ABSTRACT
PURPOSE: To examine the relationship between the intake of sugar inositol, serum inositol levels, and ROP in three groups of low birthweight infants receiving feedings containing various concentrations of inositol. METHODS: Infants with a birthweight <1500 g, with severe lung disease, were eligible for the study when they began enteral feedings. Infant formulas contained three different inositol concentrations: 2500, 710, and 242 micromol/L. Serum inositol concentrations were averaged over specific time intervals. A logistic regression model was used to investigate the confounding effect of duration of mechanical ventilation and oxygen therapy, birthweight, Apgar score, and serum inositol concentration on development of ROP. RESULTS: Infants receiving high inositol formula and with higher serum inositol concentrations at birth and after 30 days had a statistically significant lower incidence of severe ROP than those receiving the lower inositol formula and with lower serum concentrations (P<.05). The effective serum inositol concentration (EC90) associated with lesser disease was >215 micromol/L. By logistic regression, the odds of developing severe ROP were greater among infants with low serum inositol concentration (odds ratio=4.7, 95% confidence interval 0.90-24.8, P=.017). CONCLUSION: Inositol supplementation may help prevent the most severe form of ROP.
Subject(s)
Dietary Carbohydrates/administration & dosage , Infant Food , Inositol/blood , Retinopathy of Prematurity/blood , Retinopathy of Prematurity/prevention & control , Enteral Nutrition , Gestational Age , Humans , Infant , Infant, Low Birth Weight , Infant, Newborn , Inositol/administration & dosage , Prospective Studies , Retinopathy of Prematurity/etiologyABSTRACT
PURPOSE: Retained lens fragments after cataract surgery is an infrequent, but potentially serious surgical complication. The aim of this study is to evaluate outcomes after vitrectomy has been performed for removal of retained lens material. METHODS: A retrospective review was conducted to evaluate all cases of pars plana vitrectomy for removal of retained lens fragments performed at Wills Eye Hospital from April 1991 through August 1994. RESULTS: A total of 121 eyes of 121 patients underwent pars plana vitrectomy with removal of retained lens material over the 3 1/2-year period. Visual acuity on presentation was 20/200 or worse in 95 eyes (79 percent). Visual acuity after vitrectomy was 20/40 or better in 82 eyes (68 percent). The postoperative visual acuity was 20/50 to 20/400 in 21 eyes (17 percent), and counting fingers or worse in 18 eyes (15 percent). Nineteen eyes (16 percent) had retinal detachment (RD), 8 were noted at the time of vitrectomy and 11 occurred after vitrectomy. Of the 19 eyes with RD, visual acuity was 20/200 or worse in 12 (63 percent) and counting fingers or worse in 6 (32 percent) at the time of last follow-up. The use of posterior segment phacofragmentation was associated with higher rate of RD, but the difference did not reach statistical significance. Major causes of poor final visual outcome included RD (6 eyes), cystoid macular edema (4 eyes), and glaucoma (2 eyes). CONCLUSION: The timing of vitrectomy did not have a statistically significant impact on visual outcome. Neither the type of intraocular lens nor the timing of lens implantation significantly altered the final visual acuity. Most eyes with retained lens fragments do well after vitrectomy, with the majority recovering good vision. However, the risk of RD is increased, and visual outcome may be adversely affected if RD occurs.
