Amira Kamhawy, O. Salem, Yasser El Zankalony, A. Ebeid
Background To study the endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty (DMEK) using specular microscopy to provide data about the endothelial cell density (ECD), endothelial cell loss (ECL) percentage, and changes in endothelial cell shape (hexagonality) and size [coefficient of variation (CV)] and to study the factors causing these changes in endothelial cell layer after DMEK. Patients and methods This study included 20 patients investigated by specular microscopy 3 months after DMEK. We discuss the postoperative ECD, factors that affect the ECD, factors that affect hexagonality and CV, visual outcome, and advantages of DMEK. The study was approved by the ethics committee of Ain Shams University. Results This study showed that the mean ECD postoperative was 1664.80 cells/mm2, with mean ECL of 34.67%. This cell loss increased in cases of difficult graft unfolding. Donor age and preservation time had no effect on postoperative ECD. A percentage decrease in hexagonal cells and a percentage increase in CV were noticed in cases that received grafts from donors with history of diabetes mellitus. Postoperative ECD and hexagonal cell percentage had no correlation with central corneal thickness in this study. Conclusion DMEK results in significant improvement of postoperatively visual acuity (VA). Advantages of DMEK like no corneal sutures, short recovery time, less cylindrical aberration, decreased incidence of graft rejection, and good visual outcome make it the best choice to treat eyes with corneal endothelial dysfunction.
{"title":"Study of corneal endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty","authors":"Amira Kamhawy, O. Salem, Yasser El Zankalony, A. Ebeid","doi":"10.4103/ejos.ejos_90_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_90_22","url":null,"abstract":"Background To study the endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty (DMEK) using specular microscopy to provide data about the endothelial cell density (ECD), endothelial cell loss (ECL) percentage, and changes in endothelial cell shape (hexagonality) and size [coefficient of variation (CV)] and to study the factors causing these changes in endothelial cell layer after DMEK. Patients and methods This study included 20 patients investigated by specular microscopy 3 months after DMEK. We discuss the postoperative ECD, factors that affect the ECD, factors that affect hexagonality and CV, visual outcome, and advantages of DMEK. The study was approved by the ethics committee of Ain Shams University. Results This study showed that the mean ECD postoperative was 1664.80 cells/mm2, with mean ECL of 34.67%. This cell loss increased in cases of difficult graft unfolding. Donor age and preservation time had no effect on postoperative ECD. A percentage decrease in hexagonal cells and a percentage increase in CV were noticed in cases that received grafts from donors with history of diabetes mellitus. Postoperative ECD and hexagonal cell percentage had no correlation with central corneal thickness in this study. Conclusion DMEK results in significant improvement of postoperatively visual acuity (VA). Advantages of DMEK like no corneal sutures, short recovery time, less cylindrical aberration, decreased incidence of graft rejection, and good visual outcome make it the best choice to treat eyes with corneal endothelial dysfunction.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"122 - 128"},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42462257","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}
D. Hassanein, Ahmed Awadein, Aya Youssef, Gihan Shokier
Purpose To compare the measurements of the angle of deviation through spectacles versus contact lenses and with the theoretically calculated angle. Patients and methods A total of 20 patients with comitant strabismus, more than 20 PD with spectacles, associated with bilateral myopia (spherical equivalent >1 D in both eyes) were included. Angle of deviation was measured using prism and cover test with spectacles and with contact lenses fitted according to the cycloplegic refraction and refined by subjective refraction. Agreements between the measurements obtained with contact lenses and those obtained with spectacles as well as the theoretically calculated angle were analyzed. Results The mean age was 15.6±10.9 years. Average spherical equivalent was −9.1±4.2 D. Measurements obtained with contact lenses were significantly lower than those with spectacles (P<0.001) with coefficient of variation of 27.7%, indicating poor agreement of both measurements. Limits of agreement in Bland–Altman plots were more than 9 PD ([INLINE:1] ± 2 s, −8.8 to 6 PD). The agreement was lower with larger angles. Measurements obtained with contact lenses were significantly lower than theoretical angles (P=0.002) but coefficient of variation between both measurements was 8.8%, indicating good agreement of measurements. There was little systematic or proportionate bias between the contact lens measurements and the theoretical angle. Conclusions Contact lens measurements were significantly lower than spectacle measurements in myopic patients. The contact lens measurements were in good agreement with the theoretically calculated angle. This overestimation of the angle with spectacles might be responsible for overcorrection of myopic patients with exotropia after surgery.
