{"title":"Anterior segment-optical coherence tomography for evaluation of the epithelium thickness profile in keratoconic corneas and normal corneas","authors":"Soha Eltohamy","doi":"10.4103/ejos.ejos_47_21","DOIUrl":"https://doi.org/10.4103/ejos.ejos_47_21","url":null,"abstract":"","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70723462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kareem B. Elessawy, AlshymaaM Elnagar, H. Nasr, S. Abdelbaky
{"title":"Anterior lamellar recession with and without blepharoplasty in upper eyelid cicatricial entropion","authors":"Kareem B. Elessawy, AlshymaaM Elnagar, H. Nasr, S. Abdelbaky","doi":"10.4103/ejos.ejos_54_21","DOIUrl":"https://doi.org/10.4103/ejos.ejos_54_21","url":null,"abstract":"","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70723660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lensectomy with anterior vitrectomy plus goniosynechialysis followed by iris-claw intraocular-lens implantation in microspherophakia-induced glaucoma","authors":"Hazem Helmy","doi":"10.4103/ejos.ejos_51_21","DOIUrl":"https://doi.org/10.4103/ejos.ejos_51_21","url":null,"abstract":"","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70723502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdellaoui Taoufik, Chaoui Yassmine, M. Yassine, Mouzari Yassine, E. Fouad, R. Karim, O. Abdelbarre
Purpose To evaluate through a prospective study the efficiency and safety of triamcinolone in subconjunctival injection on macular edema (ME), in the short and medium term. Patients and methods All the patients included in the study underwent ophthalmologic examination and optic coherence tomography of the macula. The injection of 0.2–0.3 ml (8–12 mg) of triamcinolone was done in the subconjunctival space. We evaluated its efficiency by measuring the best-corrected visual acuity and the central macular thickness at 1, 3, and 6 months. Safety was evaluated by following up the intraocular pressure; the presence or absence of cataract and conjunctival complications at 1, 3, and 6 months; and the glycemic control. Results A total of 44 eyes (36 patients) were included. The overall best-corrected visual acuity and central macular thickness improved after injection. Overall, 67% of diabetic patients required reinjection at the third month. In the cases of inflammatory ME (uveitis and Irvine–Gass), the evolution has remained stable for 6 months after a single injection. No significant variation in intraocular pressure was noted after 1 month (P=0.38), after 3 months (P=0.20), or after 6 months (P=0.13). However, four patients developed ocular hypertension (10 mmHg or more above baseline), which has been well controlled with local monotherapy. Overall, 9.5% of phakic patients developed a cataract at the control of the sixth month. The change in glycated hemoglobin before and after the injection was not significant (P=0.84). Conclusion Subconjunctival triamcinolone acetonide seems to be an interesting and well-tolerated alternative therapy of ME in the short and medium term.
{"title":"Study of the efficiency and safety of subconjunctival triamcinolone acetonide in macular edema","authors":"Abdellaoui Taoufik, Chaoui Yassmine, M. Yassine, Mouzari Yassine, E. Fouad, R. Karim, O. Abdelbarre","doi":"10.4103/ejos.ejos_47_20","DOIUrl":"https://doi.org/10.4103/ejos.ejos_47_20","url":null,"abstract":"Purpose To evaluate through a prospective study the efficiency and safety of triamcinolone in subconjunctival injection on macular edema (ME), in the short and medium term. Patients and methods All the patients included in the study underwent ophthalmologic examination and optic coherence tomography of the macula. The injection of 0.2–0.3 ml (8–12 mg) of triamcinolone was done in the subconjunctival space. We evaluated its efficiency by measuring the best-corrected visual acuity and the central macular thickness at 1, 3, and 6 months. Safety was evaluated by following up the intraocular pressure; the presence or absence of cataract and conjunctival complications at 1, 3, and 6 months; and the glycemic control. Results A total of 44 eyes (36 patients) were included. The overall best-corrected visual acuity and central macular thickness improved after injection. Overall, 67% of diabetic patients required reinjection at the third month. In the cases of inflammatory ME (uveitis and Irvine–Gass), the evolution has remained stable for 6 months after a single injection. No significant variation in intraocular pressure was noted after 1 month (P=0.38), after 3 months (P=0.20), or after 6 months (P=0.13). However, four patients developed ocular hypertension (10 mmHg or more above baseline), which has been well controlled with local monotherapy. Overall, 9.5% of phakic patients developed a cataract at the control of the sixth month. The change in glycated hemoglobin before and after the injection was not significant (P=0.84). Conclusion Subconjunctival triamcinolone acetonide seems to be an interesting and well-tolerated alternative therapy of ME in the short and medium term.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"114 1","pages":"13 - 20"},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49510440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aya Hashish, Eman A. Awad, D. Sabry, Hatem El-Awady, M. El-Metwally
