Purpose To evaluate changes that occur in foveal avascular zone (FAZ) in diabetic hypertensive patients by optical coherence tomography angiography (OCTA). Patients and methods OCTA was performed for 60 eyes of 35 diabetic hypertensive patients. This study was done in Benha University Hospital between February and June 2021. FAZ area was measured by a frame that was centered around it. Moreover, the vessel density was measured also by detecting the superficial vessel density (SVD) and the deep vessel density (DVD). Results In diabetic hypertensive (60 eyes of 35 patients) with average age 55.52 (±6.88) years and mean duration of the disease 12.17 (±7.15) years, the mean value of the FAZ was 0.37 (±0.54) mm, denoting enlargement of the FAZ diameter. In addition, the vessel density showed that there is decreasing in the SVD (43.9±5.89) and it was correlated to the best-corrected visual acuity and age of the patients (P<0.05), while it was highly correlated to the DVD (P<0.001). On the other hand, there was a decrease in DVD with a mean of 43.17±7.44, which was statistically significant with the age of the patients (P<0.05), but there was no significant relationship with duration of the disease, glycated hemoglobin, and best-corrected visual acuity. Conclusion OCTA is a noninvasive technique to image the retinal and choroidal vasculature. The study concluded that diabetic retinopathy in the presence of systemic hypertension leads to increasing of the FAZ area. Moreover, it leads to decreasing in both the SVD and DVD. Also, it allows for early detection and easy follow-up of the disease.

Aim The aim of this study was to compare mechanical photorefractive keratectomy (PRK) to transepithelial photorefractive keratectomy (tPRK), used to correct mild and moderate myopia, with respect to the epithelial thickness mapping (ETM). Setting The study was carried out at Al-Mashreq Eye Center, Cairo, Egypt. Patients and methods This is a prospective comparative study that was carried out on 20 myopic patients (40 eyes), with spherical equivalent (SE) ranging from −1.0 to −5.0 D. The cases were divided into two groups: group A included the right eyes (OD) of all patients, and group B included the left eyes (OS). Group A underwent mechanical PRK using ‘hockey stick’ and excimer laser, using Mel-90 excimer laser with 250 Hz mode, and 0.7-mm spot scanning. Group B underwent tPRK using Mel-90 (8-mm lamellar ablation for 55 μm, 250 Hz). Uncorrected visual acuity (UCVA), manifest refraction, and ETM using AngioVue spectral domain optical coherence tomography systems were performed. The ETM was measured preoperatively and at 1 week, 1 month, and 3 months postoperatively. In addition, postoperative pain was assessed. Results The median preoperative UCVA was 0.3 (range, 0.2–0.4) in both eyes (OU), whereas the median preoperative best-corrected visual acuity was 1 (range, 0.8–1). There was a statistically significant increase in UCVA across the postoperative period in both groups (P<0.001). The median UCVA improved to 0.5 (OU) after 1 week, and to 0.9 (OD) and 1.0 (OS) after 1 month and remained almost the same at 3 months postoperatively. There was a statistically significant decrease in SE at all points of the follow-up period in both groups (P<0.001). A slight change in SE was observed between the first and third month postoperatively in both groups, which was statistically insignificant. Patients reported postoperative pain on the first postoperative day, which was more in the tPRK group. There was a statistically significant change in epithelial thickness across the study period in both groups (P<0.001). The ETM showed a faster epithelial regeneration in group B, which was statistically significant at 1 week postoperatively (P=0.004). The epithelial thickness continued to increase in both groups to reach almost the preoperative value at the third month postoperatively. All cases that showed postoperative haze were less than grade 1.0 (Hanna’s scale). Conclusion Mechanical PRK and tPRK provided very similar results 3 months postoperatively. Both procedures were predictable, effective, and safe. The patients reported postoperative pain on the first postoperative day that was more in the tPRK group. The tPRK group expressed a faster epithelial regeneration than the PRK group at 1 week postoperatively. However, at 3 months postoperatively, the corneal epithelium reached an almost normal thickness in both groups. Visual recovery was noted to be faster in the tPRK group.

Aim To evaluate the visual outcome of implantable phakic contact lens (IPCL) in high myopia. Setting Al-Mashreq Eye Center, Cairo, Egypt. Patients and methods Thirty eyes of 17 patients underwent surgery to correct high myopia using IPCL (Care Group-India) with a central hole (V2.0). Visual acuity, spherical equivalent, and intraocular pressure (IOP) were evaluated 6 months postoperatively. Anterior chamber parameters Anterior chamber volume (ACV), Anterior chamber depth (ACD), Anterior chamber angle width (ACAW) were measured using Pentacam. Results After 6 months, spherical equivalent decreased from −14.19±4.2 to −0.18±0.66 D, all cases were within ±1.00 D of intended correction. Best corrected visual acuity (BCVA) remained unchanged in 13% of cases, 13% gained one line, and 74% gained two or more lines. ACV, ACD, and ACAW decreased from 189.77±20.19 mm3, 3.15±0.27 mm, and 37.31±5.63° to 131.4±14.01 mm3, 3.05±0.29 mm, and 23.94±4.81°, respectively. Changes in IOP between preoperative and 6 months postoperatively were statistically insignificant. Conclusion IPCL is a safe, effective, and predictable surgery to correct high myopia. Most cases gained one or more lines of BCVA. Reduction of ACV did not induce IOP rise during 6 months of follow-up.