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Clinical effect of early surgery in infantile exotropia
Hae Jung Paik,Hye Bin Yim 대한안과학회 2002 Korean Journal of Ophthalmology Vol.16 No.2
To evaluate the effects of early surgical intervention in infantile exotropia on the motor and sensory functions, we reviewed the records of 17 subjects diagnosed with exotropia before the age of 12 months, receiving surgery before the age of 24 months, with a follow-up period greater than one year, between 1996 and 2000. Of the 17 subjects (6 intermittent, 11 constant), 14 (82%) (6 intermittent, 8 constant) had a final horizontal deviation of <10 PD, with 3 (18%) needing a re-operation. Fusion and gross binocularity were developed in 7 (4 intermittent, 3 constant), and 11 (6 intermittent, 5 constant) subjects, respectively. Seven subjects developed stereopsis of 200 seconds or better, and 5 of the 6 with intermittent exotropia (83%) being involved. In conclusion, over 80% of the successful alignments were obtained with surgery before the age of 24 months in infantile exotropia, which was similar to previous studies. Furthermore, early surgical intervention, particularly in the intermittent phase, resulted in more effective sensory function.
Measurement of acute pain after eye surgery in children
Hae Jung Paik,Young Mee Ahn 대한안과학회 2002 Korean Journal of Ophthalmology Vol.16 No.2
This study was performed to assess the degree of acute pain in children following eye surgery using a Face Pain Rating Scale (FPRS), with a validity and reliability test employing a Numeric/Word Graphic Rating Scale (NWGRS). The degree of pain was obtained at 2, 4, 6, 8 and 24 hours after surgery using the FPRS and NWGRS. The changes in pain intensities were analyzed using a RM-ANOVA, while the relationship between the FPRS and NWGRS was analyzed by a Pearson coefficient in SPSS/WIN. Two third of the children experienced pain equal to, or greater, than moderate to severe, and about one fifth of the subjects expressed the most severe pain at 2 hours after surgery. At 4 hours after surgery, 95.3% of the children still complained of pain, and 8 hours after surgery, 82.8% of the patients experienced ‘a little bit’ or ‘a little more’ pain or discomforts. At 1 day after surgery, only 34.4% of children were free of pain. A high correlation between the FPRS and NWGRS was identified over 5 time-points (.887 < r < .735). The gender, type of the surgery and past operation experience had no effects on the degree of pain. Our results suggest that FPRS is a reliable and valid measurement for acute pain assessment in Korean children following eye surgery, and warrants application in the integrated clinical protocol, including non-pharmacological and pharmacological management of acute pediatric pain reduction following surgery.