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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}
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":null,"pages":null},"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}
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":null,"pages":null},"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}
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":null,"pages":null},"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":null,"pages":null},"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}
{"title":"Platelet-rich plasma injections in the management of severe dry eye","authors":"P. Sookaromdee, V. Wiwanitkit","doi":"10.4103/ejos.ejos_71_21","DOIUrl":"https://doi.org/10.4103/ejos.ejos_71_21","url":null,"abstract":"","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44668444","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. Makled, Ahmad Sahban, A. Khattab, Ashraf Nossair
Aim The aim was to assess the role of optical coherence tomography angiography (OCTA) in the diagnosis, assessment of activity, and monitoring the treatment response of choroidal neovascularization secondary to age-related macular degeneration (AMD). Methods Prospective, interventional case series of eyes that were diagnosed with active neovascular AMD. Spectral-domain optical coherence tomography (SD-OCT) and OCTA were done at baseline after intravitreal antivascular endothelial growth factor (anti-VEGF) treatment to determine OCTA sensitivity in the detection of activity in relation to SD-OCT findings and its specificity following intervention. Results Twenty-five eyes were included, of which 20 eyes were imaged successfully by OCTA. The diagnostic sensitivity of OCTA in those eyes was found to be 75%, and its sensitivity in the assessment of neovascular activity was 80 and 60%, before and after anti-VEGF therapy, respectively, whereas its specificity after anti-VEGFs therapy was 100%. Conclusion Although SD-OCT continues to be the gold-standard for noninvasively diagnosing and tracking neovascular AMD treatment response, OCTA may offer a noninvasive option that can support treatment selection throughout follow-up and guide efficient therapeutic approaches. Author contributions: All authors contributed to the construction of idea and question of the research with complete assessment and managements of all the study group. Hebatalla S. Makled: Assessment of the patients with follow-up, doing OCTA for the patients with interpretation, data collection and analysis, and manuscript writing and revision. Ahmad Almabrook Sahban: recruitment of patients with consent acquisition, doing OCTA for the patients, treatment with follow-up of the patients, collection and analysis of data, and manuscript writing. Ayman M Khattab: Patients assessment, decision making and follow-up of patients treatment, OCTA interpretation, collection and analysis of data, and manuscript writing and revision. Ashraf Ahmed Nossair: Patients assessment with follow-up, OCTA interpretation, data collection and analysis, and manuscript writing and revision.
目的评估光学相干断层扫描血管造影术（OCTA）在年龄相关性黄斑变性（AMD）继发脉络膜新生血管的诊断、活性评估和治疗反应监测中的作用。方法前瞻性、介入性病例系列的眼睛被诊断为活动性新生血管AMD。在玻璃体内抗血管内皮生长因子（anti-VEGF）治疗后的基线进行光谱域光学相干断层扫描（SD-OCT）和OCTA，以确定OCTA在检测与SD-OCT结果相关的活性方面的敏感性及其干预后的特异性。结果25眼，其中OCTA成像成功20眼。在抗VEGF治疗前后，OCTA在这些眼睛中的诊断敏感性为75%，在评估新生血管活性方面的敏感性分别为80%和60%，而在抗VEGFs治疗后其特异性为100%。结论尽管SD-OCT仍然是非侵入性诊断和跟踪新生血管AMD治疗反应的金标准，但OCTA可能提供一种非侵入性选择，可以支持整个随访过程中的治疗选择，并指导有效的治疗方法。作者贡献：所有作者都为研究思路和问题的构建做出了贡献，对整个研究小组进行了全面的评估和管理。Hebatala S.Makled：对患者进行随访评估，对患者进行OCTA解读、数据收集和分析，以及手稿撰写和修订。Ahmad Almabrook Sahban：招募获得同意书的患者，为患者进行OCTA，对患者进行随访治疗，收集和分析数据，以及撰写手稿。Ayman M Khattab：患者评估、患者治疗的决策和随访、OCTA解释、数据收集和分析以及手稿撰写和修订。Ashraf Ahmed Nossair：患者评估与随访、OCTA解释、数据收集和分析以及手稿撰写和修订。
{"title":"Evaluation of the role of optical coherence tomography angiography in monitoring treatment response in patients with neovascular age-;1;related macular degeneration","authors":"H. Makled, Ahmad Sahban, A. Khattab, Ashraf Nossair","doi":"10.4103/ejos.ejos_92_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_92_22","url":null,"abstract":"Aim The aim was to assess the role of optical coherence tomography angiography (OCTA) in the diagnosis, assessment of activity, and monitoring the treatment response of choroidal neovascularization secondary to age-related macular degeneration (AMD). Methods Prospective, interventional case series of eyes that were diagnosed with active neovascular AMD. Spectral-domain optical coherence tomography (SD-OCT) and OCTA were done at baseline after intravitreal antivascular endothelial growth factor (anti-VEGF) treatment to determine OCTA sensitivity in the detection of activity in relation to SD-OCT findings and its specificity following intervention. Results Twenty-five eyes were included, of which 20 eyes were imaged successfully by OCTA. The diagnostic sensitivity of OCTA in those eyes was found to be 75%, and its sensitivity in the assessment of neovascular activity was 80 and 60%, before and after anti-VEGF therapy, respectively, whereas its specificity after anti-VEGFs therapy was 100%. Conclusion Although SD-OCT continues to be the gold-standard for noninvasively diagnosing and tracking neovascular AMD treatment response, OCTA may offer a noninvasive option that can support treatment selection throughout follow-up and guide efficient therapeutic approaches. Author contributions: All authors contributed to the construction of idea and question of the research with complete assessment and managements of all the study group. Hebatalla S. Makled: Assessment of the patients with follow-up, doing OCTA for the patients with interpretation, data collection and analysis, and manuscript writing and revision. Ahmad Almabrook Sahban: recruitment of patients with consent acquisition, doing OCTA for the patients, treatment with follow-up of the patients, collection and analysis of data, and manuscript writing. Ayman M Khattab: Patients assessment, decision making and follow-up of patients treatment, OCTA interpretation, collection and analysis of data, and manuscript writing and revision. Ashraf Ahmed Nossair: Patients assessment with follow-up, OCTA interpretation, data collection and analysis, and manuscript writing and revision.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48406890","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}
