Visual outcome and refractive status in first 3 years of age in preterm infants suffered from laser-treated Type 1 retinopathy of prematurity (ROP): a 6-year retrospective review in a tertiary centre in Hong Kong.

PURPOSE: To report the visual outcome and refractive status in first 3 years of age in preterm infants suffered from laser-treated Type 1 retinopathy of prematurity (ROP): a 6-year review in Hong Kong DESIGN: Retrospective case series METHODOLOGY: Clinical records of all infants suffered from Type 1 ROP who had undergone laser therapy between 2007 and 2012 were retrospectively reviewed. Basic demographic data, serial changes of refractive error, visual acuity, severity of ROP and laser were analyzed. Correlation with myopia and astigmatism progression, body weight, height, growth and gestational age were also analyzed. RESULT: Among 494 babies screened, 14 Chinese babies (26 eyes) recruited with 1:1 male-to-female ratio in this study. All eyes showed gradual progression of myopia in first 3 years of age but no significant change of astigmatism. Further correlation analysis showed no correlation with laser energy consumed, birth weight (p = 0.14), head circumference growth (p = 0.57) and body weight growth (p = 0.71). However, severity of myopia was related to the post-conceptual age when receiving laser therapy (p < 0.005), gestation age (p = 0.02) and possibly body height growth with age (p = 0.05). CONCLUSION: Myopia in early life is one of the most common ocular sequelae in Type 1 ROP survivors. Early detection of refractive error is important for prompt correction and visual rehabilitation to prevent amblyopia.

Retinopathy of prematurity: applicability and compliance of guidelines in Hong Kong.

OBJECTIVE: To analyse the incidence, application and compliance to Royal College of Ophthalmologists retinopathy of prematurity (ROP) screening recommendations and subsequent treatment of ROP in a neonatal intensive care unit of a large tertiary referral centre in Hong Kong. DESIGN: A retrospective review was performed for all eligible premature neonates screened for ROP over a 7-year period from June 2008 to December 2015 in our local tertiary neonatal intensive care unit in Prince of Wales Hospital, Hong Kong, using the Royal College of Ophthalmologists ROP screening guideline (2008). Comparison between established UK and American screening guidelines were analysed for their applicability in our locality. RESULTS: A total of 602 infants were screened, with the incidence of ROP in 28.2% and type 1 ROP in 3.8%, and indirect diode laser performed in all type 1 ROP cases. Overall, adherence for screening criteria was 99.7%, with the average time to commence first screening at 4 weeks postnatal age. Of the 602 cases, 94 (15.6%) were early and 35 (5.8%) were later than the guidelines, of which only 5 (0.8%) of late-screened cases developed ROP requiring treatment. Subsequent treatment of ROP for all the late-screened cases was not delayed. CONCLUSIONS: Current ROP screening using the UK guidelines (2008) is applicable, effective and safe to our predominantly Asian population in Hong Kong, with a low rate of delayed screening.

Long-term outcome of scleral-fixated intraocular lens implantation.

PURPOSE: Implantation of a scleral-fixated intraocular lens (SFIOL) for the surgical management of aphakia in the absence of capsular support is a safe procedure with a low risk of complications in the early postoperative period. However, data on long-term functional outcome are limited. The purpose of this study is to assess the long-term outcome and complication profile of SFIOL implantation in a cohort of Chinese patients. METHODS: All patients who had undergone primary or secondary SFIOL implantation between 1997 and 2008 were retrospectively reviewed for visual outcomes and complications. Patients' demographic data and information on baseline preoperative visual acuity, indication for surgery, postoperative complications, latest postoperative visual acuity and indication for any subsequent surgical procedures were collected and analysed. RESULTS: 104 eyes of 99 patients (51 males and 48 females) were identified. Mean age at surgery was 67.1 ± 13 years (range 32-88 years), with a mean follow-up of 73.4 ± 43 months (range 12-180 months). 72% of patients had unchanged or improved final postoperative visual acuity. 25 of 104 eyes (24.0%) had postoperative complications, with suture-related complications being the most common. 13 eyes (12.5%) required further procedures for postoperative complications. Suture breakage leading to lens subluxation occurred in two eyes (1.9%). CONCLUSIONS: SFIOL implantation is valuable for the management of aphakia in the absence of capsular support, and our visual outcomes and complication rates are comparable to other case series. The long-term outcomes and safety profile are favourable, but potential long-term suture-related problems should be discussed with the patients before surgery.