Surfactant prophylaxis and retinopathy of prematurity
M. X. Repka, R. J. Hardy, D. L. Phelps and C. G. Summers
Wilmer Ophthalmologic Institute, Johns Hopkins Hospital, Baltimore, MD 21287-9009.
OBJECTIVE--The use of exogenous surfactant has led to a decrease in
mortality of low-birth-weight infants. In some instances, use of this drug
has also led to a reduction in neonatal morbidity, such as respiratory
distress syndrome. This study was undertaken to determine whether
prophylactic surfactant therapy has an effect on the incidence and severity
of retinopathy of prematurity. DESIGN--The authors reviewed the findings of
sequential prospective ophthalmologic examinations performed in two
neonatal intensive care units that participated in randomized trials of
prophylactic exogenous mammalian surfactant. PATIENTS--There were 43
patients in the control group (no prophylactic surfactant) and 43 patients
in the prophylactic surfactant group. These groups did not differ on the
basis of birth weight, gestational age, race, or gender. RESULTS--The
incidence and severity of retinopathy of prematurity did not vary between
the control and surfactant-treated infants. Only birth weight appeared to
be significantly related to the incidence and severity of retinopathy of
prematurity. CONCLUSIONS--These results suggest that the widespread use of
prophylactic surfactant therapy will not change the incidence of
retinopathy of prematurity in extremely low-birth-weight infants. However,
the absolute number of affected patients will likely increase because of
the decrease in mortality of extremely low-birth-weight patients, the
patients most at risk for retinopathy of prematurity.
