Refraction changes in infantile esotropia

Infantile esotropia is a large angle esodeviation that presents within the first year of life. It represents the most common form of strabismus, with an incidence of 1 to 2%. Although the accepted treatment for this entity is by surgical alignment of the eyes, the refractive changes in infantile esotropes and their implications on the outcome has not been adequately studied. A series of 90 cases diagnosed as infantile esotropia collected from the pediatric Ophthalmology department between 1997 and 2001 were studied retrospectively to investigate the refractive state following the initial management and its effect on the ocular alignment and the outcome of therapy. The follow-up period ranged from three to seven years. Out of the 90 patients, 34 patients [37.7%] showed significant refractive error changes after initial surgical alignment that needed further correction. Among these, 25 were fully corrected with glasses and the remaining nine patients needed second surgical interference. On the other hand, 56 patients [62.2%] showed stability of refraction with no further interference. The previous findings lead to conclude that surgical alignment alone does not give the final security for infantile esotropes and that later refraction changes should not be underestimated as it may influence the outcome

Experience with 122 consecutive liver transplant procedures at king Faisal specialist hospital and research center

Saudi Arabia is a leading country in the Middle East in the field of deceased-donor liver transplantation [DDLT] and living-donor liver transplantation [LDLT]. We present out experience with DDLT and LDLT at King Faisal Specialist Hospital and Research Center [KFSHRC] for the period from April 2001 to January 2007. We performed 122 LT procedures [77 DDLTs and 45 LDLTs] in 118 patients [4 re-transplants] during this period of time. The number of adult and pediatric procedures was 107 and 11, respectively. The overall male/female ratio was 66/52 and the median age of patients was 43 years [range, 2-63 years]. In the DDLT group, the median operating time was 8 hours [range, 4-19], the median blood transfusion was 6 units [range, 0-40], and the median hospital stay was 13 days [range, 6-183]. In the DDLT group, after a mean follow-up period of 760 days [range, 2-2085], the overall patient and graft survival rate was 86%. In the LDLT group, the median opera ting time was 11 hours [range, 7-17], the median blood transfusion was 4 units [range, 0-65], and the median hospital stay was 15 days [range, 7-127]. In the LDLT group, and after a mean follow-up period of 685 days [range, 26-1540], the overall patient and graft survival rates were 90% and 80%, respectively with no significant difference in patient and graft survivals between groups. Biliary complications were significantly higher in LDLT compared to DOLT [P<0.05]. Vascular complications were also significantly higher in LDLT compared DDLT [P<0. 05]. Both DDLT and LDLT are being successfully performed at KFSHRC with early experience indicating a higher rate of biliary and vascular complications in the LDLT group