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   Table of Contents - Current issue
April-June 2019
Volume 112 | Issue 2
Page Nos. 39-66

Online since Friday, July 19, 2019

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Comparison between corrected intraocular pressure using contact versus noncontact methods in glaucoma patients p. 39
Tamer Badran, Radwa El-Shereif
Background To determine the difference between corrected intraocular pressure (IOP), based on the central corneal thickness (CCT), measured by the noncontact anterior segment anterior segment optical coherence tomography (AS-OCT), versus contact ultrasound pachymetry (USP) in the management of glaucoma patients. Patients and methods Ophthalmology Department, Ain Shams University, Cairo, Egypt. The study is a prospective, nonrandomized case series. Fifty patients were diagnosed with open-angle glaucoma and controlled with medical treatment with prostaglandin analogs and β-blockers fixed combination, controlled under medical treatment. CCT is measured by two methods, the AS-OCT and by the USP of ocular response analyzer. IOP was measured by applanation tonometry. Corrected IOP was calculated adjustment factor using Ehler’s correction nomogram, statistical analysis of the adjusted IOP with the contact and noncontact methods was done in relation to the CCT measurements. Results The mean age was 60.5±5.24 years, 54% of the studied patients were men while 46% were women. The mean CCT using AS-OCT for the right eye was 529.86±43.52 μm and for the left eye was 530.28±43.57 μm, while CCT using USP for the right eye was 534.88±43.59 μm and for the left eye was 533.34±44.33 μm. Highly significant correlation between CCT was measured by AS-OCT and ultrasound; 0.94 (P<0.01). Mean adjusted IOP by AS-OCT CCT was 15.56±2.83 mmHg (11–22) and IOP adjusted by USP was 15.32±2.78 mmHg (10–21), with no significant differences (P=0.29) and highly significant correlation; 0.96 (P<0.01). Conclusion Although USP has slightly higher measurements of CCT in comparison with measurements with anterior segment OCT, it has no significance on the adjusted IOP in controlled glaucoma patients, making the two methods equally accurate in the management and follow-up of these patients.
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Does photorefractive keratectomy with mitomycin results in less weakening effect on corneal biomechanics compared to thin-flap Lasik procedure in mild to high myopia? An Ocular Response Analyzer study p. 43
Tamer A Refai
Purpose To understand the changes in corneal biomechanics studied by Ocular Response Analyzer after thin-flap Lasik technique compared with photorefractive keratectomy (PRK) with mitomycin C in mild to high myopia to decrease the risk of ectasia. Patients and methods Forty eyes of 24 myopic patients with mild to severe myopia were divided into two groups; group A (included 20 eyes treated by thin-flap Lasik technique and group B (included 20 eyes treated by PRK with application of mitomycin C 0.02%). Patients were examined preoperatively and postoperatively. For the Ocular Response Analyzer, corneal hysteresis (CH), corneal resistance factor (CRF), and the keratoconus suspect (KS) were studied. Collected data were subjected to statistical analyses. Results In this study, postoperatively, a highly significant decrease (P<0.01) occurred in both groups regarding CH (mean reduction from 10.26±1.41 to 7.65±1.35 in group A and from 10.70±1.26 to 7.77±1.63 in group B) as well as CRF (mean reduction from 10.37±1.32 to 7.53±1.29 in group A and from 10.71±1.58 to 7.70±1.55 in group B). Similarly a highly significant increase (P<0.01) occurred in both groups regarding KS% (mean increase from 6±7.27 to 38.25±19.87% in group A and from 7.8±10.44 to 31.8±23.61% in group B). There was no statistically significant difference (P>0.05) between both groups regarding postoperative changes in CH, CRF, and KS%. A highly significant correlation (P<0.01) existed between total corrected spherocylindrical refraction and the postablative decrease in CH as well as in CRF. A statistically significant correlation (P<0.05) existed between the total corrected spherocylinderical refraction and the postablative increase in the KS% in both groups. Conclusion Both thin-flap Lasik and PRK with mitomycin for mild to high myopia resulted in significant comparable reduction in the corneal biomechanical properties, the magnitude of which is highly dependent on the extent of correction.
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Correlation between central corneal thickness and axial errors of refraction p. 52
Mervat S Mourad, Raafat A Rayhan, Mouamen Moustafa, Ahmad A Hassan
Aim This study aimed to determine the correlation between central corneal thickness (CCT) and axial refractive errors (axial myopia and axial hyperopia). Patients and methods A total of 84 eyes were included in this study. They were classified into three groups (group 1, which included 28 axially myopic eyes; group 2, which included 28 axially hyperopic eyes; and group 3, which included 28 emmetropic eyes). CCT was obtained by pentacam, axial length was obtained by A-Scan ultrasonography, and refraction was obtained with auto-refractometer after cycloplegia and being confirmed with trial lenses. Results The study showed that the mean CCT in the myopia group (group 1) was 531 nm, mean CCT in the hyperopia group (group 2) was 523.5 nm, and mean CCT for the emmetropia group (group 3) was 555 nm. CCT was obtained by pentacam, axial length (AL) was obtained by ultrasound A-scan, and refraction was obtained by auto-refractometer after cycloplegia and being confirmed with trial lenses. Discussion CCT was found to be thinner in axially ametropic eyes compared with emmetropic eyes. CCT did not differ statistically between different grades of the same refractive error. CCT decreased with age but not with sex or AL. Conclusion The study revealed that axial errors of refraction had a correlation with CCT and that CCT of axially ametropic eyes showed thinner corneas than emmetropic eyes.
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Evaluation of type 2 diabetes mellitus effect on human cornea using specular microscopy and Pentacam corneal tomography p. 61
Amal Atef Salah Taha, Abdelrahman Gaber Salman, Thanaa Helmy Mohammed, Rania Serag Elkitkat
Purpose evaluating effect of type 2 DM using pentacam and specular microscopy, and correlate changes to DM and its control. Methods A randomized cross sectional study . Ninty eyes of 45 patients were examined by pentacam HR; where elevation based "anterior corneal elevation (ACE)" and "PCE" and thickness based "TCT" and "ARTmax" indices were recorded and Specular Microscopy were "ECD" and "CV" indices were evaluated . Corneas were categorized into 3 groups according to HBA1C level; group 1 (30eyes) with uncontrolled DM,group 2 (30eyes) with controlled DM,while group 3 (30 eyes) with healthy controls. Possible effect of DM on the forementioned indices was evaluated and a correlation between HBA1C and these indices was investigated. Results regarding Pentacam elevation indices (ACE, PCE), PCE showed a significant increase in group 1 compared to group 3 (p-value=0.005), while ACE showed a significant increase between group 2 and each of group 1 (p-value =0.031) and group 3 (p-value=0.025). AS regard to pachymetric indices, TCT and ART max showed a significant difference between group 1 and group 3 (p=0.001 and 0.048). Specular Microscopy indices; ECD showed a significant difference between each of (group 1, group 2) diabetics and group 3 (p=0.001), while CV showed a significant increase in group 1 compared to group 3 (p=0.005). Regression analyses showed positive correlations between HBA1C and each of PCE, TCT, ART max, ECD, CV. Conclusion Some pentacam indices showed significant changes with variations in HBA1C level ,which are sensitive indices in ectasia detection. Regular follow up of type 2 diabetics by performing pentacam is recommended, especially for uncontrolled DM.
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