Purpose: To evaluate the long-term effects of different degrees of prematurity, retinopathy of prematurity (ROP) and associated perinatal factors on refractive error, accommodation and lens opacification development in adults born preterm aged 18-52 years.
Methods: The Gutenberg Prematurity Eye Study (GPES) investigated adults born preterm and full-term at 18-52 years in Germany to assess refractive error, accommodation amplitude and lens opacification. The participants were grouped into normal gestational age (GA) ≥37 weeks (control group), preterm participants without ROP and GA 33-36 weeks (group 2), GA 29-32 weeks (group 3), GA ≤28 weeks (group 4) and those with ROP without (group 5) or with treatment (group 6). Main outcome measures were refractive error, anisometropia, accommodation amplitude and lens opacification.
Results: In total, 856 eyes of 433 preterm and full-term individuals (aged 28.4 +/− 8.6 years, 242 females) were included. A myopic refractive error of >6 diopter was observed in 4% (11/278), 2.7% (7/264), 1.2% (2/174), 5.6% (2/36), 10.5% (8/78) and 26.9% (7/26) of eyes and anisometropia ≥2 diopter in 2.9% (4/139), 2.3% (3/132), 3.5% (3/87), 11.1% (2/18), 9.5% (4/44) and 38.5% (5/13) of participants in the respective groups. Spherical equivalent did not differ between participants without postnatal ROP born moderately, very and extremely preterm compared to the full-term control group. ROP treatment was associated with lower accommodation and more lens opacifications.
Conclusion: Retinopathy of prematurity treatment using cryocoagulation and laser coagulation increases refractive error associated with increased lens opacifications and reduced accommodation. Preterm delivery has little effect on absolute refractive error but is associated with anisometropia in adulthood.
Keywords: accommodation; birth weight; cataract; epidemiology; gestational age; retinopathy of prematurity.