Medical Hypothesis, Discovery, and Innovation in Ophthalmology最新文献

{"title":"Acquired symptomatic external punctal stenosis: a tertiary referral center study.","authors":"Mona Nassief,&nbsp;Omar Kh M Alduwailah,&nbsp;Nancy M Lotfy","doi":"10.51329/mehdiophthal1417","DOIUrl":"https://doi.org/10.51329/mehdiophthal1417","url":null,"abstract":"<p><strong>Background: </strong>To report the prevalence of acquired symptomatic external punctal stenosis (EPS) in a tertiary referral center in Kuwait, and to study the associated risk factors, etiologies, and management outcomes.</p><p><strong>Methods: </strong>This prospective interventional hospital-based study was performed at the Farwaniya governmental hospital in Kuwait between November 2018 and November 2019. All patients were referred to the oculoplastic clinic with symptomatic epiphora, age > 18 years, epiphora Munk score ≥ 0, tear film meniscus ≥ 2 mm, and punctum with grade ≤ 2 (smaller than normal size, but recognizable) were included. Eclusion criteria were congenital causes of epiphora, previous eyelid surgeries, and traumatic or neoplastic causes of punctal or canalicular obstruction.</p><p><strong>Results: </strong>A total of 418 patients with symptomatic epiphora, who were referred to our oculoplastic clinic, were enrolled in our study. The prevalence of EPS was 70.3%. Eamination of the puncta revealed different shapes, including tangential, pinpoint, elevated, slit-shaped, horse shoe-shaped, and membranous puncta, with the tangential type accounting for the greatest proportion (65.3%). Bilateral punctal stenosis was observed in 206 patients (70.1%) and unilateral involvement in 88 patients (29.9%). Dilatation and syringing were performed for all puncta upon diagnosis, and repeated dilatation was performed for 225 puncta (32.7%). Placement of a Mini-Monoka tube was performed in 11 puncta (1.6%).</p><p><strong>Conclusions: </strong>EPS was a common cause of symptomatic epiphora in our study. Aging and female sex were identified as common risk factors. Most etiological factors of EPS were associated with a pathophysiological inflammatory mechanism. For exact estimates of its prevalence, a population-based study is necessary in future.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/5a/mehdiophth-10-018.PMC10460214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10484875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior segment manifestations and imaging features post-COVID-19.","authors":"Srinivasan Sanjay,&nbsp;Sameeksha Agrawal,&nbsp;Chaitra Jayadev,&nbsp;Ankush Kawali,&nbsp;Poornachandra B Gowda,&nbsp;Rohit Shetty,&nbsp;Padmamalini Mahendradas","doi":"10.51329/mehdiophthal1427","DOIUrl":"https://doi.org/10.51329/mehdiophthal1427","url":null,"abstract":"<p><strong>Background: </strong>To report the posterior segment (uvea and retinal) manifestations and imaging characteristics of eyes of patients with and after coronavirus disease 2019 (COVID-19).</p><p><strong>Methods: </strong>We searched the PubMed/MEDLINE database to identify relevant articles using the following search terms: COVID-19, SARS-CoV-2, retina, uvea, optic nerve, retinal findings, posterior segment manifestations, and endophthalmitis. Articles published from December 1, 2019, to May 30, 2021, and indexed in PubMed/ MEDLINE were screened.</p><p><strong>Results: </strong>For the purpose of this review, we included clinical features of 26 case reports and 8 case series. The posterior segment manifestations reported included cotton wool spots, retinal hemorrhages, central serous retinopathy, papillophlebitis, optic neuritis, panuveitis, multifocal retinitis, necrotizing retinitis, central retinal artery/vein occlusion, and Purtschner like retinopathy. In this review, we have also included optical coherence tomography angiography (OCTA) features that have been described in COVID-19 patients with pneumonia.</p><p><strong>Conclusions: </strong>COVID-19 patients can experience uveo-retinal manifestations even after recovery. These patients, even if asymptomatic for eye symptoms, should undergo an eye evaluation to rule out posterior segment involvement. OCTA performed in these patients revealed microvascular changes in the superficial and deep retinal plexuses. Some of these patients may require anticoagulant or antiplatelet therapy.