To the Editor.
—The recent report on the efficacy of diode laser photocoagulation of retinopathy of prematurity adds another tool to the treatment of this potentially blinding condition.1 However, I wonder if the authors are being unnecessarily conservative.The diode laser applications were made to the avascular peripheral retina, spaced one-half burn width apart. Retreatment, if indicated, involved treating the previously untreated "skip" areas. Why need there be any such areas? The protocol for cryotherapy of retinopathy of prematurity involved contiguous freezes, with little or no (deliberate) skip areas.2 Diode treatment, if anything, seems to be more benign than cryotherapy.1 The risks of bradycardia, respiratory compromise, and injections of local anesthetics in these small infants seem far greater than the risk of a simple complete photocoagulation of the avascular retina on the initial treatment. In that case, no additional treatment would be needed, or indeed possible, under
Schechter RJ. Laser Treatment of Retinopathy of Prematurity. Arch Ophthalmol. 1993;111(6):730. doi:10.1001/archopht.1993.01090060016003