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Fused eyelids in premature infants
K Duerksen1, W E Barlow, O G Stasior
1Department of Ophthalmology, University of Arizona Health Sciences Center, Tucson.
Insights
Infants born with fused eyelids have a lower survival rate and delayed eyelid opening. Gestational age is the key factor influencing eyelid status, survival, and retinopathy of prematurity (ROP) in extremely premature newborns.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Perinatology
Background:
- Extremely premature infants often present with various health challenges.
- Eyelid development and opening are critical indicators in neonatal care.
- The incidence and implications of fused eyelids at birth require further characterization.
Purpose of the Study:
- To determine the incidence of fused eyelids in extremely premature newborns.
- To identify the timing of postbirth eyelid opening.
- To assess the survival rates of infants with fused versus open eyelids.
Main Methods:
- Retrospective chart review of 161 extremely premature infants.
- Logistic regression analysis for ophthalmic outcomes and predictors.
- Cox regression analysis for time to eyelid opening in infants with fused eyelids.
Main Results:
- The critical gestational age for eyelid opening is 25.5–26.5 weeks.
- Infants born with fused eyelids opened them an average of 5.5 days postbirth.
- Survival to discharge was 52% for infants with fused eyelids versus 83% for those with open eyelids.
- Gestational age was the primary predictor for eyelid status, survival, and retinopathy of prematurity (ROP).
Conclusions:
- Fused eyelids at birth are associated with significantly lower survival rates in extremely premature infants.
- Gestational age is the most critical factor influencing ophthalmic outcomes and survival in this population.
- Early identification and management of eyelid status may be important for extremely premature neonates.
Abstract:
The charts of 161 extremely premature newborns were reviewed to characterize and report the incidence of infants born with fused eyelids, to determine when postbirth eyelid dysjunction occurs, and to address the survivability of these infants. Logistic regression analysis was used to examine the relationship between various ophthalmic outcomes and possible predictors of these outcomes. For babies born with eyelids fused, Cox regression analysis was used to assess time to eyelid opening. From the analysis of our data, we found that the critical time for eyelid opening is between 25.5 and 26.5 weeks gestational age. If fused at birth, the average time to eyelid opening after birth was 5.5 days. Fifty-two percent of babies born with their eyelids fused survived to be discharged from the hospital, compared to 83% of those born with eyelids open. Gestational age was found to be the most important predictor of the status of the eyelids at birth, of survival, and of the presence of retinopathy of prematurity (ROP). Other variables were found to be significant, but the significance was lost once the variable was adjusted for gestational age.