PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes. [8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy.[3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others. [4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy.[3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy.[3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy.[3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy. [3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP. [6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy.[3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy.[3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy.[3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.PURPOSE: The purpose of this study was to assess the refractive outcomes of patients who underwent indirect laser photocoagulation for prethreshold type 1 retinopathy of prematurity (ROP) and high-risk type 2 prethreshold ROP in comparison to conservatively managed low-risk prethreshold type 2 ROP. A retrospective analysis was carried out on infants screened for ROP between the years 2015 and 2020. Surviving children who had developed ROP in one or both eyes and received diode laser photocoagulation and those with conservatively managed regressed type 2 ROP who underwent at least one cycloplegic retinoscopy were included in the study. A total of 144 patients were screened for ROP between 2015 and 2020 at our institution. One hundred and thirty patients (260 eyes) fulfilled the study criteria and were included in this study. The treated group consisted of 132 eyes of 66 infants, of which 38 (14.6%) eyes had prethreshold type 1 ROP while 94 (36.2%) eyes had high-risk prethreshold type 2. The nontreated control group consisted of 128 (49.2%) eyes of 64 infants with low-risk type 2 prethreshold ROP. Earlier prematurity was found to be a significant determinant of the mean change in spherical equivalent among different gestational age groups (P = 0.035). In our cohort, we found that myopia is significantly related to Zone II ROP in comparison to Zone III ROP in the treated eyes (22% vs. 9%) (P = 0.002). No statistically significant difference was found in the final refraction among the treated eyes in relation to the birth weight or stage of prematurity. In the present study, the majority of patients who were treated with diode laser for ROP had favorable anatomical and refractive outcomes. In contrast to previous studies that had suggested a trend toward myopia in laser-treated patients, in our study, the majority (71%) were hyperopes. This study suggests that other factors such as the stage and zone of ROP possibly contribute more to the development of myopia than the laser photocoagulation itself. Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder affecting primarily premature infants and was rendered a leading cause of preventable severe visual impairment in childhood worldwide.[1,2] A rise in the global incidence of ROP has been noted and is attributed to the advancements in neonatal care leading to higher survival rates of premature infants.[3] Several risk factors have been implicated in ROP patients; these include, but are not limited to, gestational age (GA), low birth weight (LBW), hypoxia, oxygen supplementation, respiratory distress syndrome, and many others.[4,5] In line with the findings of the Early Treatment for ROP (ETROP) study, indirect laser photocoagulation has now replaced cryotherapy as the standard treatment for retinal ablation of high-risk prethreshold type 1 ROP.[6] The ETROP study provided guidelines for laser treatment of ROP patients who fit the the following criteria of type 1 ROP which include patients with Zone I, any stage with plus disease; Zone I Stage 3 without plus disease; and Zone II with Stage II or III ROP and plus disease.[7] Both retinal cryotherapy and laser photocoagulation are two modalities that successfully aid in managing active ROP cases via ablating the avascular retinal areas, with the latter surpassing cryotherapy as the standard due to its many advantages including better structural and functional outcomes.[8,9] At 10-year follow-up, eyes treated with laser photocoagulation had better visual and anatomical outcomes compared to those treated with cryotherapy treatment.[10] They have both been implicated in causing higher levels of myopia, although laser therapy has been associated with lower degrees of myopia in comparison to cryotherapy. [3,10,11] The current study focuses on the effect of indirect laser photocoagulation for patients with earlier than prethreshold type 1 ROP and prethreshold type 1 ROP in terms of refractive changes and visual outcome in comparison to conservatively managed regressed prethreshold ROP patients. The study was conducted following approval by the Institutional Review Board of King Fahad Armed Forces Hospital. This research was performed in a retrospective case-control manner.