This study compares the safety and effectiveness of bicanalicular silicone intubation in individuals with primary punctal stenosis versus 3 snip punctoplasty. Patients and methods:This study included 40 eyes with primary punctal stenosis (lower punctum) who were classified into two groups according to the surgical correction technique; three snip punctoplasty (group 1) and Bicanalicular silicone Intubation (group 2). All included cases were subjected to ophthalmic history taking and full ophthalmological examination including evaluation of the lacrimal tear strip, fluorescein dye disappearance test (FDDT), syringing and degree of epiphora. Patients were assessed at one day, one week, one month, three months and six months postoperative for evaluation of silicone tube stability, patency of the punctum, lacrimal tear strip, FDDT and degree of epiphora.Results: There was highly statistically significant improvement in FDDT and grading of Epiphora in between two groups starting from the first day postoperative in group B. The incidence of patient satisfaction was higher in the silicone intubation group, but it didn't reach a statistically significant value. Recurrence of Epiphora was reported in two cases in group 1 and in 1 case only in group 2. Conclusion:Bicanalicular silicone intubation is superior than 3-snip punctoplasty for the treatment of primary punctal stenosis.

Propose: Cupping of the optic nerve head is a classic sign of glaucoma; however non-glaucomatous optic neuropathies can cause changes of the optic nerve head as well. Currently, information from visual field (VF) examination by automated perimetry, optic nerve head pallor and visual acuity are used to aid in differentiating glaucomatous from non-glaucomatous optic nerve cupping.Optical coherence tomography (OCT) has been shown to have good reproducibility of retinal nerve fiber layer thickness (RNFL thickness) measures and monitoring glaucomatous disease progression. Aim of work:The current study was conducted to differentiate between glaucomatous from non-glaucomatous optic disc cupping based on clinical and investigation methods.Patients and Methods: This study included a total of 50 eyes with optic cupping; 32 eyes with glaucoma, 8 eyes with neurological disorders, 8 eyes with physiological cupping and only two eyes glaucoma suspects. All patients were subjected to ophthalmic examinations and investigations to assess causes of optic disc cupping.Results: There was no significant difference between studied groups regarding cup to disc ratio. There was statistically significant difference between studied groups regarding ISNT rule (that normal eyes show a characteristic configuration for disc rim thickness of inferior ≥ superior ≥ nasal ≥ temporal), only 28.1% of eyes in glaucoma group followed the rule, compared with 50.0% in neurological disorders. All eyes with physiologic cupping or who were glaucoma suspect followed that rule. No visual field defects were detected in physiological cupping and glaucoma suspect eyes, although glaucomatous eyes showed visual field defects respecting the horizontal meridian in most of the studied eyes, while neurological disorders eyes respected the vertical meridian. Conclusion:Visual field and OCT appeared to be a useful technology in evaluation non-glaucomatous optic disc cupping, as the pattern of RNFL loss was varied depending upon the etiology.

This current study was conducted to investigate the influence of the variable techniques available for corneal suturing on visual outcomes in penetrating keratoplasty (PKP). Methods:In this prospective study 40 cases underwent PKP which were divided according to the technique of suturing into 2 groups each of 20 patients; first group that underwent continuous suturing and the second group underwent interrupted suturing and they were followed up along 1 year postoperative for best corrected visual acuity (BCVA) and both topographic & refractive astigmatism. Result:The results of the study showed comparable improvement between the two techniques regarding the BCVA, refractive astigmatism and topographic astigmatism along the 12 months of follow-up. The need for suture manipulation was higher in the cases underwent interrupted suturing. Conclusion:there were no significant visual or refractive differences between patients operated with continuous & interrupted suturing techniques though the patients of the interrupted technique needs more suture manipulation for favorable outcomes than that needed in continuous technique patients.