Conventional occlusion versus pharmacologic penalization for amblyopia

Li, Tianjing; Shotton, Kate; Hillis, Argye E.; Flynn, John T.; Coutu, Joyce

doi:10.1002/14651858.cd006460

Cited by 13 publications

(11 citation statements)

References 25 publications

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“…A Cochrane systematic review concluded that atropine was as effective as patching and that compliance with atropine was better. 40 Traditional treatment protocols involved daily application of 1% atropine, 41 but for moderate amblyopia (Snellen 6/24 or better) application only at weekends has been shown to be as effective. 42 Weekend-only atropine reduces potential systemic side effects such as flushing and tachycardia, which occur in about 5% of children with a daily regimen.…”

Section: Atropinementioning

confidence: 99%

Amblyopia

Jefferis

Connor

Clarke

2015

BMJ

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Section: Atropinementioning

confidence: 99%

Amblyopia

Jefferis

Connor

Clarke

2015

BMJ

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“…Recent studies have pointed to the efficacy of atropine penalization in the treatment of moderate degrees of amblyopia. 16,17 Cycloplegic retinoscopy can determine the refractive status of the graft as sutures are removed. Refractive correction is usually given once all sutures are removed but an ''interim'' correction may be needed to facilitate amblyopia therapy in cases of anisometropia and profound amblyopia.…”

Section: Postoperative Managementmentioning

confidence: 99%

Pediatric Penetrating Keratoplasty

O’Hara

Mannis

2013

International Ophthalmology Clinics

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The first successful penetrating keratoplasty was performed in 1905 by Eduard Zirm. 1 The donor for this transplant was an 11-year-old boy and the recipient a 45-year-old adult. Zirm's successful surgery was the basis for elaborating the basic principles of successful penetrating keratoplasty and ushered in an era of innovation and improvement in surgical outcomes. However, corneal transplantation with a child as the recipient has proved considerably more challenging. Before the 1970s, pediatric penetrating keratoplasty (PPK) was recommended only for older children or in children with severe bilateral disease. 2 PPK presents a unique set of surgical challenges. The young child's eye is smaller and the sclera and cornea are less rigid, making tissue sizing and apposition more difficult. Moreover, positive posterior vitreous pressure encountered in PPKs can cause significant anterior displacement of the lens-iris diaphragm during ''open sky'' surgery. The brisk inflammatory response of pediatric eyes to surgery can increase the risk of scarring, rejection, cataract, and glaucoma. In addition, many pediatric eyes coming to transplant harbor congenital anomalies that further confound the surgery.Postoperative management of the PPK also differs in that frequent examinations are necessary, commonly under general anesthesia. Parents must be prepared carefully to assume their responsibilities in a demanding postoperative regimen. Sutures are adjusted and removed much earlier than in the adult patient, requiring anesthesia in the young child. Treatment of amblyopia and close attention to refractive correction is also critical to the visual outcome.These special considerations necessitate a team approach that is distinctly different from keratoplasty in the adult. Collaboration between

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“…In this review we considered only strabismic amblyopia; interventions for other types of amblyopia have been evaluated in a series of Cochrane reviews (Antonio-Santos 2014; Li 2009; Shotton 2012). …”

Section: Introductionmentioning

confidence: 99%