Ocular cosmesis in retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group
G. Summers, D. L. Phelps, B. Tung and E. A. Palmer
Department of Ophthalmology, University of Minnesota, Minneapolis.
We report the externally apparent outcome in the natural history cohort (n
= 4099) that was followed up prospectively in the Multicenter Trial of
Cryotherapy for Retinopathy of Prematurity. The overall incidence of an
adverse cosmetic outcome in the survivors who were examined 12 months post
term (n = 2759) was 15.1%. Adverse cosmetic outcomes included strabismus
(12.8%), nystagmus (3.3%), total retrolental membrane (1%), epiphora
(0.6%), corneal opacity (0.6%), cataract (0.3%), and episcleral hyperemia
(0.3%). A comparable subgroup examined 24 months post term showed
strabismus (14.4%), nystagmus (2.2%), epiphora (0.5%), corneal opacity
(0.7%), cataract (0.5%), episcleral hyperemia (0.5%), lid fissure asymmetry
(2.4%), and corneal diameter asymmetry (2.0%). The rate of adverse
aesthetic outcome was greatest in eyes that had developed more severe acute
retinopathy of prematurity and an unfavorable structural outcome. In
patients with bilateral threshold retinopathy of prematurity who underwent
no therapeutic ocular procedures, other than randomized assignment to
undergo cryotherapy in one eye, more frequent adverse cosmetic outcomes
were found in the untreated eyes.
