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March 1989

Cryotherapy for Retinopathy of Prematurity-Reply

Author Affiliations

Portland, Ore

Arch Ophthalmol. 1989;107(3):315-316. doi:10.1001/archopht.1989.01070010325004

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In Reply.  —We thank Drs C. G. Keith, L. W. Doyle, and W. H. Kitchen for their thoughtful remarks concerning our publication. We wholeheartedly agree that visual acuity outcome results are needed, as well as longer-term̃ morphologic outcome data, before a policy is established that would require cryotherapy for all eyes reaching the defined severity threshold. This is why we did not specifically recommend cryotherapy for both eyes as a uniform procedure for every patient, and why we are beginning to collect that very data.In their concluding sentence, Drs Keith, Doyle, and Kitchen seem tacitly to endorse cryotherapy for "the subgroups at highest risk of blindness," and we submit that our severity threshold defines just such a group, having a 45% risk of outcome that is clearly unfavorable (presumed consistent with legal blindness). We are concerned about the conclusion expressed by Drs Keith, Doyle, and Kitchen that "it would

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