Hot Topic 〉The Critical Step for Child Development in Neonatal Problems: Early Screening Diagnosis, and Intervention
Adjustable strabismus surgery can increase the success rate of surgical correction of strabismus
To improve the success rate of strabismus surgery, the Ophthalmology care team of Chiayi Christian Hospital has consecutively developed several advanced surgeries, including adjustable strabismus surgery, nasal transposition of lateral rectus surgery, pull-string adjustable strabismus surgery, and fascia lata augmented lateral rectus transposition surgery, etc.
Dr. Chong-Bin Tsai, Vice President of Chiayi Christian Hospital, said that the objectives for vision screening in infants and young children are to detect developmental disorders of vision that may lead to amblyopia. Common developmental disorders of vision include severe refractive errors (e.g. severe hyperopia, high myopia, and astigmatism), strabismus, and form vision deprivation (e.g. congenital cataract or ptosis). The first consideration for the treatment of amblyopia is to ameliorate the visual developmental disorders. Another consideration is to stimulate the neurogenesis in the eyes with amblyopia. Vice President Tsai said that, the prevalence rate of strabismus in Taiwan was approximately 4%. Common treatment for strabismus includes prism correction, botulinum toxin injection, and traditional strabismus surgery (loosening or tightening the extraocular muscles). However, traditional strabismus surgery often carries high risks of over-correction or under-correction. Meanwhile, the fine control of eye movement by several extraocular muscles is precise and complicated, and anesthesia during surgery may also change the tension of extraocular muscles. Collectively, these risks and limitations indicate that traditional strabismus surgery is usually associated with extremely high surgical difficulties.
To improve the success rate of strabismus surgery, the Ophthalmology care team of Chiayi Christian Hospital has consecutively developed several advanced surgeries, including adjustable strabismus surgery, nasal transposition of lateral rectus surgery, pull-string adjustable strabismus surgery, and fascia lata augmented lateral rectus transposition surgery, etc. According to a survey in 2013, in the United States, only 25% of the ophthalmologists can perform adjustable strabismus surgery, and the application of such strabismus surgery in children was relatively rare. For all children with strabismus, the Ophthalmology care team of Chiayi Christian Hospital has developed pull-string adjustable strabismus surgery that largely reduced the difficulty of post-operative adjustment. Such adjustable strabismus surgery has been successfully applied in 123 cases of strabismus surgery in children. The success rate in the correction of strabismus was 76%, which was comparable to the success rate of 74 to 79% of the surgery performed by foreign peers.
The Critical Step for Child Development in Neonatal Problems: Early Screening Diagnosis, and Intervention
To ensure proper physical and mental development of infants and young children, the Health Promotion Administration of Taiwan provides seven preventive health care services related to the physical growth, learning development and parental education for children under seven years old.
The newborn hearing screening coverage rate in Taiwan is 98.2%, and the first six months are the golden period for the treatment of congenital hearing impairment.
In Taiwan, from 2006 to 2016, the Health Promotion Administration commissioned the ENT chief of Mackay Memorial Hospital, Dr. Hung-Ching Lin, to establish the newborn hearing screening system. Using such system, initial hearing screening can be performed among 98.2% of all newborns in Taiwan within three days after birth, and this screening coverage rate is the best in the world.
Treatment of congenital hip dislocation: The first 6 months are the golden period for correction
According to Dr. Nai-Hwei Wang, President of Kuang Tien General Hospital, the prevalence of congenital hip dislocation in Taiwan is approximately 15 cases per 10,000 newborns. Hip dislocation supportive wrap usually shows considerable efficacy for neonatal hip dislocation after 2 to 3 months of use. If such hip problem is detected late, after having learned to walk at theage of 1, surgical treatment of hip dislocation will be required due to hip deformation.