Objective: To assess the efficacy of diode laser photocoagulation for prethreshold retinopathy of prematurity (ROP) in zone I.

Methods: We considered ROP in zone I that having avascular retina presenting at least 30 degrees of circumferential extent in that zone (centered in the optic disk with a radius of twice the distance from disk to fovea). The avascular retina was photocoagulated with diode laser if ROP showed <> disease in junction with any zone of fibrovascular proliferation (prethreshold stage). Noncontiguous applications were used.

Results: 10 eyes from 5 infants were treated, obtaining a total regression of the disease in 100% of them. All the children were followed for at least 12 months. In the postoperative period a transitory worsening of proliferation was noted in 70% of eyes, sometimes with formation of <> in the temporal retina (60% of eyes). There were no complications derived from this treatment.

Conclusions: Diode laser photocoagulation is highly effective and safe in the treatment of pretheshold ROP in zone I, and we strongly recommend this new strategy for its management.