Improvement of subjective and objective manifestations of aqueous deficient dry eye occurs following punctal plug occlusion. Thermosensitive plug has good patient's compliance with fewer complications and lower rates of loss compared to the silicone plug.

Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value > 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue > 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

Purpose To compare levator tucking with resection in mild and moderate congenital ptosis: Methods Prospective comparative randomized trial involving 20 eyes of 20 patients, simple mild-to-moderate congenital ptosis with good-to-fair amount of levator action were included. Patients were randomized to either levator resection or tucking. Outcome was compared in terms of eyelid height and course of postoperative events. Data collected included margin reflex distance (MRD1), symmetry of eyelid height, contour and complications. Surgery was considered successful if the following three criteria were simultaneously met: A postoperative MRD1 of ≥ 2 mm and ≤4.5 mm, inter-eyelid height asymmetry of ≤ 2 mm, and satisfactory eyelid contour. Results Mean age was 12.9 years in resection group (range 5–25 years) and 12.20 years in tucking group (range 4-23 years) postoperative follow-up was 3 months comparing post operative levator function between resection and tucking group was statistically significant (P-value 0.025) tucking didnot improve levator function as much as levator resection did. Mean preoperative palpebral fissure height was 7.8 ml in resection group and6.9 ml in tucking group and the mean postoperative palpebral fissure height was 10.0 mm in resection group and 8.9 mm in tucking group. Conclusion Both levator resection and levator tucking are safe and efficient in correcting minimal and moderate degree of congenital blepharoptosis, with less recurrence in levator muscle resection