{"title":"Spectacle measurements versus contact lens measurements of the angle of deviation in myopic patients with strabismus","authors":"D. Hassanein, Ahmed Awadein, Aya Youssef, Gihan Shokier","doi":"10.4103/ejos.ejos_82_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_82_22","url":null,"abstract":"Purpose To compare the measurements of the angle of deviation through spectacles versus contact lenses and with the theoretically calculated angle. Patients and methods A total of 20 patients with comitant strabismus, more than 20 PD with spectacles, associated with bilateral myopia (spherical equivalent >1 D in both eyes) were included. Angle of deviation was measured using prism and cover test with spectacles and with contact lenses fitted according to the cycloplegic refraction and refined by subjective refraction. Agreements between the measurements obtained with contact lenses and those obtained with spectacles as well as the theoretically calculated angle were analyzed. Results The mean age was 15.6±10.9 years. Average spherical equivalent was −9.1±4.2 D. Measurements obtained with contact lenses were significantly lower than those with spectacles (P<0.001) with coefficient of variation of 27.7%, indicating poor agreement of both measurements. Limits of agreement in Bland–Altman plots were more than 9 PD ([INLINE:1] ± 2 s, −8.8 to 6 PD). The agreement was lower with larger angles. Measurements obtained with contact lenses were significantly lower than theoretical angles (P=0.002) but coefficient of variation between both measurements was 8.8%, indicating good agreement of measurements. There was little systematic or proportionate bias between the contact lens measurements and the theoretical angle. Conclusions Contact lens measurements were significantly lower than spectacle measurements in myopic patients. The contact lens measurements were in good agreement with the theoretically calculated angle. This overestimation of the angle with spectacles might be responsible for overcorrection of myopic patients with exotropia after surgery.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"160 - 169"},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48760552","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}
Pub Date : 2023-04-01DOI: 10.4103/ejos.ejos_119_22
Tamer I Abdelhalim, Osama A. Sorour, Mohamed Elkadim, D. Tadros
Purpose We aimed to follow up corneal refractive asymmetry index changes following refractive surgery for cornea after correction of low-grade myopia and to determine which technique causes marked affection of the indices. Patients and methods This prospective study conducted from October 2020 to December 2021 included two groups of patients, the photorefractive keratectomy (PRK) group and the laser in-situ keratomileusis (LASIK) group. Every patient in each group had to follow a schedule of visits after surgery for the next day, 1 week, 1 month, and after 3 months. Patients who failed to follow this schedule were excluded from the study. Results The PRK group contained 42 eyes with a mean uncorrected visual acuity that improved significantly, corneal power (K-reading) and pupil center thickness reduced significantly. Surface variance index, central keratoconus index, and height decentration index did not change significantly. Vertical asymmetry index and minimum radius of curvature (Rmin) increased significantly while height asymmetry index decreased significantly. Our LASIK group contained 40 eyes that underwent changes similar to those in the PRK group regarding uncorrected visual acuity, the K-reading, and the pupil center thickness. The surface variance index, vertical asymmetry index, and height asymmetry index, height decentration index and Rmin increased significantly while the central keratoconus index decreased significantly. The keratoconus index reduced significantly in both groups. Conclusion The PRK is a more conservative technique than the LASIK technique regarding the affection of corneal asymmetry indices.
