Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+ 1.00 D to + 6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 68 hyperopic patients (136 eyes) divided into two groups; Group A included 34 patients (68 eyes) that had LASIK with the application of 0.02% MMC for 10 s on the stromal bed after excimer laser treatment, and group B included 34 patients (68 eyes) that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of + 0.5 ± 0.31 D in group A and + 0.67 ± 0.39 D in group B at the 6 month visit, and + 0.63 ± 0.37 D in group A and + 0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration the Pan African Clinical Trial Registry PACTR201901543722087 , on 29 January 2019.

The influence of two intravenous (IV) sedative regimens on intra-ocular pressure (IOP) was investigated in conjunction with retrobulbar local analgesia. Forty patients of either sex, and similar age with body weight within 40-90 kg were allocated equally and randomly to two groups: Group A (alfentanil/promazine) and group M (meperidine/promazine). Measurement of IOP, systolic pressure, pulse rate, respiratory rate, PaCO2, PaO2 and O2 saturation were made before operation, after premedication, after IV sedation and post-operatively. In the Alfentanil group there was significantly stronger decrease of IOP (p < 0.001). In group A the IOP dropped from 18.1 +/- 3.2 mm Hg to 10.3 +/- 2.7 mm Hg, i.e. 43%, while in group M the reduction IOP was from 17.6 +/- 3.5 mm Hg to 12.6 +/- 1.9 mm Hg, i.e. 28.4%. Meperidine caused a significant increase in PaCO2 (4.2 +/- 0.3 mm Hg), however this increase was not sufficient to cause the IOP alterations. The oxygen saturation was lower in group M (decreased by 1.5 +/- 1% in group M versus decrease by 1.0 +/- 1.2% in group A). Cardiovascular parameters were more stable in group A. In conclusion the alfentanil regimen produced a better reduction of the IOP with excellent sedation, operative condition and least anaesthetic side effects.

Submit Manuscript | http://medcraveonline.com MethodsWe prospectively examined 23 eyes of each group of patients who were scheduled to have phacoemulsification surgery. Materials were collected from December 2016 till April 2017. Exclusion criteria were a history of previous ocular surgery or inflammation, abnormal findings by slit-lamp biomicroscopic examination, a small pupil diameter after a full dilation of less than 4.0 mm, and a preoperative endothelial cell density of less than 1500 cells/mm 2 . One surgeon performed all the surgeries. Specular microscopy was used on all eyes preoperatively, one week and one month postoperatively. Three photographs were taken per eye at each examination, and the mean of the measurements were calculated. The CCT (central corneal thickness), ECD (endothelial cell density), and CV (coefficient of variance) will be measured in all cases by automated analysis of the whole image. Complete medical history for type 2 diabetes based on medical history, blood glucose levels and HbA1c levels. Examination of visual acuity, subjective refraction, slit-lamp examination, IOP readings with applanation tonometry was done to all patients. Binocular indirect ophthalmoscopy was conducted for fundus examination.The density of the cataract was clinically graded by the same examiner on a scale of 1 to 6 using the Lens Opacities Classification system lll. IOL power and AC depth were recorded for all patients. A standardized stop and chop phacoemulsification technique was done with the phaco tip of 'white star Signature Pro®' Phaco-machine. Surgical techniques were conducted using retrobulbar anesthesia. Clear corneal incision was used with a 3.2 mm keratome. Sodium hyaluronate was injected to maintain the depth of the anterior chamber. Capsulorhexis completed using fine forceps. Hydro dissection was performed and the lens nucleus emulsified with Phaco machine using the stop and chop technique. The power used was 40-60%, a vacuum of 60-350 mmHg, and an aspiration flow rate of 25-30 ml/min. The bottle height raised to a maximum of 110 cm from a minimum of 90 cm during fragment removal. AbstractPurpose: We proposed to study the corneal endothelial change in correlation with corneal thickness after phacoemulsification with Intra Ocular Lens IOL implantation; comparing diabetics (long standing > 10 years) versus a control group of non-diabetics. These cataract patients were obtained from the Ophthalmology Clinic at Suez Canal University Hospital, Ismailia, Egypt. Aim:To determine how corneal endothelium in diabetic patients is affected by cataract surgery in comparison to age matched non-diabetics. This assessment will be made over the initial 1 month post-op period and will be determined (evaluated) by specular microscopy (model Nidek CEM 5301) as a primary report (Figure 1). Conclusion:Corneal endothelium in diabetic patients is more affected during the phacoemulsification for cataract extraction & IOL implantation surgery as evidenced in (one week) follow up post op. Comparison between pre-operat...

Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.

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