Objective. To create an age-based formula to estimate the base curve needed for contact lens fitting using measured central corneal curvature (CCC) with a handheld auto keratometer from ophthalmologically normal infants.

Methods. This is a prospective cross-sectional study involving 70 ophthalmologically normal full-term infants aged 0 to 12 months. The infants were divided into four groups: 0-3 months, >3-6 months, >6-9 months and >9-12 months. CCC was measured with a handheld auto keratometer and was used to compute for the base curve. Differences in CCC between the four groups were measured and linear regression models were used for formula creation.

Results. The mean CCC was highest in group 1 at 45.5 ±2.4 diopters (D). These values slowly decreased as age increased. A formula predictive of the base curve based on the infants age was derived using linear regression analysis. It predicted that for every month increase in age, there is a 0.063 millimeter increase in the base curve (p<0.001).

Conclusion. Infant CCC is highest at birth and gradually decreases as age increases. The formula can predict the base curve needed for contact lens fitting in infants without the need for a handheld autokeratometer.

Contact Lenses ; Infant

OBJECTIVE: To demonstrate an important differential diagnosis of unilateral pleural effusion in a peritoneal dialysis patient and to review the therapeutic options for pleuroperitoneal leak to enable patients to remain on continuous ambulatory peritoneal dialysis (CAPD).

STUDY DESIGN: Case report

SETTING: National Kidney and Transplant Institute

CASE SUMMARY: This is the case of a 57-year old female with end-atage renal disease (ESRD) secondary to diabetic nephropathy, with a previous myocardial Infarction, who was started on CAPD with the onset of uremia. Although her symptoms improved after several dialysis exchanges, she later had chest pain and progressive dyspnea. She developed a right-sided transudative pleural effusion, which recurred on resumption of peritoneal dialysis (PD). Persistently poor PD fluid drainage was noted despite a change of the PD catheter. The diagnosis of hydrothorax probably due to a pleuroperitoneal leak was confirmed by peritoneal scintigraphy. With the patient's poor cardiovascular status, it was preferable that she remain on PD. Video-assisted thoracoscopic surgery (VATS) was performed, which revealed around 6 small fenestrations on the diaphragmatic surface, covered by a thin membrane 1 to 3 millimeters in diameter. Talc poudrage was done to promote adherence of the parietal and visceral pleurae, preventing fluid reaccumulation in the peural space. PD was discontinued for 4 weeks to allow adherence of the pleurae. It was resumed using gradually increasing PD fluid dwell volumes without further recurrence of hydrothorax. The patient successfully remained on ,PD.

CONCLUSION: This is the first reported case in the Philippines using VATS and talc poudrage as treatment for hydrothorax due to a pleuroperitoneal leak in a PD patient. It is an effective form of therapy with very little associated morbidity. The presence of a pleuroperitoneal leak no longer necessitates the switch provides an option for to hemodialysis (HD). It patients to remain on PD. (Author)

Human ; Middle Aged ; Thoracic Surgery, Video Assisted ; Hydrothorax ; Peritoneal Dialysis ; End-stage Renal Disease ; Peritoneal Dialysis, Continuous Ambulatory