{"title":"Alteration in corneal topography asymmetry indices following corneal refractive surgery","authors":"Tamer I Abdelhalim, Osama A. Sorour, Mohamed Elkadim, D. Tadros","doi":"10.4103/ejos.ejos_119_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_119_22","url":null,"abstract":"Purpose We aimed to follow up corneal refractive asymmetry index changes following refractive surgery for cornea after correction of low-grade myopia and to determine which technique causes marked affection of the indices. Patients and methods This prospective study conducted from October 2020 to December 2021 included two groups of patients, the photorefractive keratectomy (PRK) group and the laser in-situ keratomileusis (LASIK) group. Every patient in each group had to follow a schedule of visits after surgery for the next day, 1 week, 1 month, and after 3 months. Patients who failed to follow this schedule were excluded from the study. Results The PRK group contained 42 eyes with a mean uncorrected visual acuity that improved significantly, corneal power (K-reading) and pupil center thickness reduced significantly. Surface variance index, central keratoconus index, and height decentration index did not change significantly. Vertical asymmetry index and minimum radius of curvature (Rmin) increased significantly while height asymmetry index decreased significantly. Our LASIK group contained 40 eyes that underwent changes similar to those in the PRK group regarding uncorrected visual acuity, the K-reading, and the pupil center thickness. The surface variance index, vertical asymmetry index, and height asymmetry index, height decentration index and Rmin increased significantly while the central keratoconus index decreased significantly. The keratoconus index reduced significantly in both groups. Conclusion The PRK is a more conservative technique than the LASIK technique regarding the affection of corneal asymmetry indices.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"93 - 98"},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42867198","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}
Aim To compare between the outcomes of cauterized conjunctival autograft (CA) with and without mitomycin C (MMC) in primary pterygium surgery. Patients and methods This prospective interventional comparative study included 50 eyes in 50 patients with primary pterygium. Patients were randomly assigned into two equal groups: group 1 underwent pterygium excision with cauterized CA fixation, and group 2 underwent pterygium excision with cauterized CA fixation and intraoperative application of 0.02% MMC for 3 min. All patients underwent a preoperative, first day, first week, first month, third month, and sixth month postoperative ophthalmic examination. Any intraoperative or postoperative complications were recorded. Primary outcomes were reported as incidence of recurrence and any major (sight threatening) complications. Secondary outcomes were reported as any minor complications. Results A total of 50 patients (28 males and 22 females, with male to female ratio 1 : 1.3) were included in this study. Complications encountered in our study included recurrence of pterygium, which occurred in one (4%) eye in group 1 and 0 eyes in group 2. Two (8%) eyes in group 1 versus one (4%) eye in group 2 showed subconjunctival hemorrhage, one (4%) eye in group 2 showed focal scleral thinning, and one (4%) eye in group 2 showed a corneal epithelial defect. There was no statistically significant difference between the two groups regarding the incidence of any complication (P>0.05). Conclusion Cauterized CA without MMC is a safe and effective procedure for the surgical treatment of primary pterygium. There was no added benefit to intraoperative MMC application.
{"title":"Cauterized conjunctival autograft with and without mitomycin C in primary pterygium surgery","authors":"Hesham A. Enany, T. Elsayed, R. Dessouky","doi":"10.4103/ejos.ejos_79_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_79_22","url":null,"abstract":"Aim To compare between the outcomes of cauterized conjunctival autograft (CA) with and without mitomycin C (MMC) in primary pterygium surgery. Patients and methods This prospective interventional comparative study included 50 eyes in 50 patients with primary pterygium. Patients were randomly assigned into two equal groups: group 1 underwent pterygium excision with cauterized CA fixation, and group 2 underwent pterygium excision with cauterized CA fixation and intraoperative application of 0.02% MMC for 3 min. All patients underwent a preoperative, first day, first week, first month, third month, and sixth month postoperative ophthalmic examination. Any intraoperative or postoperative complications were recorded. Primary outcomes were reported as incidence of recurrence and any major (sight threatening) complications. Secondary outcomes were reported as any minor complications. Results A total of 50 patients (28 males and 22 females, with male to female ratio 1 : 1.3) were included in this study. Complications encountered in our study included recurrence of pterygium, which occurred in one (4%) eye in group 1 and 0 eyes in group 2. Two (8%) eyes in group 1 versus one (4%) eye in group 2 showed subconjunctival hemorrhage, one (4%) eye in group 2 showed focal scleral thinning, and one (4%) eye in group 2 showed a corneal epithelial defect. There was no statistically significant difference between the two groups regarding the incidence of any complication (P>0.05). Conclusion Cauterized CA without MMC is a safe and effective procedure for the surgical treatment of primary pterygium. There was no added benefit to intraoperative MMC application.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"28 - 33"},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44296276","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}
Pub Date : 2023-01-01DOI: 10.4103/ejos.ejos_116_22
Amr E. Elbakry, Rania Sobhi, A. Hassanein, Hoda El Shiwy