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 3","pages":"95-106"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/a2/mehdiophth-10-095.PMC10460223.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10467186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between ocular biometric parameters and corneal endothelium in a sample of young Egyptian adults.","authors":"Mohamed N Hamza,&nbsp;Maged Maher Roshdy,&nbsp;Mouamen M Seleet,&nbsp;Tamer M El Raggal","doi":"10.51329/mehdiophthal1430","DOIUrl":"https://doi.org/10.51329/mehdiophthal1430","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the normative values of corneal endothelial cell parameters within a group of healthy young Egyptian adults using specular microscopy and to examine any correlations between endothelial parameters and refractive or biometric parameters.</p><p><strong>Methods: </strong>In this cross-sectional study, specular microscopy was used to study the right eyes of 150 healthy young volunteers and evaluated endothelial cell parameters, including cellular density, hexagonality (HEX), and coefficient of variation (CV) at 15 different points on the back corneal surface, which were later grouped into the central zone and either four quadrants or three annular zones. The same eyes underwent refractive and biometric assessments.</p><p><strong>Results: </strong>Hundred fifty healthy adults were examined, and the age ranged from 20 to 30 years, with a median of 23 (interquartile range, 21‒27) years. The mean (standard deviation) of central cell density was 2902.7 (270.7) cells/mm². The superior paracentral area had the lowest mean density (2895.8 cells/mm²), but the highest mean HEX (67.7%), while the inferior peripheral area had the highest mean density (3100.5 cells/ mm²) but the lowest mean HEX (64%). The difference in cell density among the three annular zones was not statistically significant (<i>P</i> = 0.365). However, HEX and CV in the central and paracentral zones differed statistically significantly from those of the peripheral zone (<i>P</i> < 0.001 and <i>P</i> = 0.014, respectively). Weak but non-significant correlations were detected between endothelial cell density and all measured refractive and biometric parameters.</p><p><strong>Conclusions: </strong>The findings of this study provided useful normative biometric and specular data in a specific age group and a specific population, and could be useful in planning intraocular surgery in young Egyptian adults. However, future longitudinal studies with a larger sample could refine more endothelial cell parameter specifications over time.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 3","pages":"121-128"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/e5/mehdiophth-10-121.PMC10460222.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional optical zone after wavefront-optimized versus wavefront-guided laser in situ keratomileusis.","authors":"Mariam A Elshawarby,&nbsp;Ali Saad,&nbsp;Thanaa Helmy,&nbsp;Mouamen M Seleet,&nbsp;Tamer Elraggal","doi":"10.51329/mehdiophthal1431","DOIUrl":"https://doi.org/10.51329/mehdiophthal1431","url":null,"abstract":"<p><strong>Background: </strong>Many studies have used functional optical zone (FOZ) as a measure to compare different refractive laser treatment modalities. However, to our knowledge, no study has compared wavefront- optimized (WFO) and wavefront-guided (WFG) laser in situ keratomileusis (LASIK) using FOZ. We compared the FOZ after WFO versus WFG LASIK in patients with myopia and myopic astigmatism.</p><p><strong>Methods: </strong>In this prospective comparative study, we included 100 myopic eyes of 50 patients with or without astigmatism. They were divided into two groups according to the platform used: WFO or WFG femtosecond LASIK. Using Holladay's equivalent keratometry reading (EKR) report of Pentacam HR, FOZ was defined as a zone centered on the pupil center with a standard deviation (SD) of 0.5 D, around the mean EKR. The differences in FOZ between the two platforms were analyzed at 3 months postoperatively. Visual acuity, refractive error, corneal asphericity (Q-value), and root mean square of higher-order aberrations (RMS for HOAs) were evaluated and compared.