[Congenital nasolacrimal duct obstruction and its risk factors in premature neonates]

To determine the frequency of congenital nasolacrimal duct obstruction [CNLDO] in premature newborns and its correlation with gestational age [GA], sex, family history and chronological age. This study was performed on infants who were referred for retinopathy of prematurity from 2002 to 2003. Cases of CNLDO were visited again three and six months later. This study was conducted on 60 preterm infants [26 male, 34 female] with gestational age of 33.2 +/- 1.3 weeks [range 25-36] and age of 3.8 +/- 0.9 months [range 1.5-6] at first presentation, of which 13 had CNLDO [9 unilateral and 4 bilateral]. Overall, 17 out of 120 ducts [14.1%] were obstructed. There was no correlation between CNLDO and sex, family history or gestational age. Three months later 58.4% of the obstructions were cleared and at the 6 month visit, 25% of residual obstructions were cleared, such that the total remission rate at 6 months was 83.4%. In premature newborns with CNLDO, the rate of spontaneous clearing of the obstruction is greater than 80% during the first 6 months

[Levator aponeurosis resection versus Muller's muscle-conjunctival resection for the correction of minimal blepharoptosis]

Purpose: to compare the results of levator aponeurosis resection and Muller's muscle-conjunctival resection in the correction of minimal blepharoptosis

Methods: this randomized controlled study was conducted on 20 patients with minimal ptosis [<2 mm and >1 mm] and good levator function [>10 mm] which were assigned to one of two surgical groups: levator aponeurosis resection group or Muller's muscle-conjunctival resection group. Patients were visited on days 1, 3, 7, and 14 and at months 1, 2, 3, and 6, postoperatively to evaluate the symmetry, lid contour, lid crease position, lagophthalmos, lid lag, suture keratopathy, and dry eye

Results: postoperative symmetry was found in 8 cases in both group. Lid crease position symmetry was found in 9 and 5 cases in levator and Muller groups, respectively [P= 0.23 5]. Lid lag was found in 7 cases of levator group [mean= 1.15 mm] and 3 cases of Muller group [mean= 0.5 mm] [P= 0.123]. Mean lagophthalmos was 1.75 mm and 1.15 mm in levator and muller groups, respectively [P= 0.749]. No patient had abnormal contour, suture keratopathy, or dry eye symptoms or signs. Exposure keratopathy occurred in 2 cases of each group

Conclusion: Muller's muscle-conjunctival resection is at least effective as levator aponeurosis resection in correcting minimal blepharoptosis in patients with good levator function and symmetric lid crease