Purpose To compare refractive and visual outcomes and patient satisfaction of toric implantable phakic contact lens (T-IPCL) versus bioptics (IPCL followed by femtosecond laser assisted in-situ keratomileusis) in myopia (moderate to high) with astigmatism. Patients and methods A total of 13 eyes underwent T-IPCL implantation, and 11 eyes were corrected using bioptics. Complications, uncorrected and corrected distance visual acuities, refraction, safety, efficacy, predictability, tear-film break-up time, contrast sensitivity, and patient satisfaction were assessed 6 months postoperatively. Results No complications were reported. Mean spherical equivalent was −0.62±0.49 D in T-IPCL and −0.55±0.26 D in the bioptics group (P=0.464). In 10 (76.9%) eyes of T-IPCL and 11 (100%) eyes of bioptics, the spherical equivalent and astigmatism were within ±1 D, respectively. A significantly better astigmatic correction was demonstrated in the bioptics group as confirmed by vector analysis (P<0.001). Loss of lines was not reported; both uncorrected and corrected distance visual acuities improved significantly (P<0.05), with no significant differences (P>0.05). Safety indices were 1.15±0.08 and 1.1±0.09 and efficacy indices were 1.04±0.11 and 1.03±0.06 in T-IPCL and bioptics groups, respectively, which were insignificant. The contrast sensitivity and tear-film break-up time were significantly better in the T-IPCL group (P<0.001). Distant vision satisfaction was better in the bioptics group, whereas glare, halos, and dry eye satisfaction were better in the T-IPCL group (P<0.05). Conclusion Both T-IPCL and bioptics can successfully correct moderate to high myopia with astigmatism. The T-IPCL carries better optical quality with less glare, halos, and dry eye. Bioptics gives better astigmatic correction and distant vision satisfaction but carries the risk of a second surgical intervention.
{"title":"Toric implantable phakic contact lens versus bioptics for the correction of moderate to high myopia and astigmatism","authors":"Amr E. Elbakry, Rania Sobhi, A. Hassanein, Hoda El Shiwy","doi":"10.4103/ejos.ejos_116_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_116_22","url":null,"abstract":"Purpose To compare refractive and visual outcomes and patient satisfaction of toric implantable phakic contact lens (T-IPCL) versus bioptics (IPCL followed by femtosecond laser assisted in-situ keratomileusis) in myopia (moderate to high) with astigmatism. Patients and methods A total of 13 eyes underwent T-IPCL implantation, and 11 eyes were corrected using bioptics. Complications, uncorrected and corrected distance visual acuities, refraction, safety, efficacy, predictability, tear-film break-up time, contrast sensitivity, and patient satisfaction were assessed 6 months postoperatively. Results No complications were reported. Mean spherical equivalent was −0.62±0.49 D in T-IPCL and −0.55±0.26 D in the bioptics group (P=0.464). In 10 (76.9%) eyes of T-IPCL and 11 (100%) eyes of bioptics, the spherical equivalent and astigmatism were within ±1 D, respectively. A significantly better astigmatic correction was demonstrated in the bioptics group as confirmed by vector analysis (P<0.001). Loss of lines was not reported; both uncorrected and corrected distance visual acuities improved significantly (P<0.05), with no significant differences (P>0.05). Safety indices were 1.15±0.08 and 1.1±0.09 and efficacy indices were 1.04±0.11 and 1.03±0.06 in T-IPCL and bioptics groups, respectively, which were insignificant. The contrast sensitivity and tear-film break-up time were significantly better in the T-IPCL group (P<0.001). Distant vision satisfaction was better in the bioptics group, whereas glare, halos, and dry eye satisfaction were better in the T-IPCL group (P<0.05). Conclusion Both T-IPCL and bioptics can successfully correct moderate to high myopia with astigmatism. The T-IPCL carries better optical quality with less glare, halos, and dry eye. Bioptics gives better astigmatic correction and distant vision satisfaction but carries the risk of a second surgical intervention.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"15 - 23"},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42600933","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}
Gihan Shokier, Sara Rabiea, M. Soliman, A. E. El Batawi, R. Ahmed, Nermeen Bahgat
Objectives The aim of this study was to assess the behavior of orbital cellulitis secondary to sinusitis and the detection of the causative organisms in patients presenting to Cairo University Hospitals. Patients and methods This was a cohort study in which 43 cases diagnosed with orbital cellulitis secondary to sinusitis were admitted to hospital and were enrolled in the study. All patients underwent thorough ophthalmological examinations, ENT consultations, and systemic assessments. Coronal and axial computed tomography scans of orbit, paranasal sinuses, and brain were done for all patients. Some patients had specimen sent for culture and sensitivity from the drained pus either from sinuses or lid abscesses. Results A total of 43 cases were involved in this study. The mean age was 23.93±19.38 years. Seven patients had systemic medical disorders. Six patients were diabetic. All patients received antimicrobial treatment, with seven (16.2%) patients needing addition of antifungal treatment and seven (16.2%) patients needing addition of steroids. A total of 20 (46.5%) patients needed surgical intervention. From these patients who had a specimen sent for culture and sensitivity, five (11.6%) had bacterial infections, seven (16.3%) had fungal infections, and eight (18.6%) showed no growth. A total of 39 (90.7%) patients responded clinically to treatment and four patients had recurrence within 6 months. Conclusion Bacterial infection was the commonest cause of orbital cellulitis secondary to sinusitis in the current study. Diabetes mellitus was a predisposing factor to fungal infection, which had a poor prognosis, in which visual acuity reached no light perception.