</p><p><strong>Results: </strong>The mean (SD) of patient age was 26.64 (5.67) years. The preoperative characteristics of the two groups were comparable (all <i>P</i> > 0.05). The intended optical zone (IOZ) was 6 mm in both groups. The mean laser ablation depth was significantly greater in the WFG group (18 µm per D) than in the WFO group (16 µm per D) (<i>P</i> = 0.035). At 3 months postoperatively, the mean (SD) of FOZ diameter was 4.32 (0.94) mm (71.99% [15.68%] of intended optical zone) in the WFO group and 4.16 (1.13) mm (69.33% [18.78%] of intended optical zone) in the WFG group, with no significant difference between the two groups (<i>P</i> = 0.622). The change in corneal asphericity was greater in the WFG group than in the WFO group (<i>P</i> = 0.034). Postoperative mean corrected and uncorrected distance visual acuity, manifest refraction, and RMS for HOAs showed no significant difference between the two groups (all <i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>We found that WFG LASIK resulted in greater ablation depth and change in corneal asphericity than WFO LASIK at 3 months postoperatively. However, there was no significant difference in FOZ diameter, refractive error, and RMS for HOAs between the two groups. Further research is needed to confirm these findings.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 3","pages":"129-137"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/e3/mehdiophth-10-129.PMC10460224.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10467187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the efficacy of lotrafilcon B and comfilcon A silicone hydrogel bandage contact lenses after transepithelial photorefractive keratectomy.","authors":"Nancy M Lotfy,&nbsp;Tariq Alasbali,&nbsp;Abdulrahman M Alsharif,&nbsp;Saeed M Al-Gehedan,&nbsp;Sabah Jastaneiah,&nbsp;Ashraf Al-Hazaimeh,&nbsp;Hiba Ali,&nbsp;Rajiv Khandekar","doi":"10.51329/mehdiophthal1420","DOIUrl":"https://doi.org/10.51329/mehdiophthal1420","url":null,"abstract":"<p><strong>Background: </strong>At completion of transepithelial photorefractive keratectomy (t-PRK) surgery, the eye is usually fitted with a bandage contact lens to reduce discomfort and promote epithelial healing. This study aimed to compare the outcomes of eyes fitted with lotrafilcon B versus comfilcon A, silicone hydrogel bandage contact lenses after t-PRK for the correction of low to moderate myopia, with or without astigmatism.</p><p><strong>Methods: </strong>In this comparative, prospective study, patients with myopia < -6 D with or without astigmatism (< 1.75 D), who underwent t-PRK between January and June 2018, were randomly allocated to the lotrafilcon B and comfilcon A groups. Preoperative characteristics, including age, sex, eye treated, uncorrected visual acuity (UCVA), best-corrected visual acuity, mesopic pupil size, central corneal thickness, and refractive error were recorded. Postoperatively, pain score, UCVA, and corneal epithelial defect size on days 1, 4, and 7 were compared between the two groups.</p><p><strong>Results: </strong>Twenty-nine eyes were included in each group. Demographic characteristics and preoperative measurements were similar between the two groups. UCVA was significantly improved on day 7 as compared to day 1 in the comfilcon A group (<i>P</i> = 0.03), but remained the same in the lotrafilcon B group (<i>P</i> = 0.70) as on day 1 postoperatively. There was no significant difference in UCVA between the two groups at any follow-up visits (all <i>P</i> > 0.05). The pain score on the first postoperative day was significantly higher in the lotrafilcon B-fitted eyes than in the comfilcon A group (<i>P</i> < 0.001), but was significantly reduced in both groups compared to day 1 (both <i>P</i> < 0.001). The epithelial defect in the comfilcon A group was significantly greater than in the lotrafilcon B group (<i>P</i> < 0.001) at day 1 postoperatively, with significant improvement in both groups (both <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Healing responses were better with lotrafilcon B than with comfilcon A bandage contact lenses. The patients had a greater mean pain score with lotrafilcon B than with comfilcon A lenses on the first postoperative day, yet the final outcome was comparable between the two groups. We did not encounter any postoperative complications related to contact lens wear.