Eye surgery in severe retinopathy of prematurity. Experience from the Copenhagen University Eye Clinic of Rigshospitalet 1986-91, with emphasis on cryotherapy.

Data concerning observation of 40 pre-term infants referred to the Copenhagen University eye clinic 1986-91 for evaluation of ROP, predominantly of advanced stages, have been analysed. Twenty-one eyes in 13 subjects underwent cryotherapy at stage 3 (-4), on day 50-172 after delivery (median 72 days). Out of 19 eyes available for follow-up 10 obtained good of fair function; nine eyes ended with no L. Four subjects with ROP stage 4-5 at referral underwent vitrectomy and one trabeculectomy, all in eyes where surgery on beforehand was considered palliative or 'mainly experimental'. No indication for therapy was recorded in 22 infants; they mainly appeared for evaluation rather late in the course of ROP, to have the feasibility of reconstructive anatomy considered. The mean age of the infant at first discovery of ROP was 55 days when only stage 1-2 was found, 63 days when stage 3, and 69 days when at least stage 4 was described. Altogether, the range was 30-100 days. The inhomogeneity of the data is stressed. Though the possible benefit of earlier recognition cannot be proven, the investigation clearly indicates the need of uniform observation schedules nationwide and clearer indications for referral to the vitreo-retinal department.