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PURPOSE: Identifying at-risk infants for retinopathy of prematurity (ROP) is complex in countries with emerging economies as infants that lack conventional risk factors, such as low birth weight (BW) and young gestational age (GA), still go on to develop severe ROP. Potential biomarkers, like serum insulin-like growth factor 1 (IGF-1) and slow postnatal weight gain, have been identified as good predictors for ROP in developed countries. We sought to determine the relationship between IGF-1 levels and ROP in two Latin American countries where the burden of disease is still significant. METHODS: Prospective cohort study of infants in Guadalajara, Mexico and La Plata, Argentina. Filter-paper bloodspot IGF-1 assays were performed weekly from birth until hospital discharge or 40 weeks' postmenstrual age (PMA). RESULTS: 112 infants were studied with a median BW of 1412 g (range 620 g-2390 g) and a median GA of 33 weeks (range 25-37). There was no significant difference in IGF-1 between infants who developed ROP and those who did not. CONCLUSION: Low IGF-1 was not associated with ROP in these infants. The lack of an association between ROP and IGF-1 in Latin America supports the observation that growth-based predictive models do not perform as well in this setting where more mature babies still develop severe ROP.

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Objetivo: Evaluar el efecto de la ropivacaina subtenoniana para disminuir el dolor en el postoperatorio de estrabismo en niños. Material y Método: 44 pacientes que recibieron cirugía primaria o secundaria de los músculos extraoculares fueron randomizados. 22 recibieron 0.5 ml de ropivacaína al 2 por ciento en espacio subtenoniano antes del cierre conjuntival del último músculo operado a cada ojo. El dolor fue evaluado con la escala CE-POS por los padres a 1,4 y a las 24 horas por el cirujano. Resultados: El grupo que no recibió anestésico (22) incluyó 10 niños y 12 niñas. El que la recibió se integró con 13 varones y 9 mujeres. El promedio de edad fue de 7,4 y 7,8 respectivamente. El score de dolor no mostró diferencias significativas entre los grupos en la cirugías primarias, en las de dos o más músculos y en la recesiones en los tres momentos evaluados. Se encontró diferencia entre los grupos a la primera y cuarta horas en las reintervenciones, las cirigías monomusculares y las miectomías (p: 0.0053), (p: 0.00322) and (p: 0.00446) respectivamente. Conclusión: en nuestros pacientes la ropivacaína subtenoniana se mostró efectiva en la reducción del dolor en el postoperatorio de las miectomías, las reoperaciones y las cirugías de un solo músculo.

Purpose: To evaluate the effect of subtenonian ropivacaine to diminish pain in children undergoing strabismus surgery. Material and Method: Forty four children undergoing primary or secondary strabismus surgery were randomized, receiving either 0.5 ml of subtenonian ropivacaine 2 percent inmediatly before closing conjunctiva over the last extraocular muscle operated on, or not having extra dose of anesthetic at all. Level of pain was evaluated using the CE-POS scale by parents at hours 1 and 4, and at 24 hours by the surgeon. Results: The group that did not receive the anesthetic included 10 male and 12 female. Group receiving ropivacaine included 13 males and 9 females, averaging 7.4 and 7.8 years respectively. The pain score was similar in the primary intervention group, with two or more muscle, and the recessions, at the three time points of evaluation. We found significative differences in cases of reinterventions, monomuscular surgeries, and miectomies, with p values of 0.00322, 0.00446, respectively. Conclusion: Intraoperative subtenon injection of ropivacaine is effective for reducing pain in the early postoperative period in reinterventions, one muscle surgery and miectomies.

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