Raouf Gaber, Mina Nassif, W. Shalaby, Osama A. Sorour
Aim To investigate the role of pre-injection antiglaucoma medications as a noninvasive method to prevent reflux following intravitreal injection (IVI). Patients and methods This single-center prospective randomized study included patients who were planned to receive an IVI of anti-vascular endothelial growth factor ranibizumab 0.05 ml for macular edema for diabetic macular edema, branch retinal vein occlusion, or choroidal neovascular membrane. Patients were randomized into five groups: no intervention (group 1), pre-injection topical brimonidine (group 2), pre-injection oral acetazolamide (Diamox) (group 3), pre-injection topical brimonidine and oral Diamox (group 4), and pre-injection paracentesis (group 5). The primary outcomes were the occurrence and degree of reflux following IVI. In addition, the evaluation of conjunctival bleb estimated the degree of reflux. Patient self-rated pain and early complications were secondary outcome measures. Results A total of 150 eyes of 150 patients were included. Vitreous reflux occurred in 13 (43%), 14 (46.7%), 19 (63.3%), six (20.0%), and four (13.3%) eyes in groups 1–5, respectively (P<0.001). Additionally, higher degrees of reflux were observed in group 1 compared with other groups. Discussion In our study, we raised the question of whether the intraocular pressure (IOP) before injection affects vitreous reflux. Therefore, we compared the effect of different antiglaucomatous medications on lowering the pre-injection IOP, and so decrease the vitreous reflux. We found that in both the paracentesis group and group of combined topical brimonidine and oral Diamox group, vitreous reflux rate is reduced significantly (P<0.001) because in these two groups, the IOP just before the injection was the lowest. Unfortunately, we could not measure the IOP after paracentesis and before the injection to avoid any risk of endophthalmitis, but we consider the paracentesis as a gold standard group for lowering IOP, although it is an invasive procedure. Interestingly, the self-rated pain rate was the same in all groups. Conclusion Pre-injection topical brimonidine combined with oral Diamox may be an effective and noninvasive method to prevent/reduce vitreous reflux following IVI.
{"title":"Noninvasive method to reduce vitreous reflux following intravitreal injection","authors":"Raouf Gaber, Mina Nassif, W. Shalaby, Osama A. Sorour","doi":"10.4103/ejos.ejos_93_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_93_22","url":null,"abstract":"Aim To investigate the role of pre-injection antiglaucoma medications as a noninvasive method to prevent reflux following intravitreal injection (IVI). Patients and methods This single-center prospective randomized study included patients who were planned to receive an IVI of anti-vascular endothelial growth factor ranibizumab 0.05 ml for macular edema for diabetic macular edema, branch retinal vein occlusion, or choroidal neovascular membrane. Patients were randomized into five groups: no intervention (group 1), pre-injection topical brimonidine (group 2), pre-injection oral acetazolamide (Diamox) (group 3), pre-injection topical brimonidine and oral Diamox (group 4), and pre-injection paracentesis (group 5). The primary outcomes were the occurrence and degree of reflux following IVI. In addition, the evaluation of conjunctival bleb estimated the degree of reflux. Patient self-rated pain and early complications were secondary outcome measures. Results A total of 150 eyes of 150 patients were included. Vitreous reflux occurred in 13 (43%), 14 (46.7%), 19 (63.3%), six (20.0%), and four (13.3%) eyes in groups 1–5, respectively (P<0.001). Additionally, higher degrees of reflux were observed in group 1 compared with other groups. Discussion In our study, we raised the question of whether the intraocular pressure (IOP) before injection affects vitreous reflux. Therefore, we compared the effect of different antiglaucomatous medications on lowering the pre-injection IOP, and so decrease the vitreous reflux. We found that in both the paracentesis group and group of combined topical brimonidine and oral Diamox group, vitreous reflux rate is reduced significantly (P<0.001) because in these two groups, the IOP just before the injection was the lowest. Unfortunately, we could not measure the IOP after paracentesis and before the injection to avoid any risk of endophthalmitis, but we consider the paracentesis as a gold standard group for lowering IOP, although it is an invasive procedure. Interestingly, the self-rated pain rate was the same in all groups. Conclusion Pre-injection topical brimonidine combined with oral Diamox may be an effective and noninvasive method to prevent/reduce vitreous reflux following IVI.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42591194","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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