{"title":"Hospital-based study of causative organisms and clinical picture of orbital cellulitis secondary to sinusitis","authors":"Gihan Shokier, Sara Rabiea, M. Soliman, A. E. El Batawi, R. Ahmed, Nermeen Bahgat","doi":"10.4103/ejos.ejos_78_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_78_22","url":null,"abstract":"Objectives The aim of this study was to assess the behavior of orbital cellulitis secondary to sinusitis and the detection of the causative organisms in patients presenting to Cairo University Hospitals. Patients and methods This was a cohort study in which 43 cases diagnosed with orbital cellulitis secondary to sinusitis were admitted to hospital and were enrolled in the study. All patients underwent thorough ophthalmological examinations, ENT consultations, and systemic assessments. Coronal and axial computed tomography scans of orbit, paranasal sinuses, and brain were done for all patients. Some patients had specimen sent for culture and sensitivity from the drained pus either from sinuses or lid abscesses. Results A total of 43 cases were involved in this study. The mean age was 23.93±19.38 years. Seven patients had systemic medical disorders. Six patients were diabetic. All patients received antimicrobial treatment, with seven (16.2%) patients needing addition of antifungal treatment and seven (16.2%) patients needing addition of steroids. A total of 20 (46.5%) patients needed surgical intervention. From these patients who had a specimen sent for culture and sensitivity, five (11.6%) had bacterial infections, seven (16.3%) had fungal infections, and eight (18.6%) showed no growth. A total of 39 (90.7%) patients responded clinically to treatment and four patients had recurrence within 6 months. Conclusion Bacterial infection was the commonest cause of orbital cellulitis secondary to sinusitis in the current study. Diabetes mellitus was a predisposing factor to fungal infection, which had a poor prognosis, in which visual acuity reached no light perception.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"1 - 6"},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42214743","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}
Sameh Abdelfadeel, Noha M Khalil, Lobna Khazbak, M. Sidky
Pur6pose To detect epithelial thickness-based diagnostic variables to detect early keratoconus (KC) and differentiate cases of early KC from high regular astigmatism, especially if abnormal topographic changes are present. Patients and methods A total of 84 eyes with high regular astigmatism on Scheimpflug imaging were evaluated by anterior segment optical coherence tomography (AS-OCT). Imaging of the cornea as well as pachymetry and epithelial thickness mapping was done using AS-OCT via a special lens mounted to a tomographic device. The same was done using Scheimpflug imaging (CSO Sirius device). Thickness of the corneal epithelium was automatically mapped using a computer algorithm. Calculations of the following diagnostic factors were recorded: minimum, superior–inferior, minimum–maximum, root-mean-square variation, root-mean-square pattern deviation, and thickness of the zonal epithelium. Results This study analyzed 84 eyes divided into two groups: group A (n=56 eyes) had high regular astigmatism and group B (n=28 eyes) with early KC. The mean spherical refraction, cylindrical refraction, and central corneal thickness (Scheimpflug imaging) for group A were −1.16±1.02 D, −3.67±0.67, and 542.88±29.64 μm, respectively. In group A, the mean central corneal thickness and central epithelial thickness was 538.84±29.67 and 52.34±1.69 μm, respectively. The mean spherical refraction, cylindrical refraction, central corneal, and epithelial thickness mean for group B were −1.75±0.87, −4.02±0.69 D, 505.36±28.48, and 49.93±0.9 μm, respectively. A significant correlation between central epithelial thickness with anterior elevation was noted in group B (P=0.048). Conclusion AS-OCT epithelial mapping may prove to be a useful diagnostic tool for determining early development of KC.
