which is within the expected age range for RDs locally. We have shown that age is a risk factor for RD after laser refractive surgery. It is known that the vitreous undergoes syneresis between 40 and 60 years of age, and a syneretic vitreous is a prerequisite for the occurrence of posterior vitreous detachment and subsequent RD. It would have been interesting to establish the occurrence of posterior vitreous detachments after laser refractive surgery, but we were unable to do so with the limitations of a retrospective study.With longer axial lengths, the myopic eye has a greater tendency to lattice degeneration and PVD, predisposing to retinal tears and detachments. 7-9 The incidence of RD in myopes has been reported to range from 0.71% to 3.20%, increasing to 6.7% in high myopia. 10-13 The overall mean refractive errors at SNEC are ÿ4.43 G 1.83 D for PRK and ÿ6.37 G 2.80 D for LASIK. The patients who had RD after PRK and LASIK had mean preexisting SE of ÿ8.53 G 2.71 D and ÿ9.02 G 3.33 D, respectively. These results suggest that severity of myopia is a significant risk factor for RD after refractive surgery.Retinal detachments have been reported after laser refractive surgery, and the rates are low in general, ranging from 0.05% to 0.25%. 14-17 Our rate of 0.078% similarly falls within the reported range. It must be noted, however, that these rates depend on the duration of follow-up after the laser procedure and the severity of myopia that was treated. In addition, by analyzing the data of patients who returned to SNEC for management only, we were unable to determine the patients, if any, who received surgery for RD post laser refractive surgery at another hospital.Laser refractive surgery by PRK or LASIK is associated with low incidence of RD development. Retinal detachment is encountered in the natural history of myopia and should be considered an expected event, not entirely consequent to the laser procedure. However, the effect of vacuum suction and acoustic shockwaves of the laser may predispose the older high myopes to a higher risk for PVD and RD. Ophthalmologists who perform refractive surgery need to have a higher index of suspicion for RD when these patients are past 40 years of age and have a higher degree of myopia. CORRESPONDENCE J CATARACT REFRACT SURG -VOL 32, MARCH 2006

No abstract

Obturators are custom made plastic material that is made to fit the precise contour of the hard and the soft palate that extends onwards to seal off the mouth from the nasal cavity. Fabricated by an orthodontist or a prosthodontist, it requires frequent replacements as the baby grows and preferably given at 2-3 days after birth. Breastfeeding in a cleft baby is difficult although there are a few compromised techniques that are employed such as breastfeeding positions, compression technique, supplementer usage, and nipple shield alone or in combination. Once the obturator is delivered the child stops regurgitation or vomiting as the lining of the nasal cavity is protected. Breastfeeding is very essential as it also facilitates the proper development of jawbones and facial muscles and in order to do that feeding of a child since day one of birth is a very important prerequisite that can be achieved by delivering an efficient palatal obturator.