Journal of Aapos最新文献

Purpose

Methods

Results

Conclusions

Eye injuries from sports, activities, and work are a leading cause of vision loss in youth. Most eye injuries can be prevented with protective eyewear. An open-ended survey on youth perspectives on eye trauma and protection was administered to the MyVoice Text Message Cohort of US youth ages 14-24 years. Qualitative, text message responses were coded using thematic analysis. The survey was distributed to 798 recipients; 641 (80.3%) responded. Many youth were concerned about the impact of excessive screen use (n = 278 [43.8%]) and sunlight or UV exposure (n = 239 [37.6%]) on their eye health. Fewer were concerned about injury from sports and activities (n = 115 [18.1%]) or job-related eye risks (n = 77 [12.1%]). The most common actions that youth took to protect their eyes included sun protection (eg, sunglasses; n = 300 [47.2%]), refractive correction (eg, glasses, contacts; n = 195 [30.7%]) and screen protection (eg, blue light blocking glasses; n = 159 [25.0%]). Fewer wore eye protection for sports or activities (n = 54 [8.5%]) or work (n = 41 [6.5%]). Youth concerns about eye injury from screens and sunlight are misaligned with the main causes of vision loss in this population, suggesting that public health education is needed to promote optimal eye safety.

Congenital disorders of glycosylation type I (CDG-I) are a group of autosomal recessive genetic multisystem disorders that arise from defective glycoprotein biosynthesis. Although ocular abnormalities have been described in patients with CDG-I, few ocular abnormalities have been associated with ALG12-CDG (CDG-Ig), a rare subtype of CDG-I. We report a case of Duane syndrome, a congenital strabismus syndrome, in a 17-year-old young woman with ALG12-CDG.

Purpose

To compare the efficacy of bilateral lateral rectus recession with vertical tendon transposition (LRVT) and LRVT combined with inferior oblique (IO) disinsertion for V-pattern exotropia.

Methods

The medical records of patients who had mild-to-moderate (+1 and +2) inferior oblique overaction (IOOA) and underwent half-tendon-width upward LRVT (transposition group), and LRVT with IO disinsertion (combined surgery group) for V-pattern exotropia and who had at least 3 years of postoperative follow-up were reviewed retrospectively.

Results

A total of 45 patients were included: 22 in the transposition group and 23 in the combined surgery group. Preoperatively, there were no differences in V pattern, IOOA, or horizontal misalignment in primary position, upgaze, or downgaze between groups. The amount of exotropia in the primary position was 30.2^Δ ± 10.7^Δ in the transposition group, and 31.6^Δ ± 14.1^Δ in the combined surgery group (P = 0.974). A significant decrease in V pattern was observed in the combined surgery group and the transposition group at 6 months and 3 years postoperatively (P < 0.001). The reduction of V pattern in the combined surgery group at 6 months (20.2^Δ ± 7.8^Δ vs 15.6^Δ ± 6.9^Δ [P = 0.02]) and 3 years (20.1^Δ ± 8.1^Δ vs 15.2^Δ ± 7.1^Δ [P = 0.014]) was found to be greater than the transposition group. There were no differences in the success rate in the primary position at 6 months (P > 0.05).

Conclusions

Both tendon transposition with horizontal rectus surgery and combined tendon transposition and IO-weakening surgery decreased V-pattern exotropia. However, combined surgery had a greater effect on decreasing V pattern in patients with mild-to-moderate IOOA.

Purpose

A method was developed to measure strabismic angles >50^Δ by stacking commercially available Fresnel and block prisms in the same direction (“piggyback prisms”).

Methods

With a laser pointer (wavelength of 532 nm) as the light source, the deviation of the laser spot produced by the stacked prisms was measured on a tangent screen placed 100 cm away from the prisms. To the obtained data with combinations of Fresnel prisms (5^Δ-40^Δ) and block prisms (10^Δ-50^Δ), a cubic surface function was fitted by polynomial regression.

Results

The combined effect of stacked prisms was always greater than the arithmetic sum of the labeled values of two prisms (by up to 66^Δ), increasing exponentially with each prism power and reaching the maximum of 156^Δ for the Fresnel/block combination of 30^Δ/50^Δ. We obtained contour plots to evaluate the optically induced additivity error and constructed look-up tables for quickly determining the combined effect of the prisms based on their labeled values.