Settings This study was conducted in Mansoura Ophthalmic Center, Mansoura University, Egypt, during the period from January 2018 to January 2019. Purpose This study aimed to evaluate the visual outcomes, topographic features, endothelial cell densities (ECD), and complications of deep anterior lamellar keratoplasty using big-bubble technique (BB-DALK) in different corneal stromal pathologies. Patients and methods This was a prospective, interventional study that included 24 eyes of 24 patients having corneal stromal pathologies, not involving Descemet membrane (DM) and endothelium. The primary outcome measures were the clinical, visual, and topographic outcomes (uncorrected visual acuity, best-corrected visual acuity, K1, and K2) throughout the follow-up period, whereas the secondary outcome measures were the refractive outcomes, central corneal thickness, ECD, and intraoperative and postoperative complications. Results A total of 21 (87.5%) patients underwent uneventful BB-DALK, and three (12.5%) cases were complicated by intraoperative DM microperforation who developed DM detachment and double anterior chamber (AC) postoperatively. One of them resolved spontaneously and the other two cases required intracameral air injection. Uncorrected visual acuity improved from 1.55±0.26 (logarithm of minimum angle of resolution) preoperatively to 0.63±0.2 1 year postoperatively (P<0.001) and best-corrected visual acuity improved from 1.08±0.11 (logarithm of minimum angle of resolution) to 0.30±0.12 (P=0.017). Refractive cylinder improved from −7.79±1.75 to −2.85±2.01 at 12 months of follow-up (P=0.007). Average K reading changed from 60.00±7.77 preoperatively to 43.43±2.98 postoperatively (P<0.001). Total ECD was 2248.08±431.13 by the end of the first year, with a mean of 8.2% endothelial cell loss. Loosening of the sutures occurred in five (20.8%) eyes between third and sixth months postoperatively. Urrets-Zavalia syndrome occurred in one of the two cases who were complicated with postoperative double AC and required intracameral air injection. Conclusions BB-DALK is an effective and safe technique for treatment of different corneal stromal pathologies sparing endothelium and DM.
{"title":"Evaluation of deep anterior lamellar keratoplasty for anterior corneal stromal pathology","authors":"Aya Hashish, Eman A. Awad, D. Sabry, Hatem El-Awady, M. El-Metwally","doi":"10.4103/ejos.ejos_50_20","DOIUrl":"https://doi.org/10.4103/ejos.ejos_50_20","url":null,"abstract":"Settings This study was conducted in Mansoura Ophthalmic Center, Mansoura University, Egypt, during the period from January 2018 to January 2019. Purpose This study aimed to evaluate the visual outcomes, topographic features, endothelial cell densities (ECD), and complications of deep anterior lamellar keratoplasty using big-bubble technique (BB-DALK) in different corneal stromal pathologies. Patients and methods This was a prospective, interventional study that included 24 eyes of 24 patients having corneal stromal pathologies, not involving Descemet membrane (DM) and endothelium. The primary outcome measures were the clinical, visual, and topographic outcomes (uncorrected visual acuity, best-corrected visual acuity, K1, and K2) throughout the follow-up period, whereas the secondary outcome measures were the refractive outcomes, central corneal thickness, ECD, and intraoperative and postoperative complications. Results A total of 21 (87.5%) patients underwent uneventful BB-DALK, and three (12.5%) cases were complicated by intraoperative DM microperforation who developed DM detachment and double anterior chamber (AC) postoperatively. One of them resolved spontaneously and the other two cases required intracameral air injection. Uncorrected visual acuity improved from 1.55±0.26 (logarithm of minimum angle of resolution) preoperatively to 0.63±0.2 1 year postoperatively (P<0.001) and best-corrected visual acuity improved from 1.08±0.11 (logarithm of minimum angle of resolution) to 0.30±0.12 (P=0.017). Refractive cylinder improved from −7.79±1.75 to −2.85±2.01 at 12 months of follow-up (P=0.007). Average K reading changed from 60.00±7.77 preoperatively to 43.43±2.98 postoperatively (P<0.001). Total ECD was 2248.08±431.13 by the end of the first year, with a mean of 8.2% endothelial cell loss. Loosening of the sutures occurred in five (20.8%) eyes between third and sixth months postoperatively. Urrets-Zavalia syndrome occurred in one of the two cases who were complicated with postoperative double AC and required intracameral air injection. Conclusions BB-DALK is an effective and safe technique for treatment of different corneal stromal pathologies sparing endothelium and DM.