Re: preemie-l ROP
Helen1144@aol.com
Sun, 2 Jun 1996 13:49:02 -0400
I'm glad Suzanne and Catherine brought up the issue of cryo and laser surgery
for ROP. I am just getting ready to write about these procedures for the
second edition of The Premature Baby Book. I have some information from the
medical literature that I want to share, but I also have many questions I
want to ask those of you who have been through the surgery with your
children.
First of all, the medical journal information: Two months ago, results of a
multicenter trial of cryotherapy were published detailing the outcomes at age
5 1/2 years of children who had threshold ROP (stage 3+) and who had one eye
treated with cryotherapy and one eye left untreated. Of 234 children
examined, 32% had lost all vision in the treated eye while 48% had lost all
vision in the untreated eye. In other words, cryo surgery had reduced the
incidence of total blindness. That's the good news. The bad news is that
only 13% of the children who retained sight in their treated eye had 20/40
vision or better in that eye, whereas 17% of the children who retained sight
in the untreated eye had 20/40 vision or better. This means that cryo
reduces blindness, but often at the expense of visual acuity. Obviously,
cryo is beneficial overall, but it still involves the gamble of whether or
not to sacrifice visual acuity in hopes of preventing total blindness,
keeping in mind that the eyes, even at stage 3+, sometimes get better on
their own and may achieve better vision without treatment. These results
were published in the Archives of Ophthalmology, Vol 114, April 1996. In the
same issue, another study found reduced visual fields ( for example, the loss
of peripheral vision that Catherine described) in children who had undergone
cryo surgery as opposed to those whose eyes had retained vision without cryo.
To any of you whose children had cryo, I would like to ask the following
questions:
What risks and benefits of cryo were discussed with you prior to surgery?
Was the decision for surgery a difficult one to make? When did your child
have the surgery (at what gestational age)? What form of pain relief was
used during surgery and post-op? Did your child have any particular
difficulties tolerating the surgery? What was the recovery like and how long
did it take? At what point was the ophthalmologist able to give you a
report on your baby's vision (i.e. that vision was 20/20 or whatever)? How
is your child's vision now? Do you have any advice or observations on cryo
and/or laser surgery that you would like to share with other parents through
The Premature Baby Book?
If you have information you would like to share either contact me by e-mail
or call me collect at (510) 841-6546 between the hours of 1 PM and 6 PM
Pacific time. Thanks in advance for any help you can give.
Helen Harrison