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Validation of Enyedi's rule for undercorrection of intraocular lens (IOL) power in children
e42 +0.69 strong, \ +0.4 weak or negative). Subgroup analysis was performed for presence or absence of ROP. Variability of IGF-1 and weights was calculated by standardizing measurements, fitting a linear model, and assessing variability not explained by trend over time. Results: IGF-1 levels and weight were very strongly (n 5 32)/strongly (n 5 17) correlated in 66% of infants. However, the association was weak/negative in 34% of infants. NEC, hydrocephalus, sepsis, PDA, diuretics were unrelated to degree of correlation. Weak correlation was present in 46% of infants without ROP (median, 7 IGF-1 measurements), and 14% of those with ROP (median, 12.5 IGF-1 measurements). Variability among IGF-1 measurements was 0.69 and among weights 0.12. Discussion: While most infants had strong correlation between IGF-1 and weight, a third of infants had poor correlation, which appeared to be due to a combination of higher measurement variability in IGF-1 assays and having fewer measurements. Medical conditions were not a factor. Conclusions: Not all premature infants exhibit strong correlation between IGF-1 and weight. Weight measurements have less variability and may be a more reliable predictor of ROP. 155 Validation of Enyedi's rule for undercorrection of intraocular lens (IOL) power in children. Virender Sachdeva, Sushma Katukuri, Ramesh Kekunnaya Introduction: Initial undercorrection during primary cataract surgery in children is preferred practice done using either Dahan's formula or "Enyedi's rule of seven." The long-term refractive status of these children are largely unknown. The purpose of this study is to analyze the long-term refractive status of the children who have been undercorrected according to Enyedis rule. Methods: Retrospective analysis of records of children (\7 years) who underwent cataract surgery with primary IOL implantation was performed. Main outcome measure was mean postoperativeerative refraction at age of 7 years. Results: 84 eyes of 51 children met the study criteria (18 unilateral and 33 bilateral cases). Mean age at surgery was 3.97 1.57 years. At the age of 7 years, mean refractive error and absolute refractive error for the whole cohort was 0.23 2.0 D and 1.49 1.35 D respectively. 7/84 (8.3%) children achieved emmetropia while an equal proportion were myopic (45%) or hypermetropic (46%). The median refraction at 7 years of age was 0 D (inter-quartile range IQR, 1 D to +1.5 D). There was no significant difference between the three groups in the refraction at seven years (P 5 0.10), ages 0-2: median of +2 D (IQR, 0.5 D to +2 D), ages 2-4: median of +0.375 D (IQR, 1 D to +1.5 D), ages 4-6: median of -0.25 D (IQR, 1 D to +1.25 D). Discussion: Our study is the first to validate the outcomes of the refractive error at age of seven-year in children initially undercorrected by Enyedi's Rule. Enyedi's rule tends to more accurate in children .2 years of age. Conclusions: This study suggests Enyedi's rule may be reliably used to select pediatric IOL power in children; however more studies are needed to validate various methods of undercorrection. 156 Outcome of cataract surgery in children with Down syndrome. Murtaza Saifee, Lingkun Kong, Kimberly G. Yen Introduction: To report the outcomes and complications in children with Down syndrome who have undergone cataract surgery. Methods: Retrospective chart review.
Volume 20 Number 4 / August 2016 Results: A total of 14 patients with Down syndrome who underwent cataract surgery between July 2002 and March 2015 were identified out of 454 patients who had undergone cataract surgery (3.1%) over this time period. Average age at presentation was 19.0 51.5 months (range, 0.1 to 179); average follow-up period was 73.2 54.6 months (range, 8 to 150). 6/14 patients of presented with bilateral congenital cataracts and had bilateral cataract surgery, 3/14 presented with bilateral cataracts but required surgery in only 1 eye, and 5/14 had unilateral cataracts. There were no surgical complications. 10/14 of the patients had congenital cataracts, 3/14 had developmental cataracts, and 1/14 had a traumatic cataract. 1/6 of the bilateral patients and 4/8 of the unilateral patients developed strabismus. One bilateral patient developed a visual axis opacification in the left eye 57 months after initial surgery. Aphakic glaucoma developed in two of the bilateral patients. A total of 8 patients had nystagmus (3/6 of the bilateral patients and 4/8 of the unilateral patients). Only 2/14 patients were able to perform an objective visual acuity at last follow-up. Discussion: Follow-up of children with cataracts and Down syndrome is frequently limited by ability to measure visual acuity due to the patients' developmental status. Nystagmus is present in a high number of these patients, regardless of etiology of the cataract. Conclusions: Cataract surgery in patients with Down syndrome is effective and does not appear to have a higher complication rate than cataract surgery in patients without Down syndrome. 