Safety and Efficacy of Corneal Cross-linking in Pediatric Patients with Keratoconus and Vernal Keratoconjunctivitis.

PURPOSE: The purpose of the study is to determine the safety and efficacy of corneal collagen cross-linking for keratoconus in pediatric patients with and without vernal keratoconjunctivitis (VKC). METHODS: This is a retrospective analysis of 89 eyes of 58 patients <18 years of age that underwent corneal collagen cross-linking for progressive keratoconus; inclusion criteria included a minimum of 2-year follow-up after cross-linking. The main outcomes measures included keratometry, pachymetry, vision, and complications following epithelial-off cross-linking with the Dresden protocol. RESULTS: VKC patients were more likely to be male; 81.6% of the non-VKC patients and 96.3% of VKC patients were male (P = 0.038). Comparing pretreatment to the 2-year follow-up, there was no statistically significant change in the mean steep or flat keratometry, corneal thickness, and uncorrected visual acuity or best spectacle-corrected visual acuity in either group. There were no statistically significant differences in the mean visual, keratometric, or adverse event outcomes between the two groups. The proportion exhibiting progression of ectasia at 2 years was 18.5% in the VKC group and 16.7% in the non-VKC group (P = 0.83). CONCLUSIONS: Cross-linking appears to be as safe and effective in pediatric patients with vernal keratoconjunctivits as in those without, with similar outcomes, adverse events, and progression of keratoconus after treatment. The proportion of patients exhibiting progression appears to be higher in pediatric patients than adults, and there is an association between male sex and diagnosis of VKC.

Burnout during ophthalmology residency training: A national survey in Saudi Arabia.

PURPOSE: The aim of this study is to identify burnout prevalence among ophthalmology residents and the predisposing factors associated with higher levels of burnout. METHODS: A cross-sectional study was conducted on all ophthalmology residents in Saudi Arabia using Maslach Burnout Inventory in January 2018. Associations between Emotional Exhaustion scores and other continuous variables were evaluated using Spearman's correlation coefficients. Logistic regression model was constructed, and results were reported as odds ratios with 95% confidence intervals. The significance level was set at p < 0.05. RESULTS: A total of 117 residents responded to the survey with a 70% response rate. The response rate was above 65% for each training programs by region. 41% of ophthalmology residents scored a positive burnout result on the common subscales (Emotional Exhaustion and/or Depersonalization). Further sub-analysis of data showed positive Spearman's correlation with number of call days per month and EE subscale (r 0.195). Multivariate logistic regression of the sample yielded significant results with satisfaction with work/life balance and choosing medicine again as a graduate level major p ≤ 0.05. The regression model also showed the Southern program had significantly higher burnout on the common subscales p ≤ 0.05. CONCLUSIONS: Prevalence of burnout among ophthalmology residents was lower when compared to plastic surgery and otolaryngology residents in Saudi Arabia. Work hours and on call days were associated with higher burnout. Actions must be taken to ensure that all training programs implement work hour limitations. Special attention should be given to the Southern region program due to its significantly higher levels of burnout.