Purpose: To describe the effective use of only 50% air fill of the anterior chamber for rebubbling partially detached Descemet Membrane Endothelial Keratoplasty (DMEK) grafts at the slit lamp at a time of restricted operating theatre access during the COVID-19 pandemic. Methods: We present two cases of patients who underwent rebubbling of a partially detached DMEK grafts at the slit lamp following DMEK surgery without peripheral iridotomy. The rebubbling was performed with a 27-gauge needle attached to a 1ml syringe and the patients seated at the slit lamp. Air was injected into the anterior chamber until a 50% air fill was achieved. The patients were instructed to lie supine for 30 min in clinic and the remainder of the day at home. Results: We performed two rebubbling procedures at the slit lamp using the standard needle and syringe. Both cases achieved 50% air fills without any complications. At 3 days post-procedure the air bubble had resolved and the graft appeared attached centrally and at day 14 post-procedure the two patients had a clear and attached corneal graft with corrected visual acuity of 6/7.5 and 6/9, respectively. Conclusion: Rebubbling of detached DMEK grafts at the slit lamp with 50% air fill in the anterior chamber is a relatively simple and effective procedure. This provides an alternative approach for managing the complication of partially detached DMEK grafts in the era of COVID-19 with limited operating theatre access and avoids the risk of complications such as pupillary block in ‘PI-less’ DMEK.

Backogund: Pterygium is a common ocular surface disorder with a wing shaped fibrovascular overgrowth of bulbar conjunctiva onto the cornea and it is often triangular in shape and consists of a head, i.e., the part which rests on the cornea, a neck, and a body. It is a common conjunctival degenerative condition, which is characterized by elastotic degeneration of collagen and fibrovascular proliferation. Pterygium occurs as a result of breakdown of the corneoscleral limbal barrier results in subsequent conjunctivalization of the cornea, as the scattered light might follow alternative optical paths when entering the eye, thus hitting limbal stem cells from their inner surface. Aim of Study:The aim of the current study was to compare the recurrence rate of limbal auto graft transplantation versus single intraoperative subconjunctival Bevacizumab injection after surgical removal of the primary Pterygium.Patients and Methods: This was a prospective cohort study, the study was conducted on 20 eyes (10 Patients) with primary pterygium patients, attended the outpatient clinic of the Ophthalmology Department at Al-Azhar University Hospital (Cairo), during period from January 2021 to July 2021. Patients were being divided into equal 2 groups: Group 1: Pterygium was excised then limbalautograft was placed (10 eyes), and Group 2: Pterygium was excised followed by subconjunctival injection of bevacizumab (10 eyes).Results: Hundered percent inlimbal group were not recurrent, and twenty percent of the conjunctival injection group was recurrent, and there was non-statistical significant difference between two groups as regard recurrence. Ninty percent in group A were +ve as regard improvement in visual acuity, and eighty percente of the participants in the group B had +ve improvement in visual acuity, and there was non-statistical significant difference between two groups as regard visual acuity improvement. Seventy percent of cases in group A had no congestion while all cases in group B had no congestion, and there was no statistical significant difference between two groups as regard congestion, while as regard ischemia, we found that all cases in group A had no ischemia while fourty percente in group B develop postoperative ischemia,