Nutritional strategies and growth in extremely low birth weight infants with bronchopulmonary dysplasia over the past 10 years.

OBJECTIVE: Changes in nutritional strategies over the past decade have been shown to improve postnatal growth in extremely low birth weight (ELBW) infants. We showed 10 years ago that the majority of these ELBW infants with bronchopulmonary dysplasia (BPD) suffer postnatal growth failure. We theorized that recent changes in nutritional support strategies would positively affect growth outcomes in ELBW infants with BPD. STUDY DESIGN: A retrospective study of 88 ELBW infants with BPD. Nutritional data, postnatal growth and BPD severity were compared across three cohorts: (1) weight gain ≤14 g kg(-1) per day, (2) 14.1 to 16 g kg(-1) per day and (3) ≥16 g kg(-1) per day from return to birth weight through discharge. We also compared these to a historical cohort. RESULT: In all, 73% of current subjects grew at or above fetal rates. There was less extrauterine growth restriction (EUGR) by weight and head circumference for those ELBW infants with BPD receiving higher amounts of protein. Aggressive early TPN and receipt of caloric-dense milk seemed to be the 'new' nutritional strategies improving growth for current ELBW infants with BPD compared with those 10 years ago. CONCLUSION: Despite a diagnosis of BPD, improved nutritional strategies have enhanced postnatal growth in infants at high risk for EUGR.

Correlation of laser profilometry scans with clinical results.

BACKGROUND: The homogeneity of the ablation profile of excimer lasers can be disturbed by various reasons. Laser profilometry scans may serve as a preoperative laser quality control if they can be correlated with clinical results. METHODS: Four lasers from different manufacturers were calibrated for normal photorefractive keratectomy. Preoperatively, -3.00 D ablations were performed on a standardized PMMA Exci-Check plate. Two- and three-dimensional surface scans were taken from the PMMA samples. The optical zone and the ablation depth were measured. Surface roughness and regularity of the ablation profile were compared. The PMMA ablation depth was plotted with the postoperative refraction. Surface regularity was correlated to loss of spectacle-corrected visual acuity. RESULTS: The ablation depth on PMMA changed with time in all four tested lasers. For one laser we measured an ablation depth between 6 and 9 microns which we could correlate to a postoperative refraction of -0.50 to +2.00 D at 2 months after PRK. Surface roughness of these different lasers different significantly from each other. Asymmetric ablation profiles produced a loss of spectacle-corrected visual acuity. CONCLUSION: This study indicates there may be a correlation between results of laser surface profilometry scans and clinical outcomes. A more sophisticated quality control than currently available seems possible and is necessary. Laser profilometry (Exci-Check) provided detailed information about the laser and the ablation conditions, and may help to avoid undesirable clinical outcomes from ablation profile irregularities.

Photorefractive keratectomy to treat low, medium, and high myopia: a multicenter study.

This prospective, multicenter study investigated what influence patient age, sex, and time to re-epithelialization after myopic photorefractive keratectomy (PRK) have on stability of achieved correction and intensity of corneal haze. Seven surgeons performed PRK to correct myopia on 325 eyes using the same operative procedure, type of laser, and post-PRK treatment. Follow-up was from six to 12 months. Results indicate that corneal haze intensity is influenced by the time to re-epithelialization of the treated corneal surface. Patient age and sex may also affect haze intensity, although the results from this study were not conclusive.