157 Treatment of retinoblastoma tumors with iris diode laser. Julia Sein, Gregg T. Lueder Introduction: Chemotherapy combined with laser application may be used to treat patients with retinoblastoma if globe salvage is possible. We present the clinical findings and outcomes in a sries of such patients. Methods: Retrospective review of patients with retinoblastoma treated with diode laser and systemic chemotherapy. Results: Twenty tumors in 15 eyes (4 small, 6 medium, and 10 large tumors) were treated continuously with diode laser. The power was gradually increased until visible changes were seen. Typically, small tumors whitened within 1-2 minutes. Medium and large tumors became edematous and developed petechial hemorrhages over several minutes. The mean number of laser sessions for small, medium, and large tumors was 2.3, 4.8, and 5.3, respectively. All tumors regressed. Final visual acuity outcomes were better than 20/ 50 in 5 eyes, between 20/60 and 20/200 in 5 eyes, and 20/400 or less in 5 eyes. Discussion: Direct treatment of tumor cells by continuous laser application over several sessions combined with chemotherapy can induce regression of retinoblastoma tumors. Little has been published regarding the specifics of this therapy. We describe the changes that occur in tumors during this treatment. Conclusions: Repetitive continuous diode laser treatment combined with systemic chemotherapy can successfully induce regression of retinoblastoma tumors, with globe salvage and preservation of useful vision. 158 Intermittent exotropia in children: toward a more successful surgical outcome on long term follow-up. Heba M. Shafik, Mohammed A. Eldesouky, Rabab M. Elseht, Molham A. Elbakary Introduction: The study aimed to identify different factors responsible for long term successful surgical outcome for intermittent exotropia in children.
Journal of AAPOS
Volume 20 Number 4 / August 2016 Results: A total of 14 patients with Down syndrome who underwent cataract surgery between July 2002 and March 2015 were identified out of 454 patients who had undergone cataract surgery (3.1%) over this time period. Average age at presentation was 19.0 51.5 months (range, 0.1 to 179); average follow-up period was 73.2 54.6 months (range, 8 to 150). 6/14 patients of presented with bilateral congenital cataracts and had bilateral cataract surgery, 3/14 presented with bilateral cataracts but required surgery in only 1 eye, and 5/14 had unilateral cataracts. There were no surgical complications. 10/14 of the patients had congenital cataracts, 3/14 had developmental cataracts, and 1/14 had a traumatic cataract. 1/6 of the bilateral patients and 4/8 of the unilateral patients developed strabismus. One bilateral patient developed a visual axis opacification in the left eye 57 months after initial surgery. Aphakic glaucoma developed in two of the bilateral patients. A total of 8 patients had nystagmus (3/6 of the bilateral patients and 4/8 of the unilateral patients). Only 2/14 patients were able to perform an objective visual acuity at last follow-up. Discussion: Follow-up of children with cataracts and Down syndrome is frequently limited by ability to measure visual acuity due to the patients' developmental status. Nystagmus is present in a high number of these patients, regardless of etiology of the cataract. Conclusions: Cataract surgery in patients with Down syndrome is effective and does not appear to have a higher complication rate than cataract surgery in patients without Down syndrome. 157 Treatment of retinoblastoma tumors with iris diode laser. Julia Sein, Gregg T. Lueder Introduction: Chemotherapy combined with laser application may be used to treat patients with retinoblastoma if globe salvage is possible. We present the clinical findings and outcomes in a sries of such patients. Methods: Retrospective review of patients with retinoblastoma treated with diode laser and systemic chemotherapy. Results: Twenty tumors in 15 eyes (4 small, 6 medium, and 10 large tumors) were treated continuously with diode laser. The power was gradually increased until visible changes were seen. Typically, small tumors whitened within 1-2 minutes. Medium and large tumors became edematous and developed petechial hemorrhages over several minutes. The mean number of laser sessions for small, medium, and large tumors was 2.3, 4.8, and 5.3, respectively. All tumors regressed. Final visual acuity outcomes were better than 20/ 50 in 5 eyes, between 20/60 and 20/200 in 5 eyes, and 20/400 or less in 5 eyes. Discussion: Direct treatment of tumor cells by continuous laser application over several sessions combined with chemotherapy can induce regression of retinoblastoma tumors. Little has been published regarding the specifics of this therapy. We describe the changes that occur in tumors during this treatment. Conclusions: Repetitive continuous diode laser treatment combined with systemic chemotherapy can successfully induce regression of retinoblastoma tumors, with globe salvage and preservation of useful vision. 158 Intermittent exotropia in children: toward a more successful surgical outcome on long term follow-up. Heba M. Shafik, Mohammed A. Eldesouky, Rabab M. Elseht, Molham A. Elbakary Introduction: The study aimed to identify different factors responsible for long term successful surgical outcome for intermittent exotropia in children.
Journal of AAPOS