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 2","pages":"43-49"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/2a/mehdiophth-10-043.PMC10460231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cataract prevalence following a nationwide policy to shorten wait time for cataract surgery.","authors":"Ge Yang,&nbsp;Sherif El-Defrawy,&nbsp;Graham E Trope,&nbsp;Yvonne M Buys,&nbsp;Sophia Y Liu,&nbsp;Ya-Ping Jin","doi":"10.51329/mehdiophthal1426","DOIUrl":"https://doi.org/10.51329/mehdiophthal1426","url":null,"abstract":"<p><strong>Background: </strong>Cataract is an age-related eye disease. Visual impairment from cataract can be restored by cataract surgery. In 2004 the Canadian federal government invested in a multibillion dollar wait time strategy to shorten the wait time for cataract surgery, a government-insured health service in all Canadian jurisdictions. We assessed if this nationwide policy reduced the number of Canadians waiting for cataract surgery as more individuals with cataract were free of cataract following the rapidly conducted surgery.</p><p><strong>Methods: </strong>In this cross-sectional study we analyzed data from randomly selected individuals aged ≥ 45 years responding to the Canadian Community Health Survey (CCHS) in 2000/2001, 2003, 2005, and the CCHS Healthy Aging in 2008/2009. Information on cataract was obtained from self-reported questionnaire. The age- and sex-standardized prevalence of cataract was calculated for comparisons.</p><p><strong>Results: </strong>Cataract was reported by 0.93 million Canadians in 2000/2001, 0.99 million in 2003, 1.10 million in 2005, and 1.34 million in 2008/2009. This corresponds to an age- and sex-standardized prevalence of 8.9% in 2000/2001, 9.0% in 2003, 9.5% in 2005, and 10.2% (<i>P</i> <0.05) in 2008/2009. The increase in age- and sex-standardized prevalence was greater in individuals without secondary school graduation than those with secondary school graduation or higher (4.3% versus 1.3%, <i>P</i> < 0.05) and was seen in all Canadian provinces. The largest increase was documented in a province (Saskatchewan, from 9.8% in 2000/2001 to 12.6% in 2008/2009, <i>P</i> < 0.05) with the longest median wait times for cataract surgery (118 days in 2008) and the lowest number of ophthalmologists per 100 000 population (1.96 versus 3.35 national average).</p><p><strong>Conclusions: </strong>The age- and sex-standardized prevalence of cataract increased 4‒5 years after the multibil- lion-dollar wait time strategy was launched in 2004. A lower threshold to diagnose cataract may be one potential reason for this finding. Further research is needed to understand the true reasons for the increase.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 2","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/1e/mehdiophth-10-086.PMC10460230.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractive amblyopia among children aged 4-12 years in a hospital-based setting in Gaza Strip, Palestine.","authors":"Asmaa H Eslayeh,&nbsp;Rokiah Omar,&nbsp;Norliza Md Fadzil","doi":"10.51329/mehdiophthal1428","DOIUrl":"https://doi.org/10.51329/mehdiophthal1428","url":null,"abstract":"<p><strong>Background: </strong>Refractive amblyopia is the most common cause of amblyopia in the Gaza Strip. However, the pattern of this condition has not yet been studied in this region. This study aimed to determine the pattern of refractive amblyopia in Gazan children aged 4‒12 years.</p><p><strong>Methods: </strong>This was a hospital-based cross-sectional study using a purposive sampling method. Children aged 4‒12 years who attended the Children's Unit at Gaza Ophthalmic Hospital, Gaza Strip, Palestine from September 2019 to July 2020, were examined. A comprehensive eye test was conducted for all participants. Those who failed the eye examinations and were diagnosed with refractive amblyopia were included in the study. Demographic data and amblyopic refractive error patterns were analyzed accordingly.