Retinopathy of Prematurity and Surfactant Treatment

Abstract
Surfactant therapy in premature infants has reduced the severity of respiratory distress syndrome (RDS), thus leading to a reduction in mortality. However, the anticipated effect of surfactant therapy on the incidence and severity of retinopathy of prematurity (ROP) is ambiguous. The acute rise in PaO2 and the increased survival of low-birth-weight infants may augment the risk of ROP, whereas their improved health and respiratory status may lower it. We reviewed the findings of sequential ophthalmologic examinations performed in our neonatal intensive care unit. Premature infants of gestational age under 32 weeks and weighing less than 1500 g at birth who received surfactant treatment were compared with a group of historical controls consisting of premature infants of the same mean birth weight and gestational age who did not get this supplement. ROP was present in 13 (65%) of the 20 surfactant-treated babies, and threshold disease was noted in six (30%). In the historical control group, 20 (77%) of 25 infants had ROP, of whom 10 (40%) were treated for threshold disease. These differences were not statistically significant. Surfactant therapy was not associated with an increased incidence of ROP in our series.