Pub Date : 2023-04-01DOI: 10.4103/ejos.ejos_114_22
Amr Ali, Y. Serag, Hesham Eltoukhy, Raouf Gaber, Tamer Wasfy
Background The appearance of hyperfluorescent lines next to the retinal blood vessels after successful retinal detachment (RD) surgery was explained by the occurrence of retinal displacement. This can attribute to the metamorphopsia experienced by some patients after their surgeries. Patients and methods A prospective interventional study was performed that included 30 eyes of 30 patients with primary rhegmatogenous RD, who had undergone successful RD surgery via pars plana vitrectomy and silicone oil tamponade. The entire patients had preoperative and postoperative fundus autofluorescence and optical coherence tomography. They were followed up for 3 months after surgery with testing of the best-corrected visual acuity and Amsler grid testing. Results The mean age of the included group was 53.7±9.2 years, and 17 (56.7%) patients were males. The most frequent tear site was upper temporal (43.3%), followed by multiple peripheral (23.33%), upper nasal (13.3%), lower temporal (13.3%), and the least was lower nasal (6.7%). Retinal displacement was detected by hyperfluorescent lines adjacent to the retinal blood vessels in the fundus autofluorescence imaging in 16 eyes (53.3% with 95% confidence interval: 36.7–70.0%). Patients with retinal displacement were significantly younger than patients without (P=0.019). The presence of proliferative vitreoretinopathy was significantly related to the occurrence of displacement (P=0.028). Metamorphopsia was significantly more frequent among patients with displacement (P<0.001). Conclusion Retinal displacement had a high possibility to occur after successful repair of primary rhegmatogenous RD. Young patients and patients with proliferative vitreoretinopathy are at a higher risk for displacement.
{"title":"Retinal displacement following successful pars plana vitrectomy for rhegmatogenous retinal detachment","authors":"Amr Ali, Y. Serag, Hesham Eltoukhy, Raouf Gaber, Tamer Wasfy","doi":"10.4103/ejos.ejos_114_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_114_22","url":null,"abstract":"Background The appearance of hyperfluorescent lines next to the retinal blood vessels after successful retinal detachment (RD) surgery was explained by the occurrence of retinal displacement. This can attribute to the metamorphopsia experienced by some patients after their surgeries. Patients and methods A prospective interventional study was performed that included 30 eyes of 30 patients with primary rhegmatogenous RD, who had undergone successful RD surgery via pars plana vitrectomy and silicone oil tamponade. The entire patients had preoperative and postoperative fundus autofluorescence and optical coherence tomography. They were followed up for 3 months after surgery with testing of the best-corrected visual acuity and Amsler grid testing. Results The mean age of the included group was 53.7±9.2 years, and 17 (56.7%) patients were males. The most frequent tear site was upper temporal (43.3%), followed by multiple peripheral (23.33%), upper nasal (13.3%), lower temporal (13.3%), and the least was lower nasal (6.7%). Retinal displacement was detected by hyperfluorescent lines adjacent to the retinal blood vessels in the fundus autofluorescence imaging in 16 eyes (53.3% with 95% confidence interval: 36.7–70.0%). Patients with retinal displacement were significantly younger than patients without (P=0.019). The presence of proliferative vitreoretinopathy was significantly related to the occurrence of displacement (P=0.028). Metamorphopsia was significantly more frequent among patients with displacement (P<0.001). Conclusion Retinal displacement had a high possibility to occur after successful repair of primary rhegmatogenous RD. Young patients and patients with proliferative vitreoretinopathy are at a higher risk for displacement.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44296825","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}
H. Saigol, NajamNajam Iqbal, S. Akbar, Abdul Rauf, K. Chauhan, F. Ali, AbdulRehman Alvi, Madeeha Naeem, Muhammad Zeeshan
