PurposeTo assess the 3-year safety and efficacy of femtosecond laser-assisted intrastromal corneal ring segments' (ICRS) implantation followed or accompanied by transepithelial accelerated corneal collagen cross-linking (TE-ACXL) as a treatment of keratoconus in children with vernal keratoconjunctivitis (VKC).Patients and methodsFifty two eyes of 28 children with keratoconus and vernal VKC were included in this study. Cases were divided into 2 groups; the first group had been treated with femtosecond laser-assisted ICRS (Keraring) implantation accompanied or followed by TE-ACXL, while the second group had been treated by TE-ACXL only and all cases completed a follow-up period of 3 years.ResultsIn group 1: the mean uncorrected (UCVA) and best-corrected (BCVA) visual acuity, spherical equivalent, K-max and Q-value improved markedly from 0.97 ± 0.19, 0.67 ± 0.18, −8.75 ± 4.55, 60.41 ± 4.98, and −1.18 ± 0.54 preoperatively to 0.61 ± 0.27, 0.39±0.21, −3.25 ± 3.56, 55.22 ± 5.72, and −0.44 ± 0.68 postoperatively respectively. While in group 2: the preoperative mean UCVA, BCVA, spherical equivalent, K-max and Q-values were 0.68 ± 0.28, 0.38 ± 0.24, −2.84 ± 2.59, 50.29 ± 4.04, and-0.58 ± 0.23 respectively while their corresponding postoperative values were 0.58 ± 0.34, 0.19 ± 0.17, −2.35 ± 2.07, 49.58 ± 3.26, and −0.57 ± 0.25. Only one case in group 1 required repeat cross-linking.ConclusionAlthough the long-term safety and efficacy of femtosecond laser-assisted ICRS implantation accompanied or followed by TE-ACXL in children with keratoconus and VKC is high, some cases still may need repeat cross-linking.

YAG laser is a simple, effective outpatient procedure for the management of epithelial ingrowth after LASIK.

Background: During coronary artery bypass grafting (CABG), the myocardium is subjected to endure periods of ischemia and reperfusion, which may result in post-ischemic contractile dysfunction. That is a major contributor to early and late morbidity and mortality and increased requirement of pharmacologic and mechanical circulatory support. Glucose insulin potassium (GIK) infusion was thought to provide a cardioprotective effect. Objective: To investigate whether the use of GIK solution in patients undergoing on-pump CABG affects requirements of inotropes. Patients and Method: In this prospective, randomized placebo-controlled trial, 64 patients were assigned into two groups: the GIK group in which glucose-insulin and potassium infusion was given during CABG surgery, and the non-GIK group in which only saline infusion was given during the procedure. Results: In the GIK group, all patient needed not more than two inotropes with mean of 1.28 ± 0.46, while in the non-GIK group there were patients who need up to three inotropes with mean of 1.56 ± 0.56 (P. value of 0.032). Conclusion: GIK infusion during on-pump CABG reduces perioperative inotropic requirements.

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The purpose of this review was to verify the function and potential mechanisms of glucose-insulin-potassium (GIK) solution infusion in cardiac surgery concerning cardiac protection. Myocardial damage is associated with cardiac surgical procedures involving hypothermic cardiac arrest and cardiopulmonary bypass (CPB). One of the most critical targets for cardiac surgery during anesthesia is to reduce myocardial damage. In terms of cardiac morbidity and mortality, effective intraoperative cardiac protection primarily defines postoperative outcomes. Well studied techniques and recognized cardiac safety methods do have some drawbacks in their functions. One solution to this issue is increased metabolic assistance, intended to minimize perceived ischemic injury. In practical use, many modern techniques such as glucose insulin potassium infusion are still restricted in terms of their added efficacy in cardiac protection. Providing glucose and insulin to the critically ischaemic cell has been hypothesized to have several beneficial effects, it increases the production of anaerobic adenosine triphosphate (ATP) despite the inhibition of fatty acid metabolism while retaining a defensive role on the threatened cell membrane.