Transpupillary Diode Laser Retinal Photocoagulation for the Treatment of Retinopathy of Prematurity: Experience in Southern Iran

Dear Editor, Retinopathy of prematurity (ROP) is an ischemic retinopathy of premature and low birth weight infants. According to the early treatment for retinopathy of prematurity (ETROP) study, 68% of infants with birth weight less than 1,251 grams developed ROP of any degree. 1 ROP is a potentially blinding disorder and approximately 300 children per million live births have at least one eye blinded by ROP. 2 Laser photocoagulation, typically a dense or near confluent pattern, is currently used as the standard treatment for high-risk prethreshold or worse ROP. 3 The incidence and severity of ROP are claimed to be influenced by the quality of neonatal intensive care unit facilities and probably by ethnicity. Therefore, the screening and treatment guidelines developed by the US physicians may not be fully applicable to neonates from other countries. Consequently, every country should conduct studies on its own population to refine such guidelines. The aim of the present study was to report our experience with the safety and efficacy of transpupillary diode laser photocoagulation for the treatment of type 1 ROP infants according to the definitions specified by the ETROP study. 1 In this retrospective chart review, we studied the clinical records of 51 (102 eyes) consecutive patients with type 1 ROP. These patients underwent transpupillary diode laser photocoagulation by one of the three surgeons (MA, MHN, or FR) at the Khalili Eye Hospital (Shiraz, Iran) between July 2011 and March 2013. Eyes with concomitant disorders such as congenital glaucoma or congenital eye disorders, and patients without timely referral or poor follow-up were excluded. Type1 ROP was defined 1 as: • Zone I, any stage ROP with plus disease (n=6 eyes, 5.9%) • Zone I, stage 3 ROP without plus disease (n=2 eyes, 2.0%) • Zone II, stage 2 ROP with plus disease (n=14 eyes, 13.7%) • Zone II, stage 3 ROP with plus disease (n=80 eyes, 78.4%). All patients were treated within 48 hours of diagnosis. The research protocol adhered to the tenets of the Declaration of Helsinki. Detailed informed consent was obtained from parents or legal guardians of infants. The study protocol (number: 6129) was approved by the Ethics Committee of Shiraz University of Medical Sciences. Before treatment, pupils were fully dilated with one drop of phenylephrine hydrochloride 2.5%, tropicamide 1% and cyclopentolate 1% instilled into each eye 3 times in10-minute intervals. Laser photocoagulation was performed under general anesthesia with sevoflurane and …