Background Ophthalmic trauma caused by intraocular foreign bodies (IOFBs) can impact visual prognosis by generating direct ocular structural damage. Factors bearing poor visual prognosis are related to size and velocity of IOFB, location in posterior segment with associated retinal detachment or endophthalmitis. Current study is aimed to evaluate size and location of IOFB and associated ocular structural damage. Methods In this retrospective study done at single tertiary center, patients injured by IOFBs were analyzed between January, 2010 to January, 2021 for ocular structural damage caused by size, velocity and location of impacted IOFB. All were assessed for corneal or scleral perforation and other structural damage due to IOFB. Location, route of retrieval and size of IOFB was measured. Results All 41 eyes were operated for removal of metallic IOFB. Corneal repair was done in 90.2% and scleral repair in 9.8% eyes. Hyphema cleared in 53.6% eyes. Traumatic cataract in 85.4% requiring phacoemulsification, preexisting aphakia (previous surgery) and siderosis was seen in 2.4% eyes. Retinal detachment was present in 14.6% and endophthalmitis in 4.9% eyes. Location of IOFB was on iris and lens in 2.4% each, with 19.5% impacted in retina and 75.6% were isolated in vitreous cavity. Small size IOFB was 58.3%, medium size was 29.3%, large size was 4.9% and very large size was 7.3%. No eye was deformed requiring evisceration of enucleation. Corneal or scleral repair, phacoemulsification, pars plana vitrectomy and intraocular foreign body removal as one stage procedure was done in each case. Intraocular lens implantation was done where sufficient anterior or posterior capsule was present. Conclusion Trauma caused by IOFB is commonly seen at workplace in young male laborers. It usually presents as corneal or scleral perforation, traumatic cataract, endophthalmitis and retinal detachment. Level of structural damage to ocular structures is dependent on the size, velocity and location of IOFB impaction. One stage surgical intervention for wound closure and IOFB should be considered for better surgical prognosis.
{"title":"Traumatic intraocular foreign bodies: correlation between size and structural damage","authors":"H. Saigol, NajamNajam Iqbal, S. Akbar, Abdul Rauf, K. Chauhan, F. Ali, AbdulRehman Alvi, Madeeha Naeem, Muhammad Zeeshan","doi":"10.4103/ejos.ejos_16_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_16_23","url":null,"abstract":"Background Ophthalmic trauma caused by intraocular foreign bodies (IOFBs) can impact visual prognosis by generating direct ocular structural damage. Factors bearing poor visual prognosis are related to size and velocity of IOFB, location in posterior segment with associated retinal detachment or endophthalmitis. Current study is aimed to evaluate size and location of IOFB and associated ocular structural damage. Methods In this retrospective study done at single tertiary center, patients injured by IOFBs were analyzed between January, 2010 to January, 2021 for ocular structural damage caused by size, velocity and location of impacted IOFB. All were assessed for corneal or scleral perforation and other structural damage due to IOFB. Location, route of retrieval and size of IOFB was measured. Results All 41 eyes were operated for removal of metallic IOFB. Corneal repair was done in 90.2% and scleral repair in 9.8% eyes. Hyphema cleared in 53.6% eyes. Traumatic cataract in 85.4% requiring phacoemulsification, preexisting aphakia (previous surgery) and siderosis was seen in 2.4% eyes. Retinal detachment was present in 14.6% and endophthalmitis in 4.9% eyes. Location of IOFB was on iris and lens in 2.4% each, with 19.5% impacted in retina and 75.6% were isolated in vitreous cavity. Small size IOFB was 58.3%, medium size was 29.3%, large size was 4.9% and very large size was 7.3%. No eye was deformed requiring evisceration of enucleation. Corneal or scleral repair, phacoemulsification, pars plana vitrectomy and intraocular foreign body removal as one stage procedure was done in each case. Intraocular lens implantation was done where sufficient anterior or posterior capsule was present. Conclusion Trauma caused by IOFB is commonly seen at workplace in young male laborers. It usually presents as corneal or scleral perforation, traumatic cataract, endophthalmitis and retinal detachment. Level of structural damage to ocular structures is dependent on the size, velocity and location of IOFB impaction. One stage surgical intervention for wound closure and IOFB should be considered for better surgical prognosis.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42064022","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}
