Précis: Angle procedures are safe and relatively effective for neonatal onset PCG. Watchful delay in intervention to close to the second month of life is helpful in ensuring diagnosis and making surgery more successful and easier. Purpose:The purpose of this study was to compare the surgical outcomes of visco-circumferential-suture-trabeculotomy (VCST) to rigid-probe double-entry viscotrabeculotomy (DEVT) and rigidprobe single-entry viscotrabeculotomy (SEVT) in infants with neonatal-onset primary congenital glaucoma (PCG).Design: This was a retrospective chart review. Patients and Methods: Retrospective chart review of 64 eyes of 64 infants with neonatal-onset PCG referred to Mansoura Ophthalmic Center in Mansoura, Egypt between February 2008 and November 2018. Study groups included VCST, DEVT, and SEVT, and followup covered 4 postoperative years. Complete (qualified) success was defined as intraocular pressure (IOP) ≤ 18 mm Hg and with 35% IOP reduction from baseline without (with) IOP-lowering medications or further surgical interventions, and without any sign of progression in corneal diameter, axial length, or optic disc cupping and without visual devastating complications.Results: The mean ± SD age at presentation and at the surgery of the study children was 3.63 ± 1.74 and 55.23 ± 1.60 days, respectively. The mean ± SD IOP and cup/disc ratio of all study eyes at presentation and at final follow-up were 34.91 ± 0.82 mm Hg and 0.70 ± 0.09 and 17.04 ± 0.74 mm Hg and 0.63 ± 0.08, respectively. Complete success was achieved in 54.5%, 43.5%, and 31.6% in the VCST, DEVT, and SEVT groups, respectively. A self-limited hyphema was the commonest complication in all groups.Conclusions: Angle procedures are safe and marginally effective for the surgical treatment of neonatal-onset PCG, bringing IOP under control for at least 4 years of follow-up. Circumferential trabeculotomy as a first-line treatment has more favorable outcomes than rigid-probe SEVT. Rigid-probe viscotrabeculotomy offers an alternative to the noncompleted circumferential procedure.
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.
Purpose: This study was to evaluate effectiveness of I-BiT system for treatment of amblyopia in comparison with standard patching of dominant eye.Methods: This was a prospective randomized comparative study conducted on cooperative amblyopic patients up to 20 years attending outpatient clinic of Mansoura University, Ophthalmic Center. All cases were exposed to full history taking, ophthalmic history, ocular examination which included assessment of visual acuity, slit lamp biomicroscopy, in addition to, Worth 4 Dot Test and Lang test.Results: there was a statistically significant improvement in the (BCVA) (p <0.001) of both groups after 6 months of treatment. There was a statistically significant improvement of Worth 4 dot test results with increased fusion in the cases of both groups. There was a statistically significant improvement of Lang test and achieving positive results in the cases of group 1(29.4% of cases) and group 2 (10.5% of cases) at 6 months of treatment as compared with the pretreatment data.Conclusion: I-BiT system can give equal results to patching of sound eye in treating cases of moderate amblyopia but in a new, simple and joyful way.
To evaluate inferior oblique (IO) recession as a primary surgical procedure for treatment of superior oblique palsy.
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