The Results of Cross-Linking With Riboflavin/UV-A in Patients With Progressive Keratoconus

Özet

Objective: To evaluate the results of corneal cross-linking with UV-A/riboflavin in patients with progressive keratoconus.Methods: Forty-seven eyes of 30 patients with progressive keratoconus (16 female, 14 male) were included in the study. Uncorrected and the best corrected distance visual acuities, biomicroscopic findings, intraocular pressure measurements, fundoscopic findings, pachymetric measurements and corneal topography parameters were recorded for each patient.Results: The mean age of the patients was 18.3±5.34 (range: 8-31) years and the mean follow-up duration was 7±2.4 (range: 3-12) months. Following the procedure, the mean decrease in K1, K2, Kav, spherical and cylindrical values were 0.77 D, 0.85 D, 0.80 D, 0.50 D and 0.74 D, respectively (p<0.05). There were no cases with decrease in visual acuity and significant complication during or after the treatment.Conclusion: Cross-linking with riboflavin/UV-A in patients with progressive keratoconus is an effective procedure. In addition, the preservation of visual acuity and not seen a significant complication indicate that a safe metod. However, large prospective randomized controlled studies are needed to evaluate the long-term effects of this treatment.Key words: corneal cross-linking, keratoconus, corneal topography

Abstract

Objective: While there are suggestions for oral hydration times after general anesthesia, there is no published study with regard to sedation. The aim of this prospective study was to determine a safe time for oral intake after pediatric sedation and its association with nausea and vomiting after discharge.Methods: A total of 180 children (aged 1 month to 13 years) sedated for magnetic resonance imaging were randomly assigned into three groups. All patients fasted for 6 hours and were allowed to take clear fluids until 2 hours before sedation with thiopental (3 mg/kg). After the patients were transported to the recovery room, we allowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the patients met the discharge criteria for group II, and 2 hours after the patients met the discharge criteria for group III. All patients were assessed for vomiting in the recovery room until 1 hour after their first oral hydration. The parents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospital admission.Results: There were no statistically significant intergroup differences with respect to age, sex, weight, or the ASA status. There was no nausea and vomiting in either the recovery or post discharge period in any group. In the telephone questionnaire, no hospital admissions were reported.Conclusion: Oral hydration just before discharge is safe, and fasting children after discharge for a period of time is unnecessary for patients sedated with thiopental.Key words: Sedation, oral intake, postoperative nausea and vomiting