A. Galal, Moumen Seleet, Mohamed Kabeel, Ayman Swar
Context DMEK is used to treat corneal decompensation. This study focuses on the succcess and outcome of DMEK with and without secondary IOL implantation. Aims The purpose of our work is to evaluate Descemet membrane endothelial keratoplasty (DMEK) with secondary Intraocular lens (IOL) implantation in cases of aphakic bullous keratopathy with insufficient capsular support. Settings and design Pilot study. Methods and material This was a nonrandomized comparative prospective interventional case series where 11 eyes of 11 patients with aphakic bullous keratopathy secondary to complicated cataract surgery underwent DMEK with secondary IOL implantation using modified Yamane technique, and results were compared to 11 eyes of 11 patients underwent DMEK only. Statistical analysis used The statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS 15.0.1 for windows; SPSS Inc, Chicago, IL, 2001). Results Both groups showed a high success rate (81.8%) with rebubbling required in 3 eyes in both groups. Both groups also showed significantly improved BCVA, decreased CCT and a decrease in donor graft ECD. Conclusions DMEK combined with secondary IOL implantation by modified Yamane technique appears to be a feasible method in managing aphakic bullos keratopathy with inadequate capsular support, and results are comparable to DMEK alone.
DMEK用于治疗角膜失代偿。本研究的重点是DMEK合并和不合并二次人工晶状体植入术的成功和结果。目的评价无晶状体大泡性角膜病变囊膜支持不足的患者行膜内皮角膜移植术(DMEK)联合继发性人工晶状体植入术的疗效。试验研究。方法和材料:本研究是一项非随机对照前瞻性介入病例系列研究，11例复杂性白内障术后继发无晶状体大泡性角膜病变患者的11只眼采用改良Yamane技术行DMEK合并二次人工晶状体植入术，并将结果与11例仅行DMEK的11只眼进行比较。统计分析采用SPSS 15.0.1 for windows;SPSS公司，芝加哥，伊利诺伊州，2001)。结果两组手术成功率均为81.8%，均有3只眼需要再泡。两组患者BCVA均显著改善，CCT降低，供体ECD降低。结论DMEK联合改良Yamane技术二次人工晶状体植入术是治疗无囊性大疱性角膜病变的可行方法，其效果与DMEK单独植入术相当。
{"title":"Evaluation of DMEK with secondary IOL implantation in cases of aphakic bullous keratopathy","authors":"A. Galal, Moumen Seleet, Mohamed Kabeel, Ayman Swar","doi":"10.4103/ejos.ejos_19_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_19_23","url":null,"abstract":"Context DMEK is used to treat corneal decompensation. This study focuses on the succcess and outcome of DMEK with and without secondary IOL implantation. Aims The purpose of our work is to evaluate Descemet membrane endothelial keratoplasty (DMEK) with secondary Intraocular lens (IOL) implantation in cases of aphakic bullous keratopathy with insufficient capsular support. Settings and design Pilot study. Methods and material This was a nonrandomized comparative prospective interventional case series where 11 eyes of 11 patients with aphakic bullous keratopathy secondary to complicated cataract surgery underwent DMEK with secondary IOL implantation using modified Yamane technique, and results were compared to 11 eyes of 11 patients underwent DMEK only. Statistical analysis used The statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS 15.0.1 for windows; SPSS Inc, Chicago, IL, 2001). Results Both groups showed a high success rate (81.8%) with rebubbling required in 3 eyes in both groups. Both groups also showed significantly improved BCVA, decreased CCT and a decrease in donor graft ECD. Conclusions DMEK combined with secondary IOL implantation by modified Yamane technique appears to be a feasible method in managing aphakic bullos keratopathy with inadequate capsular support, and results are comparable to DMEK alone.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45789788","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}
W. Ebeid, A. A. Abdel Latif, A. Mousa, Mohammad Akram Awwad
