Cataract after laser treatment of retinopathy of prematurity – challenges in pediatric ophthalmology

Retinopathy of prematurity (ROP) is one of the most serious eye diseases affecting prematurely born infants. Modern treatment methods, including laser photocoagulation, have significantly reduced the incidence of blindness and severe visual impairment due to tractional retinal detachment, macular folds, or excessive myopia. However, long-term complications are still observed in some patients, among which cataract formation holds particular significance. The aim of this study was to evaluate the risk of cataract development in premature infants treated for type 1 ROP. We performed a retrospective study during which we studied 660 premature infants (352 boys and 308 girls) for a period of 5 years. Of these, 145 children (21.97%) were diagnosed with ROP at different stages. A total of 97 children (66.9% of those with ROP) underwent treatment for type 1 ROP. Of these, 80 were treated with laser photocoagulation, and 17 with intravitreal anti-VEGF medications. In the remaining 48 children, spontaneous regression of the disease occurred, and no treatment was necessary. During the study period, only one child (1.25%) developed a cataract. The proper balance between laser energy and number of laser spots is crucial for avoiding complications such as cataract formation. Laser therapy for ROP saves the vision of thousands of children worldwide, but it carries a risk of later complications, including cataract formation. Early detection, along with appropriate surgical treatment, optical correction, and occlusion therapy, is crucial for amblyopia prevention and normal visual development. These patients require long-term follow-up and multidisciplinary care to ensure maximum visual potential.