{"title":"Role of epithelial mapping in the differentiation between early keratoconus and high regular astigmatism using spectral-domain optical coherence tomography","authors":"Sameh Abdelfadeel, Noha M Khalil, Lobna Khazbak, M. Sidky","doi":"10.4103/ejos.ejos_75_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_75_22","url":null,"abstract":"Pur6pose To detect epithelial thickness-based diagnostic variables to detect early keratoconus (KC) and differentiate cases of early KC from high regular astigmatism, especially if abnormal topographic changes are present. Patients and methods A total of 84 eyes with high regular astigmatism on Scheimpflug imaging were evaluated by anterior segment optical coherence tomography (AS-OCT). Imaging of the cornea as well as pachymetry and epithelial thickness mapping was done using AS-OCT via a special lens mounted to a tomographic device. The same was done using Scheimpflug imaging (CSO Sirius device). Thickness of the corneal epithelium was automatically mapped using a computer algorithm. Calculations of the following diagnostic factors were recorded: minimum, superior–inferior, minimum–maximum, root-mean-square variation, root-mean-square pattern deviation, and thickness of the zonal epithelium. Results This study analyzed 84 eyes divided into two groups: group A (n=56 eyes) had high regular astigmatism and group B (n=28 eyes) with early KC. The mean spherical refraction, cylindrical refraction, and central corneal thickness (Scheimpflug imaging) for group A were −1.16±1.02 D, −3.67±0.67, and 542.88±29.64 μm, respectively. In group A, the mean central corneal thickness and central epithelial thickness was 538.84±29.67 and 52.34±1.69 μm, respectively. The mean spherical refraction, cylindrical refraction, central corneal, and epithelial thickness mean for group B were −1.75±0.87, −4.02±0.69 D, 505.36±28.48, and 49.93±0.9 μm, respectively. A significant correlation between central epithelial thickness with anterior elevation was noted in group B (P=0.048). Conclusion AS-OCT epithelial mapping may prove to be a useful diagnostic tool for determining early development of KC.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"7 - 14"},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48372396","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}
Pub Date : 2023-01-01DOI: 10.4103/ejos.ejos_107_22
Amr E. Elbakry, M. Attia, Hoda El Shiwy, A. Hassanein, M. Sidky
Background A safe alternative to excimer laser in fixing high myopia is the implantable phakic contact lens (IPCL). Cycloplegics have been found to produce vault changes in the implantable collamer lens but not tested yet for the IPCL. Purpose To analyze central vault changes linked with instillation of cyclopentolate in myopic IPCL implanted patients and its association with anterior chamber depth (ACD), pupillary diameter, and white-to-white (WTW) diameter. Patients and methods This prospective study assessed the left eyes of 37 patients. Patients were followed up for 3 months postoperatively. The basic outcome measures were the safety and efficacy indices, while the main outcome was the vault measurements before and after cyclopentolate. Results Twenty (54.1%) females and 17 (45.9%) males, with a mean age of 24±4 years (18–32) were recruited. The safety index was 1.08±0.07 and the efficacy index was 0.99±0.1. There was a significant increase in central vault ‘V(C)’ after cyclopentolate [83.7±86.7 μm (−48 to 303); P<0.001). A good positive correlation existed between V(C) and ACD (r=0.7, P<0.001), and a fair correlation with pupil diameter (r=0.4, P=0.014), WTW (r=0.39, P=0.017), and the original vault ‘V(B)’ (r=0.34, P=004) was demonstrated. Conclusion Cyclopentolate induces an increase in central vault in most IPCL implanted myopic eyes, which is typically associated with ACD, pupillary diameter, WTW, and the original vault. Care should be advised to avoid angle narrowing.
