—We welcome the opportunity to respond to the points raised by Drs Topilow and Ackerman. They are critical of our hypothesis that firm chorioretinal adhesion from the cryotherapy may predispose to retinal break formation as the eye grows, and that we did not rule out the possibility of vitreous traction as the cause of the retinal breaks. A more careful reading of our article would have revealed the fact that we did state the following: "Although there was no obvious traction present, vitreous and preretinal membranes as causative factors in retinal break formation cannot be ruled out." We might add that there is no more evidence, and in our opinion perhaps even less, to support this idea as a mechanism of retinal break formation.Drs Topilow and Ackerman refer to their results in 39 eyes of 20 "severely premature" infants, 31 of which had stage 3+ ROP and
Greven C, Tasman W. Cryotherapy for Stage 3+ Retinopathy of Prematurity-Reply. Arch Ophthalmol. 1990;108(1):15–16. doi:10.1001/archopht.1990.01070030017008
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