Purpose To assess the long-term outcome of Stab incision glaucoma surgery (SIGS) and compare it with subscleral trabeculectomy (SST) in the management of open-angle glaucoma (OAG). Methods Twenty eyes of 20 OAG patients were randomly assigned into group 1: 10 patients underwent SIGS + Mitomycin C (MMC), and group 2: 10 patients underwent SST + MMC. The patients were followed-up over 2 years after surgery. Our outcome measures were: Postoperative intraocular pressure IOP, number of medications used, and postoperative complications. Results Twenty-four months postoperatively, the mean IOP was 13.78±2.05 mmHg in the SIGS group compared with preoperative IOP of 26.33±5.1 mmHg (P <0.001, paired t-test), and 14.38±4.56 mmHg in SST group compared with preoperative IOP of 30.13±7.51 mmHg (P <0.001, paired t-test). No significant differences in mean IOP between groups either preoperatively (P=0.15) or along follow-up (P=0.62 at last visit). The mean IOP drop from baseline was 12.56±5.00 mmHg (46.33±10.50%) in SIGS group and 15.75±8.22 mmHg (49.50±17.95%) in SST group (P=0.26). A significant decrease in the number of glaucoma medications was noted in the SIGSS group (P <0.001), in the SST group, the number decreased but was not statistically significant (P =0.120). Conclusion SIGS is comparable with SST in achieving long-term significant and maintained IOP reduction over up to 2 years, in addition to decreasing the number of antiglaucoma medications postoperatively. SIGS is recommended for surgical management of primary OAG as it has the advantage of being a faster, easier, less traumatic alternative to conventional SST with fewer complications.
{"title":"Long-term outcome of stab incision glaucoma surgery versus trabeculectomy surgery in the management of primary open angle glaucoma","authors":"W. Ebeid, A. A. Abdel Latif, A. Mousa, Mohammad Akram Awwad","doi":"10.4103/ejos.ejos_95_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_95_22","url":null,"abstract":"Purpose To assess the long-term outcome of Stab incision glaucoma surgery (SIGS) and compare it with subscleral trabeculectomy (SST) in the management of open-angle glaucoma (OAG). Methods Twenty eyes of 20 OAG patients were randomly assigned into group 1: 10 patients underwent SIGS + Mitomycin C (MMC), and group 2: 10 patients underwent SST + MMC. The patients were followed-up over 2 years after surgery. Our outcome measures were: Postoperative intraocular pressure IOP, number of medications used, and postoperative complications. Results Twenty-four months postoperatively, the mean IOP was 13.78±2.05 mmHg in the SIGS group compared with preoperative IOP of 26.33±5.1 mmHg (P <0.001, paired t-test), and 14.38±4.56 mmHg in SST group compared with preoperative IOP of 30.13±7.51 mmHg (P <0.001, paired t-test). No significant differences in mean IOP between groups either preoperatively (P=0.15) or along follow-up (P=0.62 at last visit). The mean IOP drop from baseline was 12.56±5.00 mmHg (46.33±10.50%) in SIGS group and 15.75±8.22 mmHg (49.50±17.95%) in SST group (P=0.26). A significant decrease in the number of glaucoma medications was noted in the SIGSS group (P <0.001), in the SST group, the number decreased but was not statistically significant (P =0.120). Conclusion SIGS is comparable with SST in achieving long-term significant and maintained IOP reduction over up to 2 years, in addition to decreasing the number of antiglaucoma medications postoperatively. SIGS is recommended for surgical management of primary OAG as it has the advantage of being a faster, easier, less traumatic alternative to conventional SST with fewer complications.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44920306","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_104_22
Gihan Shokier
Objective The aim of this study was to detect the posterior segment indications for the use of handheld optical coherence tomography in the pediatric age group. Patients and methods This was a retrospective observational study that included patients who were candidates for handheld spectral domain optical coherence tomography (HH-OCT) imaging for retinal or optic nerve (ON) diseases in Abo Elreesh hospital during the period from June 2018 to June 2022. The image, demographic, and clinical database of the included patients were reviewed. Data were tabulated using Microsoft Excel. Appropriate statistical methods were used to analyze and correlate the obtained data. Results A total of 189 patients were included in this study, comprising 109 (57.7%) male patients. The mean age was 7.2±3.9 (range: 0.2–16 years) years. Overall, 46 (24.3%) patients were less than 5 years of age (i.e. infants and preschool age). Patients who underwent HH-OCT scanning due to retinal causes (i.e. nystagmus, unexplained poor vision, uveitis, Coat’s