{"title":"Assessment of Central Vault Changes induced By Cyclopentolate In Myopic Patients Implanted with the Implantable Phakic Contact Lens®","authors":"Amr E. Elbakry, M. Attia, Hoda El Shiwy, A. Hassanein, M. Sidky","doi":"10.4103/ejos.ejos_107_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_107_22","url":null,"abstract":"Background A safe alternative to excimer laser in fixing high myopia is the implantable phakic contact lens (IPCL). Cycloplegics have been found to produce vault changes in the implantable collamer lens but not tested yet for the IPCL. Purpose To analyze central vault changes linked with instillation of cyclopentolate in myopic IPCL implanted patients and its association with anterior chamber depth (ACD), pupillary diameter, and white-to-white (WTW) diameter. Patients and methods This prospective study assessed the left eyes of 37 patients. Patients were followed up for 3 months postoperatively. The basic outcome measures were the safety and efficacy indices, while the main outcome was the vault measurements before and after cyclopentolate. Results Twenty (54.1%) females and 17 (45.9%) males, with a mean age of 24±4 years (18–32) were recruited. The safety index was 1.08±0.07 and the efficacy index was 0.99±0.1. There was a significant increase in central vault ‘V(C)’ after cyclopentolate [83.7±86.7 μm (−48 to 303); P<0.001). A good positive correlation existed between V(C) and ACD (r=0.7, P<0.001), and a fair correlation with pupil diameter (r=0.4, P=0.014), WTW (r=0.39, P=0.017), and the original vault ‘V(B)’ (r=0.34, P=004) was demonstrated. Conclusion Cyclopentolate induces an increase in central vault in most IPCL implanted myopic eyes, which is typically associated with ACD, pupillary diameter, WTW, and the original vault. Care should be advised to avoid angle narrowing.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"34 - 41"},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42977686","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}
Aim of the study The aim was to evaluate the level of awareness among parents and caregivers of visually impaired children. Methods This was a prospective cross-sectional study that was conducted on parents/caregivers of visually disabled children to assess their realization of visual impairment through a structured questionnaire. Results The respondents included 604 parents/caregivers of visually impaired children. The results revealed that 48% were mothers, 82.1% were college graduates, 26.4% were aware of the availability of visual impairment rehabilitation, 66.9% believed that early detection of the child visual impairment was family’s responsibility, and 57.1% thought that the environment plays a key role in forming these children’s personality. Overall, 93.4% agreed that the family’s culture and social awareness play a key role in avoiding psychological burden, 91.9% agreed that the proper awareness campaigns have a significant role in mitigation of the children’s psychological burden, and 91.9% agreed that these programs could have a positive effect of the children’s educational career. The primary source of information was through the ophthalmology clinic, as reported by 45.6% of participants. In addition, 84.9% believed that these children should join regular schools, and 96.2% agreed that providers of educational services should be trained. Moreover, 51.7% were aware of the presence of special schools for these children. Furthermore, 51.5% believed that with the help of the family and environment, children with visual impairment could adapt in the society, and 65.2% agreed that these children could lead an independent life. Conclusion Raising public awareness particularly among families about the childhood visual impairment is crucial to foster understanding and acceptance of children with visual impairment, so that they can face challenges, interact with community, adapt to their surrounding environment, and lead an independent life.
{"title":"Awareness of childhood visual impairment","authors":"Rania. A. Zaki, R. Elshinawy, Karim M Naguib","doi":"10.4103/ejos.ejos_88_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_88_22","url":null,"abstract":"Aim of the study The aim was to evaluate the level of awareness among parents and caregivers of visually impaired children. Methods This was a prospective cross-sectional study that was conducted on parents/caregivers of visually disabled children to assess their realization of visual impairment through a structured questionnaire. Results The respondents included 604 parents/caregivers of visually impaired children. The results revealed that 48% were mothers, 82.1% were college graduates, 26.4% were aware of the availability of visual impairment rehabilitation, 66.9% believed that early detection of the child visual impairment was family’s responsibility, and 57.1% thought that the environment plays a key role in forming these children’s personality. Overall, 93.4% agreed that the family’s culture and social awareness play a key role in avoiding psychological burden, 91.9% agreed that the proper awareness campaigns have a significant role in mitigation of the children’s psychological burden, and 91.9% agreed that these programs could have a positive effect of the children’s educational career. The primary source of information was through the ophthalmology clinic, as reported by 45.6% of participants. In addition, 84.9% believed that these children should join regular schools, and 96.2% agreed that providers of educational services should be trained. Moreover, 51.7% were aware of the presence of special schools for these children. Furthermore, 51.5% believed that with the help of the family and environment, children with visual impairment could adapt in the society, and 65.2% agreed that these children could lead an independent life. Conclusion Raising public awareness particularly among families about the childhood visual impairment is crucial to foster understanding and acceptance of children with visual impairment, so that they can face challenges, interact with community, adapt to their surrounding environment, and lead an independent life.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"60 - 67"},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48023587","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}
