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Purpose: We aimed to identify the risk factors that may predispose preterm neonates to develop aggressive posterior retinopathy of prematurity (APROP). Methods: This retrospective case control study included 16 infants with APROP in zone 1 or posterior zone 2. Thirty-four gestational age and birth weight-matched controls with stage 2 or less ROP were included. We reviewed medical records on infant birth and postnatal characteristics. Results: Patients who developed APROP had a significantly longer duration of caffeine therapy, were significantly more likely to be small for gestational age (SGA), and were more likely to have a positive blood culture than patients who developed less severe ROP. Patients with APROP who required retreatment had received inotropes for a longer duration of time, had received more plasma transfusions, were more likely to have IVH, and had a greater decrease in the serum hemoglobin during hospitalization. Conclusion: Being SGA, receiving caffeine for a longer duration, and having culture-proven sepsis were associated with APROP. IVH, a low serum hemoglobin, the need for more plasma transfusions, and a longer duration of inotropes were associated with APROP which required retreatment. [ABSTRACT FROM AUTHOR]

Purpose: To compare the accuracy of IOL power calculation formulae in a large cohort of children who underwent IOL implantation. Setting: Cairo University Children Hospital. Design: Retrospective, case series. Methods: A retrospective chart review of all children < 14 years, who underwent primary or secondary IOL implantation in Cairo University Children Hospital from January 2016 to December 2019, was performed. Absolute prediction error (APE) was calculated for SRKII, SRK/T, Holladay I and Hoffer-Q formulae using the patients' AL, keratometric (K) readings, implanted IOL power and refraction done two months postoperatively. Results: The study included 308 eyes of 255 patients with a mean age of 4.74 ± 3.19 years at the time of surgery. The mean K-reading was 43.42 ± 3.57 diopters (D) and mean AL was 22.01 ± 1.93 mm. The percentage of eyes with APE within 0.5D was 27.7% (85 eyes), 32.2% (99 eyes), 30.6% (94 eyes) and 25.4% (78 eyes) with SRK II, SRK/T, Holladay I and Hoffer-Q formulae, respectively. APE was significantly lower with the SRK/T formula (P≤ 0.004) and significantly higher with the Hoffer-Q formula (P≤ 0.002). There was a negative correlation between the age of the patient and the APE of the SRK II formula (P=0.02). Moreover, the SRK/T, Holladay and Hoffer-Q formulae APEs were affected by the average k-readings (P=0.019, 0.005 and 0.035) respectively. Conclusion: The SRK/T and Holladay I formulae were the most predictable formulae in IOL power calculation in pediatric eyes. [ABSTRACT FROM AUTHOR]

Purpose: To compare results of sutureless transscleral intraocular lens (IOL) fixation to retropupillary iris‐claw lens implantation in cases of paediatric aphakia without capsular support. Methods: Thirty eyes of children with insufficient capsular support for IOL implantation were randomized to undergo sutureless transscleral IOL fixation or iris‐claw lens fixation. The primary outcome was best‐corrected visual acuity (BCVA). Secondary outcomes included operative time, astigmatism, central corneal thickness, endothelial cell count (ECC), IOL decentration and tilt, central foveal thickness and complications. Results: There was a significant improvement in BCVA at all follow‐up visits, with no significant difference between both groups. 53.3% in the transscleral‐fixated IOL group and 80% in the iris‐claw IOL group had a final BCVA ≥0.3. The operative time was significantly shorter in the iris‐claw IOL group (p = 0.001). IOL decentration and tilt were higher in the transscleral‐fixated IOL group, but the difference was not significant. The ECC was reduced by 14.6% in the transscleral‐fixated IOL group and 11% in the iris‐claw group at 6 months, with no significant difference between both groups (p = 0.5). In the transscleral‐fixated IOL group, two eyes developed ocular hypertension and two eyes had IOL decentration, while in the iris‐claw IOL group, 1 eye developed glaucoma, three eyes had haptic disenclavation, and one eye had retinal detachment. Conclusion: Both techniques yielded a comparable visual outcome. Retropupillary iris‐claw lens fixation is a shorter procedure and technically easier than sutureless transscleral fixation, but the risk of disenclavation should be considered especially in younger age groups. Scleral fixation is the only option in case of severe iris damage, but may be associated with more endothelial cell loss. [ABSTRACT FROM AUTHOR]