal intensive care unit in St.Petersburg, Russia
Fomina, N.1
Children"s Hospital N17, St.Petersburg, Russia
In the last years the survival of premature babies with extremely low birthweight has increased. In St. Petersburg in the Neonatal Intensive Care Unit N 17 the mortality of babies with birthweight below 1500 g was 17% in 2000 and 29% in 1999. In 2000 ROP was diagnosed in 52% of babies with a birthweight below 1500 g.
Since 1995 in St. Petersburg the Russian diode laser (wavelength 960 run) has been used successfully because the disability from ROP requiring treatment has been decreased by about 2 times.
Since 1999 when the diode laser had been improved we have the opportunity to perform transpupillary lasercoagulation.
Purpose: To choose the method of laser treatment for ROP.
Methods: 223 babies were treated with a diode laser from January 1998 through December 2000 by a single surgeon.
Transscleral laser was used to treat patients before December 1999 and transpupillary laser was used thereafter.
9 babies were treated by transpupillary laser, and all the others by transscleral. The median birthweight of the 9 babies treated by transpupillary laser were 1308±370 g, and the median gestational age 29±2 weeks. All these babies were born sick and more than 30 days in the reanimation department.
Results: In 418 eyes (93,7%) regression of ROP occurred after a single or a second laser treatment with a good anatomical outcome. In 28 eyes. (6,30/9) there was an unfavorable result (stages IV - V of cicatrical RLF). There were no cataracts or other ocular complications noted after laser treatment.
Conclusion: Diode laser is a safe and effective treatment of the active stages of ROP (threshold). We have been making the laser coagulation by a transpupillary and a transscleral approach.
We prefer transpupillary diode laser when the changes are in the center of the retina (zone I, posterior 1/3 of zone II). We consider that transscleral laser coagulation is more simple than transpupillary.