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   2019| October-December  | Volume 20 | Issue 4  
    Online since December 17, 2019

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Causes and clinical manifestations of ocular trauma
Elsayed M Elsayed, Sameh M Saleh, Dalia Sabry, Adel M Hassan
October-December 2019, 20(4):166-171
Purpose The aim of this work was to provide data about the causes and nature of ocular trauma and to find the relationship of these causes with age and sex. Patients and methods Patients with all types of eye injuries such as mechanical (by blunt object, sharp object, or foreign body), chemical or physical injuries were enrolled in the current study from April 2015 to August 2015 in both Mansoura Ophthalmic Center and Alsinbelaween Ophthalmic Section. Thereafter, patients were classified according to the demographic information, causes, and nature of trauma. Results This study included 200 patients with ocular injuries. Patients living in urban areas constituted the majority of the cases (123=61.5%), while patients living in rural areas accounted for 77/200 (38.5%) patients. Closed-globe injuries constituted most of the cases (33.75%), while 49.25% were for contusions and lamellar lacerations. Open-globe injuries constituted most of the cases of admitted patients (17% of all patients), and rupture globe accounted for 12% of cases of all patients. Conclusion Blunt trauma is a major type of ocular trauma that can produce marked sudden distortion of the globe, resulting in more severe damage than may be clinically apparent. Severe trauma leads to lesions in the globe ranging from relatively superficial to vision-threatening lesions.
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Subconjunctival bevacizumab injection versus mitomycin C application after primary pterygium surgery
Hani A Albialy, Haitham Y Al-Nashar
October-December 2019, 20(4):139-143
Purpose The aim of this study was to compare subconjunctival bevacizumab injection and mitomycin C (MMC) application after primary pterygium surgery in terms of recurrence rates and complications. Patients and methods This prospective comparative clinical study included 90 eyes of 90 patients with primary pterygium who underwent excision with bare sclera technique. Patients were randomized into three groups: group A (30 eyes), in which MMC 0.02% was applied to the bare scleral area for 3 min; group B (30 eyes), which received 2.5 mg/0.1 ml subconjunctival bevacizumab injection at the end of surgery; and group C (30 eyes), which was used as a control group and did not receive any adjuvant medications after pterygium excision. Patients were followed up for 6 months, and the recurrence rates of pterygium and any complications were reported. Results At 6 months after surgery, the recurrence rates in the three groups were as follows: two (6.7%) eyes in the MMC group A, two (6.7%) eyes in the bevacizumab group B, and 11 (36.7%) eyes in the control group C, with a significant difference among groups (P=0.01). No serious complications, except subconjunctival hemorrhage, were observed in all groups. Conclusion Groups receiving topical 0.02% MMC and 2.5 mg/0.1 ml subconjunctival bevacizumab injections after surgery showed lower recurrence rates than the control group. However, no difference in the recurrence rate was observed between both groups.
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Effect of continuous intrastromal corneal ring (MyoRing) implantation on intraocular pressure measurements in patients with keratoconus
Mahmoud Abd El-Radi, Mohamed G Saleh
October-December 2019, 20(4):144-147
Purpose The aim of this study was to document the effect of implanting continuous intrastromal corneal ring (MyoRing) on intraocular pressure (IOP) measurements by Goldmann applanation tonometer (GAT). Patients and methods Patients with moderate keratoconus with keratometric (K) readings between 48 and 55 D, corneal thinnest location on pentacam of more than 380 μm, and clear cornea underwent MyoRing implantation using a femtosecond laser system as per standard care. IOP was measured over the central cornea using GAT at baseline and after surgery by 1 week, 1, and 6 months, with the readings of month 6 being used in statistical analysis. Results A total of 30 eyes of 30 patients were enrolled in the study. The mean preoperative IOP was 14.3 mmHg, whereas the mean postoperative IOP was 13.9 mmHg, with no statistical significance (P>0.05). The mean preoperative pachymetry at the center of the cornea was 442.4 μm, whereas the mean postoperative pachymetry at the center of the cornea was 438 μm, with no statistical significance (P>0.05). Conclusion Implantation of MyoRing in patients with keratoconus resulted in a mild decrease in IOP measurements that was neither clinically nor statistically significant.
