Aim of the study Measurement of the mean angle Kappa pre-keratorefractive and post-keratorefractive surgery utilizing Orbscan 3. Patients and methods This retrospective study was conducted on patients who had refractive surgeries, group A included patients who underwent Lasik and group B included patients who underwent Photo Refractive Keratectomy (PRK). Mean age from 18 to 45 years. Preoperative, 1-week, and 1-month postoperative assessments included detailed ocular examination, slit-scanning topography done by Orbscan 3, and total ocular aberrations by Zywave 3 were done. Results The study comprised 146 eyes of 75 individuals. Preoperative data demonstrated that angle Kappa mean in Lasik group (group A) was 2.38±1.54 at 147.05±96.94, in PRK group (group B) was 2.31±1.17 at 137.67±85.7. Paired mean differences of the two groups between preoperative data and 1-week postoperative show no statistically significant difference in central corneal thickness (CCT) nor angle Kappa values. Paired mean differences of the two groups between preoperative data and 1-month postoperative show no statistically significant difference regarding CCT nor angle Kappa values. Preoperative, 1-week postoperative, and 1-month postoperative correlation of angle Kappa to refractive error, spherical equivalent, average K-reading, CCT and axial length, showed that both groups had a positive correlation with axial length. Conclusion Keratorefractive surgeries do not affect angle Kappa or its intercept measurements.

Purpose To investigate the effect of anterior chamber maintainer (ACM) usage during phacoemulsification on the occurrence of pseudophakic retinal detachment (PRD) in high myopia. Design A retrospective nonrandomized comparative interventional study was conducted. Participants A total of 632 high myopic eyes of 501 patients who had eventless phacoemulsification with in-the-bag intraocular lens implantation in the period between March 2013 and December 2018. Methods Patients were divided into two groups according to the use of ACM during cataract surgery: (a) ACM group, and (b) no-ACM group. Patients were followed at 6, 12, 18, 24, 30, and 36 months after surgery for detection of PRD. The time-related cumulative incidence of RD in each group was evaluated by means of Kaplan–Meier survival curves. Results In the ACM group, the 3-year cumulative incidence of RD was 2.4% compared with 5.9% in the other group (P=0.039). Regarding age, the 3-year cumulative incidence of RD increased significantly in the younger age group when the ACM was not used (P=0.023), whereas it was not when the ACM was used. Using the ACM increased the 3-year cumulative survival ratio from 86.2 to 92% in patients with a posterior staphyloma (P=0.03). Conclusion ACM is a potential prophylactic intraoperative tool against PRD in highly myopic eyes.

Aim To evaluate the visual outcome of implantable phakic contact lens (IPCL) in high myopia. Setting Al-Mashreq Eye Center, Cairo, Egypt. Patients and methods Thirty eyes of 17 patients underwent surgery to correct high myopia using IPCL (Care Group-India) with a central hole (V2.0). Visual acuity, spherical equivalent, and intraocular pressure (IOP) were evaluated 6 months postoperatively. Anterior chamber parameters Anterior chamber volume (ACV), Anterior chamber depth (ACD), Anterior chamber angle width (ACAW) were measured using Pentacam. Results After 6 months, spherical equivalent decreased from −14.19±4.2 to −0.18±0.66 D, all cases were within ±1.00 D of intended correction. Best corrected visual acuity (BCVA) remained unchanged in 13% of cases, 13% gained one line, and 74% gained two or more lines. ACV, ACD, and ACAW decreased from 189.77±20.19 mm³, 3.15±0.27 mm, and 37.31±5.63° to 131.4±14.01 mm³, 3.05±0.29 mm, and 23.94±4.81°, respectively. Changes in IOP between preoperative and 6 months postoperatively were statistically insignificant. Conclusion IPCL is a safe, effective, and predictable surgery to correct high myopia. Most cases gained one or more lines of BCVA. Reduction of ACV did not induce IOP rise during 6 months of follow-up.

Purpose To evaluate changes that occur in foveal avascular zone (FAZ) in diabetic hypertensive patients by optical coherence tomography angiography (OCTA). Patients and methods OCTA was performed for 60 eyes of 35 diabetic hypertensive patients. This study was done in Benha University Hospital between February and June 2021. FAZ area was measured by a frame that was centered around it. Moreover, the vessel density was measured also by detecting the superficial vessel density (SVD) and the deep vessel density (DVD). Results In diabetic hypertensive (60 eyes of 35 patients) with average age 55.52 (±6.88) years and mean duration of the disease 12.17 (±7.15) years, the mean value of the FAZ was 0.37 (±0.54) mm, denoting enlargement of the FAZ diameter. In addition, the vessel density showed that there is decreasing in the SVD (43.9±5.89) and it was correlated to the best-corrected visual acuity and age of the patients (P<0.05), while it was highly correlated to the DVD (P<0.001). On the other hand, there was a decrease in DVD with a mean of 43.17±7.44, which was statistically significant with the age of the patients (P<0.05), but there was no significant relationship with duration of the disease, glycated hemoglobin, and best-corrected visual acuity. Conclusion OCTA is a noninvasive technique to image the retinal and choroidal vasculature. The study concluded that diabetic retinopathy in the presence of systemic hypertension leads to increasing of the FAZ area. Moreover, it leads to decreasing in both the SVD and DVD. Also, it allows for early detection and easy follow-up of the disease.

