Corneal endothelial and ocular biometric parameters in children with history of retinopathy of prematurity and treated with laser or intravitreal injections.

Objective: To investigate corneal endothelial and ocular biometric parameters in children with retinopathy of prematurity (ROP) treated with intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) or laser photocoagulation.

Design: A retrospective cohort study.

Participants: Seventy-four children with a history of ROP who visited a tertiary hospital between 2016 and 2021; 13 children were treated with laser and 61 with IVI.

Methods: Patients were divided into ROP-laser and ROP-IVI groups. Evaluated parameters included endothelial cell density (ECD), coefficient of variation (CV), hexagonal cell ratio (HEX), central corneal thickness (CCT), refractive status, axial length, anterior chamber depth (ACD), and corneal diameter (CD). The main outcomes were the corneal endothelial and ocular biometric differences between the two groups. A generalized estimating equation was used for comparison.

Results: The ROP-laser group exhibited significantly higher spherical power (p = 0.0019), cylindrical power (p = 0.0060), spherical equivalent (p = 0.0003), and steeper corneal curvature (p < 0.0001) compared to the ROP-IVI group. Conversely, the ROP IVI group had deeper ACD (p = 0.0078), and larger CD (p = 0.0006). ECD was significantly higher in the ROP-laser group (P = 0.0011), whereas CV, HEX, and CCT were similar. Over time, the ROP-IVI group exhibited a greater decrease in ECD (p = 0.0016) and a significant increase in HEX (p = 0.0421). Trends in CV and CCT are similar.

Conclusions: Children treated with laser for ROP had more myopia, steeper corneas, smaller CD, and higher ECD compared to IVI. However, HEX improved more in the ITVI group. The significance of these differences requires further investigation.