| 3 | AB032.The effect of eyemasks on reducing stress associated with retinopathy of prematurity screening显示文摘Background:Retinopathy of prematurity(ROP)is a disorder of retinal development in the low birthweight preterm infant.Eye screening is routinely performed for infants at risk of developing this disorder.While these examinations help prevent blindness,they can be physiologically stressful for infants,with changes in oxygen saturation,blood pressure and heart rate occurring during the exam and increased apneic episodes reported the 24-48 hours period afterward.The cause of these increased apneic episodes is not currently known.Our Background is to evaluate the effect of decreasing light simulation during mydriasis using an eye mask on the frequency of stressful episodes after ROP screening.Methods:Multi-centre randomized clinical study.This study was approved by hospital ethics boards at all sites.After informed consent was obtained,infants with a birthweight<1,500 g or gestational age of≤32 weeks and scheduled for their first ROP screening were randomized to receive either standard of care or a phototherapy mask during pupil dilation in addition to routine care.Dilated retinal exams were performed by retinal surgeons and fellows.The primary outcome was the frequency of any desaturation,bradycardic event,or apneic event 12 hours following the examination,compared to a baseline rate 12 hours prior to the exam.Heart rate,respiratory rate and oxygen saturation were recorded for up to 48 hours following the examination and compared to baseline.Results:A total of 51 infants were examined;28 randomized to the masked group and 23 to the control group.Ten and 13 infants were on ventilator support at the time of examination in each group,respectively.There was a 57.7%decrease in the total number of all stressful events in the masked group compared to controls in the 12-hour post exam period(rate ratio 0.42,95%CI,0.2-0.9,P=0.024).There was a 61.3%decrease in the number of bradycardic events in the masked group compared to controls(RR 0.39,95%CI,0.2-1.0,P=0.042).Heart rate was significantly higher in both groups after the exam(Mean HR:164.67 bpm post vs.157.3 bpm pre;P=0.04),with no difference in between groups(Effect by group P=0.31).There was no significant difference seen in either group in respiratory rate or oxygen saturation at 2 or 4 hours after the ROP examination compared to baseline.Risk factors that were associated with increased stress included younger gestational age(RR=1.3295%CI,1.2-1.5 per week),lower birthweight[RR=1.39(1.2-1.5)per 100 g],ventilator support around the time of exam[RR=2.67(1.3-5.6)],diagnosis of intraventricular hemorrhage[RR=3.78(1.9-7.3)],and hyponatremia[RR=3.42(1.8-6.6)].No adverse events occurred while using eye masks.Conclusions:The infants who wore a phototherapy mask during pupillary dilation had lower rates of stressful episodes following screening for retinopathy of prematurity,particularly lower episodes of bradycardia. | Andrei-Alexandru Szigiato Matthew Speckert Jeanne Zielonka Kathleen Hollamby Mary Debono Filiberto Altomare Eugene Ng Rosane Nisenbaum Michael Sgro | 2018 | Annals of Eye Science2018，，1： | 0 |
| 4 | AB075.Population trends in adult strabismus surgery显示文摘Background:To review the trends in adult strabismus procedures in Ontario from 2000-2014.Methods:A population based,retrospective data analysis was conducted.Ontario Health Insurance Plan billing claims for strabismus procedures were collected and subdivided by number of muscles repaired,the use of adjustable sutures and repeat procedures,adjusted by the total adult population.The number of Ophthalmologists performing adult strabismus surgery was also analyzed,subdivided by high volume and low volume surgeons.Results:From 2000-2014,per 100,000 adult population,the number of total strabismus surgeries in Ontario increased 29.1%;single muscle surgery increased 25.0%,two muscle surgery increased 46.3%,and three or more muscle surgeries increased 8.3%.During the study period,strabismus procedures using adjustable sutures increased 26.1%and repeat procedures increased 65.1%.The number of surgeons performing adult strabismus surgery decreased 21.7%from 2000-2014.In 2014,88.4%of surgeries were performed by 29.8%of all of surgeons who performed adult strabismus surgery.Conclusions:From 2000-2014,more strabismus surgery was performed in adults by fewer surgeons from 2000-2014.The number of adult strabismus surgeries in Ontario increased since 2000,including procedures using adjustable sutures and repeat procedures.These changes may be due to increases in healthcare funding and an increased awareness of the functional and psychosocial benefits of strabismus surgery. | Andrei-Alexandru Szigiato Meggie Caldwell Yvonne M.Buys Stephen P.Kraft Kamiar Mireskandari | 2018 | Annals of Eye Science2018，，1： | 0 |
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