To compare refractive and biometric outcomes of intravitreal bevacizumab (IVB) and laser photocoagulation for treatment of retinopathy of prematurity (ROP).

All premature infants refered to Rassoul Akram Hospital, from March to September 2013, were considered to enroll this study if exclusion criteria were not met. When treatment was indicated infants were allocated to intravitreal bevacizumab (aggressive posterior ROPs) or laser photocoagulation (others). Cycloplegic refraction and biometry was performed at the first visit and after a corrected postnatal age of 9 months.

Thirty-four neonates including 17 patients (28 eyes) in the IVB group and 17 patients (34 eyes) in the laser groups were studied. GA, BW and corrected age at the end of follow-up was not statistically different between two groups. Baseline prevalence of myopia (SE < -0.5) in IVB group decreased at the end of study (71.04% vs. 35.55%; P= 0.004).. In laser therapy group no significant change in myopia prevalence was observed. (35.55% vs. 38.24%; P=0.36).. Although baseline biometric measurements were similar between the two groups (AL = 16.78 ± 0.45 vs. 17.1 ± 0.71 mm (p=.06), , LT = 3.96 ± 0.22 vs. 4.00 ± 0.17 mm (P=0.42),), eyes treated with IVB demonstrated a larger increase in AL and a larger decrease in LT, yielding significatly longer globes and thinner lenses in eyes treated with IVB ( AL: 20.07±1.16 vs. 19.46±1.02; P=0.037 and LT: 3.78±0.26 vs. 3.99±0.21; P= 0.002).

Refractive outcomes indicates emmetropization continues in both groups, but the development of crystalline lens and vitreous cavity is hampered after laser photocoagulation, while it relatively preserved after IVB injection.