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"114 1","pages":"21 - 29"},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43969387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Phacoemulsification acoenergy and shortening the phacotime can decrease this risk. Aim The aim of this work is to compare the safety and the efficiency of phacoemulsification using conventional and torsional ultrasound modalities for hard nucleus cataracts. Settings and design This was a prospective randomized interventional study. Patients and methods A total of 30 eyes of 29 patients having hard nuclear cataract (grades IV and V) were divided into two groups. Group A included 15 eyes whose cataract was operated on by conventional phacoemulsification using the Infiniti machine. Group B included 15 eyes whose cataract was operated on by torsional phacoemulsification using the OZil technology of the Infiniti machine. Intraoperative ultrasound time and cumulative dissipated energy were recorded. Postoperative central corneal thickness (CCT) was measured at days 1, 7, and 30, and specular microscopy was done at 1 month. Statistical analysis The collected data were coded, tabulated, and statistically analyzed. Results The mean ultrasound time and cumulative dissipated energy and the amount of irrigating fluid were significantly higher in group A. There was a highly significant decrease in endothelial cell count (ECC) in both groups. ECC was significantly lower in the conventional group than in the torsional group at 1 month postoperatively. CCT in both groups was significantly increased at day 1 and then decreased at 1 week and 1 month but was still significantly higher than the preoperative level. CCT became higher in the conventional group than in the torsional group at all follow-up times, but this was significant only at day 1 and week 1 and not significant at 1 month. Conclusion Both ultrasound modalities can be used in hard nucleus phacoemulsification. However, the torsional ultrasound proved to be safer. The choice between these technologies is of particular importance when operating eyes with low ECC.
{"title":"Comparative study of conventional versus torsional phacoemulsification in management of hard nucleus","authors":"Shereen Salman, Mervat Mourad, Rafek ElGhazawy, Rafaat Rihan","doi":"10.4103/ejos.ejos_43_20","DOIUrl":"https://doi.org/10.4103/ejos.ejos_43_20","url":null,"abstract":"Background Phacoemulsification acoenergy and shortening the phacotime can decrease this risk. Aim The aim of this work is to compare the safety and the efficiency of phacoemulsification using conventional and torsional ultrasound modalities for hard nucleus cataracts. Settings and design This was a prospective randomized interventional study. Patients and methods A total of 30 eyes of 29 patients having hard nuclear cataract (grades IV and V) were divided into two groups. Group A included 15 eyes whose cataract was operated on by conventional phacoemulsification using the Infiniti machine. Group B included 15 eyes whose cataract was operated on by torsional phacoemulsification using the OZil technology of the Infiniti machine. Intraoperative ultrasound time and cumulative dissipated energy were recorded. Postoperative central corneal thickness (CCT) was measured at days 1, 7, and 30, and specular microscopy was done at 1 month. Statistical analysis The collected data were coded, tabulated, and statistically analyzed. Results The mean ultrasound time and cumulative dissipated energy and the amount of irrigating fluid were significantly higher in group A. There was a highly significant decrease in endothelial cell count (ECC) in both groups. ECC was significantly lower in the conventional group than in the torsional group at 1 month postoperatively. CCT in both groups was significantly increased at day 1 and then decreased at 1 week and 1 month but was still significantly higher than the preoperative level. CCT became higher in the conventional group than in the torsional group at all follow-up times, but this was significant only at day 1 and week 1 and not significant at 1 month. Conclusion Both ultrasound modalities can be used in hard nucleus phacoemulsification. However, the torsional ultrasound proved to be safer. The choice between these technologies is of particular importance when operating eyes with low ECC.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"114 1","pages":"1 - 12"},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47522654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose To evaluate the safety and efficacy of combined femtosecond laser-assisted intrastromal corneal ring segments implantation plus accelerated transepithelial corneal collagen cross-linking (ATE-CXL) in cases of pellucid-like keratoconus (PLK). Patients and methods This retrospective study included 25 eyes of 13 patients with PLK. Cases were divided into two groups: group 1 consisted of 13 eyes (seven patients) that had been treated by femtosecond laser-assisted Kerarings implantation and ATE-CXL in the same session, whereas group 2 included 12 eyes (six patients) that had been treated with ATE-CXL alone. Results After 1 year of surgery, the mean uncorrected visual acuity (UCVA) of group 1 improved from 0.94±23 (logMAR) to 0.73±18, whereas the mean best-corrected visual acuity improved from 0.75±16 to 0.49±0.22. The mean preoperative maximum keratometry (Kmax) was 65.23±5.03 D, whereas the mean postoperative Kmax was 53.92±4.21 D. However, in group 2, the preoperative mean UCVA was 0.63±0.31 and the postoperative UCVA was 0.55±0.29, whereas the mean best-corrected visual acuity changed from 0.31±0.26 to 0.23±0.19. The mean preoperative Kmax was 51.38±3.73 D, whereas the mean postoperative Kmax was 48.43±2.98 D. Conclusion Combined femtosecond laser-assisted Kerarings implantation and ATE-CXL is safe and effective in the treatment of PLK.