</p><p><strong>Results: </strong>Of the 107 children, 72.9% were newly diagnosed with refractive amblyopia. The mean (standard deviation [SD]) of age of the children who participated was 7.85 (1.55) years. Approimately two-thirds of the patients were female (57.9%). Unilateral amblyopia was predominant in 60.7% of the cases. Moderate amblyopia was common (81.9%). A total of 149 amblyopic eyes were examined in total, with a mean (SD) (range) of best-corrected distance visual acuity and spherical equivalent of 0.45 (0.19) (0.2 to 1.3) logarithm of the minimum angle of resolution and + 0.76 (4.51) diopters (- 10.25 to + 11.50). Astigmatism was the most common amblyogenic factor (53.7%) among children with amblyopia.</p><p><strong>Conclusions: </strong>The frequency of refractive amblyopia was 72.9%, and meridional amblyopia accounted for the highest percentage. Girls were more commonly affected than boys. The majority were in the 7-year-old age group. Most cases were unilateral with moderate refractive amblyopia. Our study yields insights into the patterns of refractive amblyopia among children in the Gaza Strip.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 3","pages":"107-113"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/ad/mehdiophth-10-107.PMC10460220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial cell loss rate after penetrating keratoplasty: optical versus therapeutic grafts.","authors":"Abdelrhman Shams,&nbsp;Ayman Abdelmoneim Gaafar,&nbsp;Rania Serag Elkitkat,&nbsp;Mohamed Omar Yousif","doi":"10.51329/mehdiophthal1424","DOIUrl":"https://doi.org/10.51329/mehdiophthal1424","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the rate of endothelial cell loss (ECL) after penetrating keratoplasty (PKP) for optical versus therapeutic grafts at 3-, 6-, and 12-month postoperatively. Furthermore, the study aimed to investigate postoperative graft viability and the rate of graft rejection during the first year of follow-up for both indications.</p><p><strong>Methods: </strong>This was a prospective, observational, comparative study that included patients who sought medical advice at the cornea outpatient clinic of Ain Shams University Hospitals, Cairo, Egypt. The study recruited 60 patients: group 1 included 30 transplanted corneas of 30 patients who underwent optical PKP for various indications, while group 2 included 30 transplanted corneas of 30 patients who underwent therapeutic PKP for unhealed, resistant infectious keratitis. Specular microscopy was performed for all patients at the 3-, 6-, and 12-month follow-up visits using Nidek CEM-530 specular microscopy. Postoperative clinical examinations were performed at the same follow-up visits to detect graft rejection.</p><p><strong>Results: </strong>There were no statistically significant differences between the groups concerning the postoperative timing of graft clarity or the rate of ECL at 3- and 6-months postoperatively; however, the rate of ECL was significantly greater in group 2 than in group 1 at 12-months postoperatively (<i>P</i> = 0.03), although the difference was small from a clinical point of view. Moreover, there was no statistically significant difference between the groups in terms of the graft rejection rate.</p><p><strong>Conclusions: </strong>Therapeutic PKP results were comparable to optical PKP with respect to graft viability, the rate of ECL, and the rate of graft rejection 1 year after grafting.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 2","pages":"74-79"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/b8/mehdiophth-10-074.PMC10460226.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on indications, complications, and outcomes of scleral contact lenses.","authors":"Raul E Ruiz-Lozano,&nbsp;Daniela E Gomez-Elizondo,&nbsp;Maria F Colorado-Zavala,&nbsp;Denise Loya-Garcia,&nbsp;Alejandro Rodriguez-Garcia","doi":"10.51329/mehdiophthal1435","DOIUrl":"https://doi.org/10.51329/mehdiophthal1435","url":null,"abstract":"<p><strong>Background: </strong>The role of scleral contact lenses (SCLs) has increasingly expanded since the first lens was fitted more than a century ago. While it was initially prescribed for the management of severely compromised corneas, the indications for modern SCL use have expanded to include less severe diseases. In this review, we aimed to provide an up-to-date overview of the current indications, complications, and outcomes for the various types of SCLs.