2.11. Advantages of indirect laser photocoagulation over cryotherapy for ROP treatment

Cryotherapy was the first method that stopped the progression of ROP toward blindness [6]. The rationale was to destroy the non-vascular retina by applications of cryo on the sclera.

Indirect laser photocoagulation of the retina proved to be as effective as cryo in preventing ROP-related blindness, but with significantly fewer side effects. The pressure exerted by the cryoprobe on the infants' sclera was associated with high risk of myopia. Cryotherapy itself is more laborious than laser and requires more time and general anesthesia. By consequence, more anesthesia-related incidents were reported during cryo as compared to laser. In posterior ROP, it is very difficult (sometimes impossible) to reach the retina in the posterior pole with the cryoprobe. Therefore, posterior non-vascular retina may remain untreated with a high risk of ROP progression.

For all these reasons, currently indirect laser photocoagulation replaced cryotherapy in the treatment of ROP in most of settings.

ROP offers an eloquent example in which laser energy has revolutionized the treatment of an extremely serious disease, with significant socioeconomic and life quality positive impact.