{"title":"Combined femtosecond laser-assisted intrastromal corneal ring segments implantation and corneal collagen cross-linking for treatment of pellucid-like keratoconus","authors":"M. Abozaid","doi":"10.4103/ejos.ejos_48_20","DOIUrl":"https://doi.org/10.4103/ejos.ejos_48_20","url":null,"abstract":"Purpose To evaluate the safety and efficacy of combined femtosecond laser-assisted intrastromal corneal ring segments implantation plus accelerated transepithelial corneal collagen cross-linking (ATE-CXL) in cases of pellucid-like keratoconus (PLK). Patients and methods This retrospective study included 25 eyes of 13 patients with PLK. Cases were divided into two groups: group 1 consisted of 13 eyes (seven patients) that had been treated by femtosecond laser-assisted Kerarings implantation and ATE-CXL in the same session, whereas group 2 included 12 eyes (six patients) that had been treated with ATE-CXL alone. Results After 1 year of surgery, the mean uncorrected visual acuity (UCVA) of group 1 improved from 0.94±23 (logMAR) to 0.73±18, whereas the mean best-corrected visual acuity improved from 0.75±16 to 0.49±0.22. The mean preoperative maximum keratometry (Kmax) was 65.23±5.03 D, whereas the mean postoperative Kmax was 53.92±4.21 D. However, in group 2, the preoperative mean UCVA was 0.63±0.31 and the postoperative UCVA was 0.55±0.29, whereas the mean best-corrected visual acuity changed from 0.31±0.26 to 0.23±0.19. The mean preoperative Kmax was 51.38±3.73 D, whereas the mean postoperative Kmax was 48.43±2.98 D. Conclusion Combined femtosecond laser-assisted Kerarings implantation and ATE-CXL is safe and effective in the treatment of PLK.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"113 1","pages":"147 - 152"},"PeriodicalIF":0.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49299598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mostafa El Manhaly, Ossama El Hadad, Hesham Goweini, A. Souka
Context Retinopathy of prematurity (ROP) is a vascular proliferative disease affecting premature infants. Aims The aim was to assess the extent of peripheral retinal vascular growth and recurrence rate in patients with type 1 ROP treated with ranibizumab. Settings and design Patients with ROP attending the pediatric eye clinic in the main university hospital in Alexandria Faculty of Medicine were recruited. Participants and methods This prospective study included 20 eyes of 10 patients showing type 1 ROP, treated with 0.25 mg ranibizumab intravitreal injection only. Patients were followed for 6 months, where peripheral vascularization and rate of recurrence were assessed through indirect ophthalmoscopy and RetCam imaging. Statistical analysis Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. The tests used were χ2 test, Fisher’s exact test, and Student t test. Results A total of 16 (80%) eyes showed good peripheral vascularization and favorable anatomical outcome. The average timing for temporal zone III retinal vascularization was 15.71±2.09 weeks, with three eyes not reaching zone III after 6 months of injection. One eye showed retinal folding and macular ectopia. Three (15%) eyes showed signs of recurrence, with two eyes showing neovascularization at the initial vascular ridge by the fifth week after intravitreal ranibizumab injection (IVR), and one eye showing the recurrence of thick temporal ridge by the fourth months. Conclusions Ranibizumab is a potential effective treatment for patients with type 1 ROP. Delayed peripheral vascularization and disease recurrence mandate tailored long-term follow-up period according to individual response.
