role of peripheral iridectomy in prevention of secondary glaucoma after paediatric cataract surgery

To evaluate the role of peripheral iridectomy [PI] alter irrigation/aspiration [I/A] and posterior chamber intraocular lens [PCIOL] implantation in paediatric cataract and its efficiency as a preventive measure against secondary glaucoma occurring post-operatively. The study was conducted as retrospective review for sixty four eyes of forty four patients operated for paediatric cataract at the Research Institute of Ophthalmology, Cairo, during the period from 2004-2006. All patients were selected as isolated congenital or traumatic cataract. After initial detailed evaluation including IOP measurement and surgery performancc, postoperative follow-up was done for a period of 1-3 years. Results retrieved during the early postoperative period [up to one month] showed significant difference of IOP rise in cases without PI rather than when PI was performed. The long-term follow-up showed that after one month from the surgery, there were no difference in the rate of occurrence of IOP rise between those who performed PI and those who did not. Peripheral iridectomy was found to be effective in prevention of early onset glaucoma, which is usually of the pupillary block type. In late onset glaucoma, peripheral iridectomy did not prove to be effective as the pathology of this type of glaucoma is usually of the open angle type

Retinal nerve fiber layer and ganglion cell layer thickness in normal Egyptians by fourier domain optical coherence tomography

To determine retinal nerve fiber layer thickness [RNFLT] and ganglion cell layer thickness [GCLT] among different normal Egyptian age groups using the Fourier domain optical coherence tomography [Optovue RTVue 2006]. Eighty two eyes of 82 normal subjects [36 males and 46 females: age range: 20 to 78 years; mean: 47.29 +/- 14.54 years] who satisfied the inclusion and exclusion criteria were included. The subjects were defined as normal if they had best corrected visual acuity of 6/9 or better, intra-ocular pressure less than 22 mmhg with normal optic disc and no ocular abnormality. All patients underwent optical coherence tomography [OCT] imaging with the Opto-Vue RTVue 2006. The results were evaluated and compared to determine normal variations in nerve fiber layer and ganglion cell layer thickness among different age groups. Mean RNFLT was 110.27 +/- 7.54 micro m [range: 97 to 131 micro m] and mean GCLT was 100.59 +/- 4.47 micro m [range: 89 to 110 micro m] with no significant difference between males and females. Thickest NFL was found among the youngest group between 20 and 30 years old [115.43 +/- 11.41 micro m; range: 102 to 131 micro m] and thinnest in the over 60 years group [105.67 +/- 5.4 micro m; range: 98 to 118microm]. Regarding the ganglion cell layr thickness, the least was in the oldest age group above 60 [95.83 +/- 4.56 micro m; range: 89 to 103 micro m]. Younger age groups had very little difference in between. Mean RNFLT in the superior quadrant was 140.46 +/- 11.08 micro m [range: 112 to 168 micro m], nasal was 78.12 +/- 7.49 micro m [range: 60 to 93 micro m], inferior 137.61 +/- 12.3 micro m [range: 120 to 171 micro m] and temporal quadrant was 84.9 +/- 11.12 micro m [range: 65 to 120 micro m]. Our results provide normal nerve fiber layer and ganglion cell layer thickness in normal Egyptians. RNFLT and GCLT decrease in old age

Refraction changes in infantile esotropia

Infantile esotropia is a large angle esodeviation that presents within the first year of life. It represents the most common form of strabismus, with an incidence of 1 to 2%. Although the accepted treatment for this entity is by surgical alignment of the eyes, the refractive changes in infantile esotropes and their implications on the outcome has not been adequately studied. A series of 90 cases diagnosed as infantile esotropia collected from the pediatric Ophthalmology department between 1997 and 2001 were studied retrospectively to investigate the refractive state following the initial management and its effect on the ocular alignment and the outcome of therapy. The follow-up period ranged from three to seven years. Out of the 90 patients, 34 patients [37.7%] showed significant refractive error changes after initial surgical alignment that needed further correction. Among these, 25 were fully corrected with glasses and the remaining nine patients needed second surgical interference. On the other hand, 56 patients [62.2%] showed stability of refraction with no further interference. The previous findings lead to conclude that surgical alignment alone does not give the final security for infantile esotropes and that later refraction changes should not be underestimated as it may influence the outcome