disease, trauma, and high myopia) were 130 (68.8%) patients, whereas 59 (31.2%) patients were indicated due to ON disease (i.e. primary congenital glaucoma and juvenile open angle glaucoma, optic disc hyperemia, swelling or pallor, and cases of large physiological cupping). Conclusion HH-OCT is a noninvasive feasible image modality for evaluation of retina and ON in infants and young children. The lack of a normative database for retinal nerve fiber layer thickness and ON head parameters in the pediatric age group in the device available in our service is considered a limitation in its use for proper evaluation of different pathologies involving the ON.
{"title":"Posterior segment indications of handheld spectral domain optical coherence tomography in pediatric age group in a tertiary eye center in Egypt","authors":"Gihan Shokier","doi":"10.4103/ejos.ejos_104_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_104_22","url":null,"abstract":"Objective The aim of this study was to detect the posterior segment indications for the use of handheld optical coherence tomography in the pediatric age group. Patients and methods This was a retrospective observational study that included patients who were candidates for handheld spectral domain optical coherence tomography (HH-OCT) imaging for retinal or optic nerve (ON) diseases in Abo Elreesh hospital during the period from June 2018 to June 2022. The image, demographic, and clinical database of the included patients were reviewed. Data were tabulated using Microsoft Excel. Appropriate statistical methods were used to analyze and correlate the obtained data. Results A total of 189 patients were included in this study, comprising 109 (57.7%) male patients. The mean age was 7.2±3.9 (range: 0.2–16 years) years. Overall, 46 (24.3%) patients were less than 5 years of age (i.e. infants and preschool age). Patients who underwent HH-OCT scanning due to retinal causes (i.e. nystagmus, unexplained poor vision, uveitis, Coat’s disease, trauma, and high myopia) were 130 (68.8%) patients, whereas 59 (31.2%) patients were indicated due to ON disease (i.e. primary congenital glaucoma and juvenile open angle glaucoma, optic disc hyperemia, swelling or pallor, and cases of large physiological cupping). Conclusion HH-OCT is a noninvasive feasible image modality for evaluation of retina and ON in infants and young children. The lack of a normative database for retinal nerve fiber layer thickness and ON head parameters in the pediatric age group in the device available in our service is considered a limitation in its use for proper evaluation of different pathologies involving the ON.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70723352","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}
A. Tabl, Mahrous Shaheen, Ahmed El Alim Mohamed, M. Tabl
Purpose To evaluate the outcomes of using air versus sulfur hexafluoride (SF6) gas tamponade in management of primary rhegmatogenous retinal detachment (RRD). Study design Retrospective case-series comparative study. Patients and methods We collected data from 120 patients in three tertiary university hospitals, that were diagnosed as primary RRD due to upper retinal break in the period from January 2021 to November 2022 and had undergone 23-G lens-sparing pars-plana vitrectomy with either air tamponade (Air group) or SF6 gas tamponade (SF6 group) and were followed up for 6 months. We analyzed the final visual outcomes between both groups. Results The mean age of the studied patients was 51±13 years (Air group=60 eyes, SF6 group=60 eyes). The mean axial length in Air group was 26.59±1.84 mm, the mean axial length was 26.46±1.49 mm in SF6 group. Best-corrected visual acuity was improved in both groups at the sixth month. In Air group 18.33% had recurrent RRD, while 10% in SF6 group. No significant difference regarding metamorphopsia was reported. Higher rate for cataract progression was noted among SF6 group. Conclusions Both Air and SF6 gas showed favorable results regarding the final visual outcome. Air is a less expensive tamponade with less timing for postoperative-prone positioning. Cataract progression was higher among SF6 group, however, the incidence of recurrent RRD was lower among SF6 group. Missed break was the primary cause for failed retinal reattachment.
