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Background: Modifications in eyelid position change pressure exerted on the corneal anterior surface and produce topographic changes that may affect the quality of vision and corneal refractive power and related measurements. Aim of work: The aim of the current study is to evaluate corneal topographic changes after ptosis surgery. Patient and Methods: 30 eyes of 30 patients of ptosis underwent surgical correction. Complete ophthalmic examination and computerized topography were performed before surgery, then 1-month and 3-months after surgery. The pre-operative and post-operative data were subtracted and statistically analyzed. Data included K1, K2, average keratometry (avgK), corneal astigmatism (value & type), apical keratometry front (AKf) and symmetry index front (SIf). The effect of surgery on BCVA was also evaluated. Results: 1-month postoperative, none of the measured parameters did show any significant change. 3-months postoperative, corneal astigmatism demonstrated a significant reduction from baseline 1.2 ± 0.3 D to 0.7 ± 0.3 D (p = 0.007). (avgK) also demonstrated a significant reduction from baseline 43.1 ± 1.3 D to 42.2 ± 1.5 D (p = 0.011). Another significant difference was also reported in (AKf) which decreased from baseline 46.21 ± 1.81 to 44.22 ± 2.04 (p = 0.033). (SIf) decreased from baseline-1.23 ± 1.61 to-1.05 ± 1.39, difference was insignificant (p = 0.308). The BCVA improved from baseline 0.54 ± 0.22 to 0.61 ± 0.18 (p = 0.285), improvement was statistically insignificant. Conclusion: The surgical correction of eyelid urges the modification of the anterior corneal surface, restoration of symmetry of the cornea and regular corneal astigmatism.

Background: In patients with type 2 diabetes mellitus, the development of diabetic retinopathy (DR) correlates positively with elevated serum chemerin levels. This study was aimed at investigating the probable association between the serum chemerin level and the development of DR in patients with type 1 diabetes mellitus (T1DM). Methods: In this cross-sectional study, we included Egyptians and classified them into four groups: group 1, including healthy individuals; group 2, including patients with T1DM without DR; group 3, including patients with T1DM with non-proliferative DR (NPDR); and group 4, including patients with T1DM with proliferative DR (PDR). The assessment included best-corrected distance visual acuity assessment, slit-lamp biomicroscopy, funduscopy, fundus fluorescein angiography, and macular ocular coherence tomography. Fasting blood samples were obtained from all participants to measure serum chemerin, glycated hemoglobin (HbA1c), total cholesterol, triglyceride, and creatinine levels. Serum chemerin levels were compared among the groups, and their correlations with age, duration of diabetes, HbA1c, total cholesterol, triglyceride, and creatinine levels were analyzed. Results: We recruited 209 participants, including 46 healthy individuals in group 1, 52 patients (T1DM and no DR) in group 2, 61 patients (T1DM and NPDR) in group 3, and 50 patients (T1DM and PDR) in group 4, with comparable mean ages and sex ratios among groups. The diabetes duration, body mass index, HbA1c, total cholesterol, triglyceride, and serum chemerin levels differed significantly among the groups (all P < 0.001), whereas the creatinine level did not (P > 0.05). The serum chemerin level was significantly higher in group 4 than in groups 3 and 2, in group 3 than in group 2, and in groups 3 and 4 than in group 1 (all P < 0.001). However, it was comparable between groups 1 and 2 (P > 0.05). It correlated with the duration of T1DM and HbA1c, total cholesterol, triglyceride, and creatinine levels but not with age. Conclusions: Patients with T1DM with DR showed higher serum chemerin levels than those with T1DM without DR or healthy individuals. Serum chemerin levels were higher in those with PDR than in those with NPDR. Thus, serum chemerin levels are a potential biomarker of the development and severity of DR in patients with T1DM. Nevertheless, future diagnostic accuracy studies are required to confirm these potential applications.

AIM: The purpose of the study was to study the effect of implantation method and fluid load (aspiration time, aspiration volume) on corneal endothelium in uneventful phacoemulsification surgeries. METHODS: This study was a prospective and interventional study involved 77 eyes, 50−81 years, divided into three groups according to implantation method (on Saline, Healon, or Methylcellulose). Specular microscope analysis of corneal endothelial parameters: Cell density (CD), central corneal thickness (CCT), coefficient of variation (CV), and Hexagonality (HEX) were done before and 3 months after surgery. RESULTS: A total of 77 eyes with cataracts were studied, and there was a significant increase in CCT and CV with a decrease in CD and HEX in all three groups. On comparing the same parameters between the three groups, there were insignificant differences regarding CCT and HEX changes. Although there was a significant change in CD, the highest loss was in the Healon group (median −0.138), followed by the Saline group (median −0.118), and the lowest was in the Methyl group (median −0.075). There was a significant change in CV, showing the highest increase in the Healon group (median 0.16129) followed by the Saline group (median 0.13307) and the lowest in the Methyl group (median 0.1266). There was a non-significant change in all corneal parameters among cases in each group with different aspiration volumes and times. CONCLUSION: Endothelial cell loss was lowest with Methyl followed by saline, and highest with Healon implantation. Fluidics had an insignificant effect in the three groups. Saline implantation was comparable to Healon, with an insignificant difference in CD loss.

To report clinical, serological, and histopathological findings in Egyptian patients with dacryoadenitis associated with ImmunoglobulinG4-related disease (IgG4-RD). Methods: We retrospectively revised medical records of patients presented to Al-Azhar University Hospitals with lacrimal gland (LG) swelling between June 2016 and February 2022. We included patients with definite IgG4-related disease (IgG4-RD) diagnosis and excluded those with possible, probable, or unlikely IgG4-RD based on The Japanese Ministry of Health, Labour, and Welfare's 2011 guidelines. Results: Sixteen cases were included in the study (Fourteen females and two males, mean age 39.2±12.2 years); Seven cases met the criteria of Mikulicz disease, and nine cases met full clinical, serological, and histopathological criteria. Mean reported serum IgG was 1792.5 ± 313.7 (range 1063-2134) mg/dl, mean serum IgG4 was 576.25±215.3 (range 112-841) mg/dl, and mean Serum IgG4/IgG ratio was 31.9 ± 12.4%. The mean number of IgG4+ plasma cells/HPF was 74 ± 21.2, and the mean IgG4+ plasma cell percentage was 55 ± 9.7%. Serum IgG4 level showed a positive correlation to tissue IgG4+plasma cell percentage, while serum IgG4/IgG ratio positively correlated to both percentage and number of IgG4+plasma cells. Steroids had a good initial response, but recurrences were common. Conclusion:A considerable proportion of patients with lacrimal gland swelling fall within the range of IgG4-RD. Proper diagnosis requires clinical, serological, and histopathologic correlation. Patients require long follow-up periods.