Purpose To compare surgical outcome of anchored hang-back technique (HBT) against conventional HBT in bimedial rectus-muscle recession (BMR) for large-angle esotropia. Design A retrospective nonrandomized comparative interventional study. Participants In total, 94 patients with esotropia and indicated for at least 6-mm BMR. Methods Patients were randomly assigned into two groups according to surgical technique of BMR: (a) anchored HBT and (b) conventional HBT. Postoperatively, angles of deviation were quantified for near and far. Alignment within 10-prism diopters (PD) of orthotropia was considered a successful result by the end of 6 months. Kaplan–Meier analysis was used to determine the cumulative survival in both groups. Results In total, 48 patients underwent conventional HBT and 46 patients in the anchored HBT. Preoperatively, mean angles of deviation for near and far were 61.6 and 60.1 PD in the conventional group, versus 62.2 and 60.4 PD in the anchored group, respectively (P>0.05). By the sixth postoperative month, the mean angles of deviation for near and far in the conventional group were –1.4 and –3.4 PD, versus 1.2 and 0.1 PD in the anchored group, respectively (P=0.03). Success rate was 76% in the conventional group, versus 87.5% in the anchored group (P=0.03). Kaplan–Meier survival analysis showed a significantly higher cumulative 6-month incidence of failure in the conventional HBT group than the anchored one (P=0.025, Log rank). Conclusion Anchored HBT showed a higher efficacy than conventional HBT in large BMR recession.

Aim To evaluate how micropulse transscleral diode laser cyclophotocoagulation (MP-TSCPC) is a safe and effective procedure, in reducing intraocular pressure (IOP) in different glaucoma patients among the Egyptian population. Study design Prospective, noncomparative interventional study. Patients and methods This study assessed the effect of MP-TSCPC laser on patients with different types of glaucoma. Forty eyes of 40 patients were included in our study. Patients were recruited from Benha University Hospital and Egyptian Eye Academy, and the procedure was done during the period between January 2020 and July 2021. Results The mean±SD baseline IOP was 27.72±8.6 mmHg, which showed significant reduction at postsurgical month 6, becoming 16.28±6.38 mmHg (P=0.001). The mean number of IOP-lowering agents was 2.35±1.03 preoperatively, which dropped significantly to 1.50±1.24 at 6 months. Postoperative logMAR best-corrected visual acuity was not significantly reduced from baseline. There was no development of significant postoperative complications. Conclusion MP-TSCPC is an efficient, safe, and simple technique with promising results in lowering IOP and can be used in patients with different types of glaucoma.

Background Age-related macular degeneration (AMD) is a progressive retinal degenerative disease divided into two types: early dry non-neovascular AMD and advanced wet neovascular AMD. It is recognized as the leading cause of irreversible blindness in high-income nations, with an increasing incidence among the elderly. This study aims to assess the awareness of AMD among the Saudi population and identify the groups with the least knowledge and the factors influencing their level of knowledge. Patients and methods A cross-sectional study was conducted using a validated questionnaire adapted from the AMD Alliance International Global Report. Univariate analysis was performed to determine the factors associated with awareness of AMD, and the odds ratio and 95% confidence interval were calculated. Two-tailed analysis with P value less than 0.05 was used as the cutoff for statistical significance. Results Among the 1008 participants who agreed to participate, the most common age group was 41–50 years (33.7%) and nearly two-thirds (63%) were female. Only 7.6% of participants were aware of AMD, whereas 92.4% were not aware, and higher educational levels were associated with increased awareness of AMD. Conclusion There is a low level of awareness of AMD among the Saudi population. A great emphasis on the importance of AMD education and awareness of modifiable risk factors is necessary, especially among the high-risk population.

Objectives To investigate the changes in ophthalmological practice between the first and current waves of the coronavirus disease 2019 (COVID-19) pandemic as well as to evaluate the pattern of ophthalmology practice following COVID-19 vaccination. Patients and methods This is a cross-sectional observational analytical study of ophthalmologists working in different hospitals in Cairo, Egypt. The data were collected through a self-administered questionnaire that included separate sections about (a) demographic data, (b) experience with COVID-19 infection, (c) current ophthalmologists’ and patients’ concerns, (d) experience with COVID-19 vaccination, (e) current changes of practice, (f) current safety measures, and (g) current flow of cases. Results The questionnaire was sent to 200 ophthalmologists, with a 77% response rate. Since the onset of the pandemic in Egypt, ∼60% of the participants (83% were below 45 years of age) have been infected with COVID-19. When compared with the first wave, more than two-thirds of respondents expressed less psychic concern but the same economic concern about the pandemic. Although 90% of the participants have been vaccinated against COVID-19, more than 50% still feel unsafe regarding new infection. In comparison with the first wave, 45% of participants have reduced clinical safety measures. Participants also found that their patients’ psychological concern was significantly lower compared with the first wave and patients’ flow increased to approach prepandemic levels. Conclusion Concerns among ophthalmologists and patients have decreased significantly since the first COVID-19 wave, but economic concerns remain high.