{"title":"Evaluating peripheral retinal vascularization and rate of recurrence after intravitreal injection of ranibizumab as a primary treatment for retinopathy of prematurity","authors":"Mostafa El Manhaly, Ossama El Hadad, Hesham Goweini, A. Souka","doi":"10.4103/ejos.ejos_39_20","DOIUrl":"https://doi.org/10.4103/ejos.ejos_39_20","url":null,"abstract":"Context Retinopathy of prematurity (ROP) is a vascular proliferative disease affecting premature infants. Aims The aim was to assess the extent of peripheral retinal vascular growth and recurrence rate in patients with type 1 ROP treated with ranibizumab. Settings and design Patients with ROP attending the pediatric eye clinic in the main university hospital in Alexandria Faculty of Medicine were recruited. Participants and methods This prospective study included 20 eyes of 10 patients showing type 1 ROP, treated with 0.25 mg ranibizumab intravitreal injection only. Patients were followed for 6 months, where peripheral vascularization and rate of recurrence were assessed through indirect ophthalmoscopy and RetCam imaging. Statistical analysis Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. The tests used were χ2 test, Fisher’s exact test, and Student t test. Results A total of 16 (80%) eyes showed good peripheral vascularization and favorable anatomical outcome. The average timing for temporal zone III retinal vascularization was 15.71±2.09 weeks, with three eyes not reaching zone III after 6 months of injection. One eye showed retinal folding and macular ectopia. Three (15%) eyes showed signs of recurrence, with two eyes showing neovascularization at the initial vascular ridge by the fifth week after intravitreal ranibizumab injection (IVR), and one eye showing the recurrence of thick temporal ridge by the fourth months. Conclusions Ranibizumab is a potential effective treatment for patients with type 1 ROP. Delayed peripheral vascularization and disease recurrence mandate tailored long-term follow-up period according to individual response.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"113 1","pages":"125 - 132"},"PeriodicalIF":0.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41505659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Elkhawaga, Nehal Elshakankiri, H. Helaly, A. Elkamshoushy
Background There is an ongoing need to move toward sutureless surgery with less surgical manipulations, while maintaining the same results achieved by conventional surgery. Aim The aim was to evaluate the safety and the effectiveness of fenestration technique of the medial recuts muscle with resection of ipsilateral lateral rectus muscle in patients with sensory esotropia. Design A prospective, noncomparative, single-institution interventional study was conducted. Patients and methods This is a prospective study conducted on 16 children with sensory esotropia. Fenestration of the medial rectus muscle is a novel technique of weakening of the medial rectus by excising a rectangular wide central part extending from the insertion to a point back 5–8 mm depending on the angle of the esotropia leaving superior and inferior longitudinal muscle sleeves with no muscle sutures needed. Postoperative angle was reported at 3 months and at final follow-up. Results The procedure reduced the angle of esotropia from mean preoperative angle of 36.6±9 (20–50) to 5.3±5.9 (0–20) PD. Satisfactory horizontal alignment, defined as postoperative alignment within 8 PD of orthotropia at distance, was achieved in 81.25% of the cases at 3 months of follow-up. There were no overcorrections. The procedure was well tolerated by patients. Conclusion Fenestration technique is a safe and effective weakening procedure for medial rectus in cases of sensory esotropia.
