Purpose To demonstrate the demographic features, causative agents, and outcome of pediatric traumatic cataract surgery in eyes without posterior segment involvement at Assiut University Hospital, Upper Egypt. Patients and Methods This is a retrospective study on children (aged <18 years old) who underwent traumatic cataract surgery from January to June 2019. Children with posterior segment injury and those who did not complete 6 months of postoperative follow-up were excluded. The demographic features, mechanism and time of eye injury, clinical features, surgical approach, and outcome were recorded and analyzed. Results The study included 34 eyes of 34 children, 23 (68%) of them were boys. The mean age at the time of cataract surgery was 10±3.97 years. Twenty-one eyes sustained open globe injury (62%) with the most common cause of trauma was wooden sticks, while 13 eyes had closed globe injury (38%) with the most common cause of injury was thrown stones. The time interval between eye injury and cataract surgery ranged from 1 day to 9 years with a median of 2.05 months. Posterior chamber intraocular lenses were implanted in all eyes; in 33 eyes, the posterior chamber intraocular lenses were implanted primarily at the time of cataract extraction. Corrected distance visual acuity significantly improved from 2.63±0.66 LogMAR preoperatively, to 0.41±0.38 LogMAR postoperatively (p < 0.001). Conclusion Pediatric traumatic cataract is commonly present in primary school age especially after open globe injury. Primary prevention through health awareness should target this age population. Useful vision can be regained with timely proper surgical intervention and posterior chamber intraocular lens implantation. Clinicaltrials.gov Id NCT04630509.
Purpose To evaluate the ocular manifestations of post-acute COVID-19 syndrome. Methods A retrospective, comparative study included 100 patients who had recovered from COVID-19 and 100 controls who were recruited by stratified randomization from hospital registration system and analyzed regarding history, full ophthalmological examination, general examination including internal medicine and neurological evaluation. Laboratory tests were done. Results Mean±SD of age were 55.5 ± 6.2 in COVID group vs 56.5 ± 5.8 in control group; P value = 0.7. In COVID group, 57 patients (57%) were males vs 51 patients (51%) in control group (P value = 0.39), the other compared parameters including history and risk factors showed non-significant difference except for ESR and D-dimer which were elevated in COVID group. In COVID group, 5 patients (5%) were having retinal vascular occlusion, 2 patients (2%) were having anterior ischemic optic neuropathy AION, 3 patients (3%) were having uveitis and 2 patients (2%) were having central serous chorioretinopathy CSCR. While in control group, 2 patients (2%) were having retinal vascular occlusion, and none had AION, uveitis or CSCR (P value = 0.006). Conclusion Post-acute COVID-19 syndrome could affect the eyes in the form of coagulation problems, neurological morbidities, and other manifestations. This necessitates meticulous follow-up of recovered patients from COVID-19.
Purpose. To compare safety and efficacy between a low-cost glaucoma drainage device (GDD), the Aurolab aqueous drainage implant (AADI), and the Baerveldt glaucoma implant (BGI) in refractory childhood glaucoma in Egypt. Methods. This is a retrospective study of patients who received either an AADI or BGI at a tertiary care postgraduate teaching institute. Children aged <16 years with uncontrolled intraocular pressure (IOP) with or without prior failed trabeculectomy who completed a minimum 6-month follow-up were included. The outcome measures were IOP reduction from preoperative values and postoperative complications. Results. Charts of 57 children (younger than 16 years old) diagnosed with refractory childhood glaucoma were included. Of these, 27 eyes received AADI implants (group A), while 30 received BGI implants (group B). The mean preoperative baseline IOP was 34 ± 5 mmHg in group A versus 29 ± 2 mmHg in group B (p=0.78) in patients on maximum allowed glaucoma medications. In group A versus group B, the mean IOP decreased to 13.25 ± 8.74 mmHg (p=0.6), 12.8 ± 5.4 mmHg (p=0.7), and 12.6 ± 5.6 mmHg (p=0.9) after 1 week, 3 months, and 6 months, respectively. However, in group A, an anterior chamber reaction appeared around the tube in 14 cases starting from the first month and resolved with treatment in only 4 cases. In the other 10 cases, the reaction became more severe and required surgical intervention. This complication was not observed in any eye in group B. Conclusion. AADI, a low-cost glaucoma implant, is effective in lowering IOP in patients with recalcitrant paediatric glaucoma. However, an intense inflammatory reaction with serious consequences developed in some of our patients; we believe these events are related to the valve material. We therefore strongly recommend against its use in children.
Purpose: To assess the presence of anti-SARS-CoV-2 IgA in the conjunctival secretions of confirmed COVID-19 patients by nasopharyngeal swabs and correlate its presence with the severity of the disease, patient's age, sex and ocular symptoms. Methods: This study included 44 positive COVID-19 patients confirmed with nasopharyngeal swabs during the period 17-28 February 2021 at Sohag Tropical Medicine Hospital. Tears and conjunctival secretions were examined for the presence of anti-SARS-CoV-2 IgA. Results: While non-reactive results are strongly correlated to low titre and vice versa, severity showed significant correlation with neither IgA reactivity nor titre. Meanwhile, IgA reactivity did not show significant correlation with either age or sex. The reactivity and IgA titre are correlated with ocular symptoms. Conclusion:The anti-SARS-CoV-2 IgA could be found in ocular secretions in SARS-CoV -2 patients. There is no correlation with age or sex or severity of the disease; however, they are correlated with ocular symptoms.
Performing phacoemulsification in eyes with corneal opacities is challenging even with expert surgeons. Several techniques have been described to improve intraoperative visualization through opacified corneas. This retrospective interventional case series included 10 eyes of 10 patients with coexisting senile cataract and corneal opacity who underwent phacoemulsification with intraocular lens (IOL) implantation under slit illumination of the surgical microscope. Uneventful phacoemulsification with IOL implantation was achieved in all eyes without intraoperative complications. Slit illumination reduced the light scattering and reflection from the corneal opacity, enhanced the red reflex, and improved depth perception simultaneously in different steps of phacoemulsification. Phacoemulsification was safely performed in eyes with corneal opacity under slit illumination of the surgical microscope. It can be considered as a viable option for improving intraoperative visualization in patients with corneal opacities without additional instrumentation.
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