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Articaine versus lidocaine with and without dexmedetomidine for peribulbar anesthesia in phacoemulsification
Esraa O Eissa, Omyma S Mohamed, Ahmed M Eid, Ahmed Korani
October-December 2019, 20(4):148-156
Background The aim of this study was to compare the use of articaine versus lidocaine either with or without dexmedetomidine for peribulbar anesthesia in phacoemulsification. Patients and methods This is a prospective, randomized double-blind study that included 120 adult patients subjected to phacoemulsification with peribulbar anesthesia. They were randomly allocated into four groups: articaine (group 1, A), lidocaine (group 2, L), articaine–dexmedetomidine (group 3, AD), and lidocaine–dexmedetomidine (group 4, LD). Ocular akinesia was evaluated using Brahma scoring system. Pain assessment was carried out by four-point verbal rating score. Patient satisfaction and surgeon satisfaction were also recorded. Results Regarding the ocular movement score, a statistically significant lower score was recorded in group 3 (AD) when compared with each of the other groups. Within each group, there was a significant decrease in eyelid score at 5, 10 min and end of surgery when compared with baseline score. Regarding the mean duration of globe akinesia, it was significantly longer in group 3 (AD) (139±20.4 min) in comparison with the other groups [group 4 (LD)=120.83±21.09 min, group 1 (A)=73±10.55 min, and group 2 (L)=50.33±4.9 min]. Patient satisfaction was significantly better in group 3 (AD) and in group 4 (LD). Surgeon’s satisfaction was significantly better in group 1 (A), group 3 (AD) and group 4 (LD) when compared with group 2 (L) and in group 1 (A) and group 3 (AD) in comparison with group 4 (LD), with the best quality detected in group 3 (AD). Conclusion Articaine was superior over lidocaine for peribulbar block in achieving shorter onset and longer duration of globe akinesia and anesthesia. Addition of dexmedetomidine improved the quality of each.
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Incidence of retinopathy in patients with chronic hepatitis C treated with dual and triple antiviral protocols
Mouaz A Abd-Elhadi, Hazem E Haroun, Noha M Khalil, Safaa A Aboud
October-December 2019, 20(4):161-165
Purpose The aim of this study was to compare the incidence of ophthalmological complications in chronic hepatitis C virus patients treated with dual versus triple antiviral protocols. Study design A Prospective, observational, comparative study. Setting Ahmed Maher Teaching Hospital and revised in the Outpatient Clinic of Ophthalmology Department of Beni Suef University. Patients and methods One hundred and fifty chronic hepatitis C virus patients were treated by dual therapy of sofosbuvir and ribavirin for 6 months (group A), and 150 patients were treated by triple therapy of sofosbuvir, ribavirin, and interferon pegylated interferon (pegINF-α) for 3 months (group B). Full general and ophthalmological examinations were done at the baseline visit before receiving treatment and at 3 and 6 months after treatment. Any ophthalmological complications including deterioration in best corrected visual acuity, anterior segment inflammation, or retinal complications in the form of hemorrhages, soft exudates, or changes in cup/disk ratio were recorded. Results In 11% of the patients under triple therapy, retinal hemorrhages and soft exudates were detected by the second visit; however, they resolved by the third visit. Patients under dual therapy showed no ophthalmological complications throughout the 6-month follow-up period. No uveitis or changes in best corrected visual acuity and cup/disk ratio were detected. Conclusion Interferon-free protocols showed no retinal complications. However, the retinal complications related to the interferon-containing protocols resolved shortly within weeks. Thus, interferon-free protocols showed higher safety on the eye.
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Influence of yttrium aluminum garnet laser posterior capsulotomy opening size on intraocular pressure and central macular thickness
Ahmed A Alhagaa, Nermeen M Badawi
October-December 2019, 20(4):157-160
Purpose This study aimed to show the effect of yttrium aluminum garnet (YAG) laser posterior capsulotomy opening size on intraocular pressure (IOP) and central macular thickness (CMT). Patients and methods Two hundred eyes having posterior capsule opacification were included in this study. These eyes were classified into two groups: the first group (100 eyes) had undergone small YAG laser posterior capsulotomy, whereas the second group (100 eyes) had undergone large YAG laser posterior capsulotomy. Eyes in both groups were carefully examined preoperatively and at 1 day, 3 days, 1 week, 1 month, 3 months, and 6 months postoperatively. In each visit, IOP and CMT were recorded in all eyes, and the results were compared between both groups. Results Patients in the second group with large YAG laser posterior capsulotomy opening size showed significantly higher IOP and higher CMT. Conclusion Neodymium : YAG laser posterior capsulotomy is a safe technique even with the presence of some possible complications like increased IOP, which is controlled rapidly after the first postoperative day, and macular edema, which improved rapidly with no long-lasting effect on vision.
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