</p><p><strong>Methods: </strong>In this narrative review, we thoroughly searched the PubMed/MEDLINE database for literature published from January 1980 to November 2021. Only relevant up-to-date English references were included. Furthermore, the figures in this manuscript were derived from our unit's patient documentation.</p><p><strong>Results: </strong>Currently, SCLs can successfully be used to manage ocular surface diseases, visually rehabilitate irregular corneas, and correct irregular refractive errors. Although newer materials have yielded the same visual outcomes with fewer complications, these consequences still occur in approximately one-third of contact lens wearers, including difficulties in insertion and/or removal, discomfort or pain, and developing either halos, blurriness, or haze. Even though most of these complications are minor and can be easily treated, a good practice is essential to avoid sight-threatening complications such as microbial keratitis.</p><p><strong>Conclusions: </strong>SCLs are indispensable in ophthalmic clinics. The development of better-quality SCLs has increased the number of indications and improved the achievable visual rehabilitation. The future of developing improvements in SCL design, materials, and fit, and the expansion of their indication range is promising.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 4","pages":"165-178"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/8c/mehdiophth-10-165.PMC10460232.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10114188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression in pediatric glaucoma: lessons learnt from 8 years' follow-up.","authors":"Farideh Sharifipour,&nbsp;Elahe Arasteh,&nbsp;Maryam Hajizadeh,&nbsp;Atefe Mahdian-Rad,&nbsp;Mohammad Sadegh Mirdehghan","doi":"10.51329/mehdiophthal1432","DOIUrl":"https://doi.org/10.51329/mehdiophthal1432","url":null,"abstract":"<p><strong>Background: </strong>Surgical procedures are used as 1 of the main treatment modalities for pediatric glaucoma, even though progression may occur. In this study, we aimed to investigate the risk factors affecting the progression of pediatric glaucoma.</p><p><strong>Methods: </strong>In this retrospective cohort study, we reviewed the medical records of patients diagnosed with pediatric glaucoma between April 2009 and March 2017. Pediatric glaucoma patients who underwent regular follow-up for at least 1 year were included. Demographics, intraocular pressure (IOP), central corneal thickness (CCT), axial length (AL), cup-to-disc ratio (C/D ratio), corneal diameter, type of glaucoma, age at time of diagnosis, and age at surgery were recorded. Progression was defined as an increase in AL > 2 mm, C/D ratio > 0.2, or corneal diameter > 1 mm during 1 year of follow-up.</p><p><strong>Results: </strong>Eighty-three eyes from 46 patients were included: 37 eyes (45%) with primary congenital glaucoma (PCG), 46 eyes (55%) with secondary glaucoma, and 27 of these 83 eyes (32.5%) showed progression. Progression was comparable between eyes with PCG and secondary glaucoma (PCG, 22%; secondary glaucoma, 41%; <i>P</i> = 0.152). Age at the time of diagnosis and age at the time of the first surgery were significantly lower in the eyes with progression (<i>P</i> = 0.046 and 0.012, respectively). The mean (standard deviation) of surgeries in progressed versus non-progressed eyes was 1.88 (1.1) versus 1 (0.8) (<i>P</i> = 0.015). The frequency of comorbid systemic disease was significantly higher in patients with glaucoma progression (<i>P</i> = 0.043). The progressed and non-progressed eyes were comparable in terms of other demographic characteristics and ocular parameters (all <i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Pediatric glaucoma patients who were younger at the time of diagnosis and the first glaucoma surgery and those with comorbid systemic disease are at higher risk of glaucoma progression. These findings are useful for clinicians when counseling parents of children with pediatric glaucoma about disease outcomes. However, future prospective studies with larger sample sizes and longer follow-up periods are needed to confirm our findings.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 3","pages":"138-145"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/a8/mehdiophth-10-138.PMC10460221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}