Conclusions

Stacking prisms is a practical method to evaluate a large strabismic angle that cannot be measured by any single prism and is especially useful in dealing with severely paralytic strabismus.

Purpose

To evaluate the outcomes of a novel modification of the Nishida procedure with medial rectus recession (Nishida-MRc) for myopic strabismus fixus (MSF) and to compare this modified procedure with the half Jensen’s union with medial rectus recession (U-MRc).

Methods

The medical records of MSF patients who underwent strabismus surgery at a single institution between January 2017 and June 2022 were retrospectively reviewed. The main outcome measures assessed were postoperative improvements in ocular alignment and motility. Surgical success was defined as horizontal and vertical deviations ≤15^Δ.

Results

A total of 45 patients were included, of whom 39 had no previous strabismus surgery. All but 3 had follow-up ≥8 months. Nishida-MRc, with or without a traction suture (Ts), had a success rate (9/16 [56%]) higher, though not statistically significantly so, than U-MRc with or without Ts (11/29 [38%]). The Nishida-MRc group tended to have less frequent use of Ts (25% vs 52%; P = 0.076), and 94% of these patients had a deviation within 20^Δ, compared with 59% for U-MRc (P = 0.012). In cases with esotropia of ≥123^Δ, final residual esotropia in the Nishida-MRc without Ts (12.40^Δ ± 8.30^Δ) and U-MRc-Ts (19.75^Δ ± 18.62^Δ) groups was significantly lower (P = 0.019) than in the U-MRc without Ts group (63.40^Δ ± 40.83^Δ), and the average correction of esotropia was significantly greater (P = 0.014).

Conclusions

In our study cohort, Nishida-MRc produced a greater effect in the treatment of MSF than U-MRc.

Purpose

To determine whether extremely premature infants require screening for retinopathy of prematurity (ROP) if <31 weeks’ postmenstrual age (PMA).

Methods

The medical records of infants born in community hospital settings at <31 weeks’ gestational age (GA) were reviewed retrospectively. Prevalence and progression of ROP in infants born at <24 weeks’ GA were compared with infants born at 24-30 weeks’ GA.

Results

A total of 2,061 records were reviewed: 1,969 infants were born at 24-30 weeks’ GA; 92, at <24 weeks. Infants born <24 weeks’ GA were more likely to develop pre-plus and plus disease or require treatment than infants born 24-30 weeks’ GA (P < 0.0001) and did so earlier (P = 0.0001). Eight infants developed pre-plus or greater ROP <31 weeks’ PMA; 6 were born <24 weeks’ GA. Three infants developed plus disease or required treatment <31 weeks’ PMA, the earliest at 27 and 3/7 weeks.

Conclusions

Clinicians should consider initiating ROP screening examinations before 31 weeks’ PMA, particularly for infants born <24 weeks’ GA and those with lower birth weights.

Background

Pediatric aphakia may be treated conservatively with aphakic contacts or spectacles. Many families and surgeons opt for a secondary intraocular lens (IOL) when the child is older. In certain situations, pediatric aphakic patients must undergo implantation earlier than planned. The purpose of this study was to investigate how often and why early implantation occurs.

Methods

We retrospectively reviewed the medical records of consecutive patients who were left aphakic after cataract surgery in infancy and were seen at our institute at ≥4 years of age. Early implantation was defined as occurring at <4 years of age.

Results

A total of 175 patients fit inclusion criteria. We found that 22 of 90 patients (24%) with unilateral cataracts had undergone early secondary IOL implantation before 4 years of age compared to 10 of 85 patients (12%) with bilateral cataracts, a statistically significant difference in the relative risk of early implantation (OR 2.43 [95% CI 1.07-5.49]). Of our patients undergoing early implantation, 15 of 31 (44%) had Medicaid as the primary insurance provider, which is representative of the practice overall. In patients requiring early implantation, failure with contact lens accounted for 26 of 32 cases (81%), with 7 of 26 (27%) of these failures attributed to nonmedical reasons.

Conclusions

Of the factors we analyzed, only the presence of unilateral aphakia was associated with increased risk of early IOL implantation in our study cohort.