E. Edrees, Fekry Zaher, A. Assaf, M. Yousef, A. Ebeid
Background Intracorneal implants have been proposed over the years as a possible easier way for managing keratoconus, having a favorable influence on the course of the disease. KERATACx is a relatively new form of intracorneal ring segments that has been recently introduced but not thoroughly studied regarding its safety and efficacy. Moreover, implanting a complete intrastromal ring into a corneal pocket, MyoRing (Dioptex GmbH, Austria), is an alternative technique, which can be considered safe, effective, and relatively easy for the treatment of keratoconus. Aim To compare between the effect of MyoRing and KERATACx corneal implants as new modalities of treatment on the visual acuity, as well as assess corneal topography findings in cases with moderate to severe keratoconus. Patients and methods Our study is a prospective comparative study conducted at specialized eye centers in Cairo. A total of 20 keratoconic eyes were eventually recruited. Overall, 10 of those eyes had 355° intracorneal ring segment implants (KERATACx ring segments) inserted into a femtosecond laser-created corneal tunnel at a depth of 75% of the thinnest location at the proposed tunnel site (group A), whereas the other 10 eyes had complete ring (MyoRing) implantation into a femtosecond laser-created corneal pocket at a 300-μm corneal depth (group B), by the same designated surgeon. The study was approved by the Ethics Committee of Ain-Shams University. Results Both types were proven to be statistically effective, with no statistically significant differences between the two groups related to any of the followed up parameters. In fact, both proved safe, effective, and reliable methods for managing keratoconus, with no difference of importance even to the degree of myopic refractive error correction. There were no significant intraoperative or postoperative complications reported within both groups throughout the whole study and follow-up period, but in turn, stability of the achieved results was found in both groups. Conclusion Both MyoRing and KERATACx were found to be equally effective, safe, and reliable methods for keratoconus management.
{"title":"Comparison between MyoRing and 355°KERATACx in the management of keratoconus","authors":"E. Edrees, Fekry Zaher, A. Assaf, M. Yousef, A. Ebeid","doi":"10.4103/ejos.ejos_80_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_80_22","url":null,"abstract":"Background Intracorneal implants have been proposed over the years as a possible easier way for managing keratoconus, having a favorable influence on the course of the disease. KERATACx is a relatively new form of intracorneal ring segments that has been recently introduced but not thoroughly studied regarding its safety and efficacy. Moreover, implanting a complete intrastromal ring into a corneal pocket, MyoRing (Dioptex GmbH, Austria), is an alternative technique, which can be considered safe, effective, and relatively easy for the treatment of keratoconus. Aim To compare between the effect of MyoRing and KERATACx corneal implants as new modalities of treatment on the visual acuity, as well as assess corneal topography findings in cases with moderate to severe keratoconus. Patients and methods Our study is a prospective comparative study conducted at specialized eye centers in Cairo. A total of 20 keratoconic eyes were eventually recruited. Overall, 10 of those eyes had 355° intracorneal ring segment implants (KERATACx ring segments) inserted into a femtosecond laser-created corneal tunnel at a depth of 75% of the thinnest location at the proposed tunnel site (group A), whereas the other 10 eyes had complete ring (MyoRing) implantation into a femtosecond laser-created corneal pocket at a 300-μm corneal depth (group B), by the same designated surgeon. The study was approved by the Ethics Committee of Ain-Shams University. Results Both types were proven to be statistically effective, with no statistically significant differences between the two groups related to any of the followed up parameters. In fact, both proved safe, effective, and reliable methods for managing keratoconus, with no difference of importance even to the degree of myopic refractive error correction. There were no significant intraoperative or postoperative complications reported within both groups throughout the whole study and follow-up period, but in turn, stability of the achieved results was found in both groups. Conclusion Both MyoRing and KERATACx were found to be equally effective, safe, and reliable methods for keratoconus management.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"116 1","pages":"50 - 59"},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43896125","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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