Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
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Randomized Controlled Trial Clinical Trial
The use of subtenon ropivacaine in managing strabismus with adjustable sutures.
Squint angle alterations with the use of adjustable sutures after strabismus surgery can be painful. Ropivacaine is a long-acting local anesthetic that, at low doses, produces sensory block with limited nonprogressive motor block. ⋯ Ropivacaine appears to reduce the pain of postoperative suture adjustment without adversely affecting the final outcome, although it does not appear to ease the adjustment itself. This small pilot study shows promising results in postoperative analgesia in these patients, although further larger trials are recommended.
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Nasolacrimal duct obstruction occurs in 5% to 6% of neonates. Many studies advocate the probing of nasolacrimal duct obstruction under general inhalational anesthesia in patients at a late age (12 to 13 months) because a high percentage will resolve spontaneously. Others support early surgical intervention in patients aged younger than 6 to 9 months without anesthesia. We present late nasolacrimal duct probing under intravenous propofol sedation as an alternative approach to the treatment of nasolacrimal duct obstruction with a decrease in cost and time compared with probing under general inhalational anesthesia. ⋯ Late probing for nasolacrimal duct obstruction under intravenous propofol sedation is comparable in efficacy to late probing under general inhalational anesthesia with a shorter time for the procedure and decreased expense.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of increasing doses of levodopa on children with strabismic amblyopia.
The purpose of this study was to determine the efficacy and tolerance of a levodopa/carbidopa combination and to test its dose-effect response when combined with occlusion therapy for children with amblyopia. ⋯ Levodopa, at an average dose of 0.51 mg/kg per day, is well tolerated and produces a clinical and statistically significant short-term improvement of visual acuity in children with amblyopia.
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Trilateral retinoblastoma is a rare and almost exclusively fatal disease. Previous treatment regimens have failed to prolong life once the diagnosis is made. We present the first documented case of a patient with neonatal trilateral retinoblastoma successfully treated with chemotherapy and sequential local retinal treatment who is alive and well 26 months after diagnosis.
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What are the consequences of suddenly legalizing fireworks sales in a largely rural society? Would the spectrum of ocular injuries caused by fireworks differ from those found in the Western world? This is the first study on ocular injuries caused by fireworks conducted in the Republic of South Africa. We analyzed the presenting features and prospectively followed up all patients who presented to the casualties served by our ophthalmic department over the New Year celebrations of 1996-1997. The sale of fireworks to the public had been deregulated the previous year. ⋯ Our findings echo those found in Western countries where fireworks have not been restricted by law. We suggest that young boys, regardless of race, nationality, literacy, or social circumstances, are at risk for ocular injuries caused by fireworks. Countries planning to unban fireworks should aim their education program at this target group.