{"title":"Evaluation of fenestration technique of the medial recuts muscle with resection of ipsilateral lateral rectus muscle in patients with sensory esotropia","authors":"M. Elkhawaga, Nehal Elshakankiri, H. Helaly, A. Elkamshoushy","doi":"10.4103/ejos.ejos_28_20","DOIUrl":"https://doi.org/10.4103/ejos.ejos_28_20","url":null,"abstract":"Background There is an ongoing need to move toward sutureless surgery with less surgical manipulations, while maintaining the same results achieved by conventional surgery. Aim The aim was to evaluate the safety and the effectiveness of fenestration technique of the medial recuts muscle with resection of ipsilateral lateral rectus muscle in patients with sensory esotropia. Design A prospective, noncomparative, single-institution interventional study was conducted. Patients and methods This is a prospective study conducted on 16 children with sensory esotropia. Fenestration of the medial rectus muscle is a novel technique of weakening of the medial rectus by excising a rectangular wide central part extending from the insertion to a point back 5–8 mm depending on the angle of the esotropia leaving superior and inferior longitudinal muscle sleeves with no muscle sutures needed. Postoperative angle was reported at 3 months and at final follow-up. Results The procedure reduced the angle of esotropia from mean preoperative angle of 36.6±9 (20–50) to 5.3±5.9 (0–20) PD. Satisfactory horizontal alignment, defined as postoperative alignment within 8 PD of orthotropia at distance, was achieved in 81.25% of the cases at 3 months of follow-up. There were no overcorrections. The procedure was well tolerated by patients. Conclusion Fenestration technique is a safe and effective weakening procedure for medial rectus in cases of sensory esotropia.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"113 1","pages":"142 - 146"},"PeriodicalIF":0.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42072724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Elwan, Tharwat H. Mokbel, A. Badawi, W. A. Abou Samra, S. Hagras
Purpose To evaluate the role of spectral domain optical coherence tomography (SD-OCT) in affecting the decision making in eyes prepared for silicon oil removal (SOR) and to identify the cases that should have an obligatory preoperative SD-OCT. Patients and methods This prospective nonrandomized study involved patients with silicone-filled eyes recruited over the period from 2015 to 2018. Data from preoperative clinical examination and SD-OCT imaging and proposed modifications on SOR surgery based on both ways of examinations were recorded and compared. Cohen’s Kappa test was used to study the agreement between the clinical and OCT results. Results A total of 146 eyes of 138 patients were included in the study. Before SOR, clinical examination revealed normal macula in 108 (74%) eyes compared with 62 (42%) by OCT. OCT was able to detect significantly higher macular pathologies than did the clinical examination alone (P<0.0005). The number of eyes with macular edema (ME) and epiretinal membrane detected by OCT was significantly higher than that detected clinically (P<0.0005). There was a weak agreement between the results of clinical and OCT examination regarding ME (weighted K=0.426). Modifications added to the routine SOR based on clinical findings were suggested in 25 (17%) eyes compared with 65 (45%) eyes on adding OCT findings in decision making. Superadded modifications based on SD-OCT alone were significantly more in diabetic than nondiabetic patients regarding management of ME and macular retinal detachment (P=0.003). Conclusion SD-OCT was proved to be a helpful tool for following silicone-filled eyes, especially in diabetic patients. Preoperative OCT findings influenced the surgical plans of the routine SOR, thus aided in managing treatable macular lesions such as epiretinal membrane, ME, macular holes, and macular detachment.
{"title":"Effect of macular optical coherence tomography on decision making before silicone oil removal","authors":"M. Elwan, Tharwat H. Mokbel, A. Badawi, W. A. Abou Samra, S. Hagras","doi":"10.4103/ejos.ejos_51_20","DOIUrl":"https://doi.org/10.4103/ejos.ejos_51_20","url":null,"abstract":"Purpose To evaluate the role of spectral domain optical coherence tomography (SD-OCT) in affecting the decision making in eyes prepared for silicon oil removal (SOR) and to identify the cases that should have an obligatory preoperative SD-OCT. Patients and methods This prospective nonrandomized study involved patients with silicone-filled eyes recruited over the period from 2015 to 2018. Data from preoperative clinical examination and SD-OCT imaging and proposed modifications on SOR surgery based on both ways of examinations were recorded and compared. Cohen’s Kappa test was used to study the agreement between the clinical and OCT results. Results A total of 146 eyes of 138 patients were included in the study. Before SOR, clinical examination revealed normal macula in 108 (74%) eyes compared with 62 (42%) by OCT. OCT was able to detect significantly higher macular pathologies than did the clinical examination alone (P<0.0005). The number of eyes with macular edema (ME) and epiretinal membrane detected by OCT was significantly higher than that detected clinically (P<0.0005). There was a weak agreement between the results of clinical and OCT examination regarding ME (weighted K=0.426). Modifications added to the routine SOR based on clinical findings were suggested in 25 (17%) eyes compared with 65 (45%) eyes on adding OCT findings in decision making. Superadded modifications based on SD-OCT alone were significantly more in diabetic than nondiabetic patients regarding management of ME and macular retinal detachment (P=0.003). Conclusion SD-OCT was proved to be a helpful tool for following silicone-filled eyes, especially in diabetic patients. Preoperative OCT findings influenced the surgical plans of the routine SOR, thus aided in managing treatable macular lesions such as epiretinal membrane, ME, macular holes, and macular detachment.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"113 1","pages":"153 - 159"},"PeriodicalIF":0.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47194412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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