目的评价空气与六氟化硫(SF6)气体填塞治疗原发性孔源性视网膜脱离(RRD)的疗效。研究设计回顾性病例系列比较研究。患者和方法我们收集了2021年1月至2022年11月在三所三级大学医院诊断为原发性视网膜上裂的120例患者的资料，这些患者于2021年1月至2022年11月期间接受了23-G保留晶状体的玻璃体切除术，采用空气填塞(air组)或SF6气体填塞(SF6组)，随访6个月。我们分析了两组患者的最终视觉效果。结果患者平均年龄51±13岁(Air组60眼，SF6组60眼)。空气组平均轴长26.59±1.84 mm, SF6组平均轴长26.46±1.49 mm。6个月时两组最佳矫正视力均有改善。Air组复发率为18.33%，SF6组为10%。在变形方面无显著差异。SF6组白内障进展率较高。结论空气和SF6气体对最终的视觉效果都有良好的效果。空气是一种较便宜的填塞方法，术后俯卧位的时间较短。SF6组白内障进展明显，但RRD复发发生率较SF6组低。未断裂是视网膜再植失败的主要原因。
{"title":"Outcomes of air versus sulfur hexafluoride tamponade in primary rhegmatogenous retinal detachment in phakic eyes","authors":"A. Tabl, Mahrous Shaheen, Ahmed El Alim Mohamed, M. Tabl","doi":"10.4103/ejos.ejos_2_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_2_23","url":null,"abstract":"Purpose To evaluate the outcomes of using air versus sulfur hexafluoride (SF6) gas tamponade in management of primary rhegmatogenous retinal detachment (RRD). Study design Retrospective case-series comparative study. Patients and methods We collected data from 120 patients in three tertiary university hospitals, that were diagnosed as primary RRD due to upper retinal break in the period from January 2021 to November 2022 and had undergone 23-G lens-sparing pars-plana vitrectomy with either air tamponade (Air group) or SF6 gas tamponade (SF6 group) and were followed up for 6 months. We analyzed the final visual outcomes between both groups. Results The mean age of the studied patients was 51±13 years (Air group=60 eyes, SF6 group=60 eyes). The mean axial length in Air group was 26.59±1.84 mm, the mean axial length was 26.46±1.49 mm in SF6 group. Best-corrected visual acuity was improved in both groups at the sixth month. In Air group 18.33% had recurrent RRD, while 10% in SF6 group. No significant difference regarding metamorphopsia was reported. Higher rate for cataract progression was noted among SF6 group. Conclusions Both Air and SF6 gas showed favorable results regarding the final visual outcome. Air is a less expensive tamponade with less timing for postoperative-prone positioning. Cataract progression was higher among SF6 group, however, the incidence of recurrent RRD was lower among SF6 group. Missed break was the primary cause for failed retinal reattachment.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41977622","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_113_22
S. Fawzy, Mohammed Al-Tawab, Z. Ismail, W. Ebeid
Aim We aimed to compare the anatomical and visual response of newly diagnosed choroidal neovascularization (CNV) secondary to pathological myopia or age-related macular degeneration with relatively poor initial vision to treatment with three intravitreal injections of ranibizumab. Patients and methods This prospective, comparative study included 29 eyes of 29 patients newly diagnosed with subfoveal active CNV, either secondary to age-related macular degeneration (AMD-CNV, 15 eyes) or to pathological myopia, that is, myopic CNV (MCNV, 14 eyes). All patients had an initial best-corrected visual acuity (BCVA) equal to or worse than 1.00 Log Mar. Patients received three intravitreal injections of 0.50 mg ranibizumab on a monthly basis. Patients were evaluated before injections and one month after each injection for BCVA and optical coherence tomography-measured retinal parameters: central macular thickness, total volume, and average thickness (AT). Amsler’s chart was used to detect scotomas and metamorphopsias. Results One month after the three injections, a significant improvement was noted in the two groups in central macular thickness, total volume, and AT. The improvement was significantly better in AT of the AMD group. The mean BCVA improved significantly in the AMD group only as patients either improved or remained stationary, whereas in the MCNV group, 21% of patients deteriorated, which affected the significance of the overall mean of improvement (P=0.7823); the difference in the overall mean was insignificant. Despite that, almost half of the patients in each group had their visual acuity improved by an average of 9.5 letters in AMD and 10.7 in MCNV. Conclusion Naïve AMD-CNV and MCNV of initially poor VA can get significant improvement in all optical coherence tomography-measured retinal parameters following a three-injection course of ranibizumab on a monthly basis. VA improvement is more predictable in AMD, as no patients deteriorated after the injections, yet the overall difference in VA improvement between groups was insignificant.
{"title":"Comparison of the outcome of limited protocol Ranibizumab injection in naïve choroidal neovascular membranes secondary to pathological myopia versus age-related macular degeneration","authors":"S. Fawzy, Mohammed Al-Tawab, Z. Ismail, W. Ebeid","doi":"10.4103/ejos.ejos_113_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_113_22","url":null,"abstract":"Aim We aimed to compare the anatomical and visual response of newly diagnosed choroidal neovascularization (CNV) secondary to pathological myopia or age-related macular degeneration with relatively poor initial vision to treatment with three intravitreal injections of ranibizumab. Patients and methods This prospective, comparative study included 29 eyes of 29 patients newly diagnosed with subfoveal active CNV, either secondary to age-related macular degeneration (AMD-CNV, 15 eyes) or to pathological myopia, that is, myopic CNV (MCNV, 14 eyes). All patients had an initial best-corrected visual acuity (BCVA) equal to or worse than 1.00 Log Mar. Patients received three intravitreal injections of 0.50 mg ranibizumab on a monthly basis. Patients were evaluated before injections and one month after each injection for BCVA and optical coherence tomography-measured retinal parameters: central macular thickness, total volume, and average thickness (AT). Amsler’s chart was used to detect scotomas and metamorphopsias. Results One month after the three injections, a significant improvement was noted in the two groups in central macular thickness, total volume, and AT. The improvement was significantly better in AT of the AMD group. The mean BCVA improved significantly in the AMD group only as patients either improved or remained stationary, whereas in the MCNV group, 21% of patients deteriorated, which affected the significance of the overall mean of improvement (P=0.7823); the difference in the overall mean was insignificant. Despite that, almost half of the patients in each group had their visual acuity improved by an average of 9.5 letters in AMD and 10.7 in MCNV. Conclusion Naïve AMD-CNV and MCNV of initially poor VA can get significant improvement in all optical coherence tomography-measured retinal parameters following a three-injection course of ranibizumab on a monthly basis. VA improvement is more predictable in AMD, as no patients deteriorated after the injections, yet the overall difference in VA improvement between groups was insignificant.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70723396","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}
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":null,"pages":null},"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}
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":null,"pages":null},"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}
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":null,"pages":null},"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}
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