Cystoid macular edema in aphakic diabetics

One hundred and ten patients who underwent cataract extraction were divided into three groups. The first group consisted of 50 patients, 25 were diabetics, 25 non diabetics. All the 50 pts have undergone ECCE. The second group consisted of 40 patients, 20 diabetics, 20 non diabetics, where they have undergone ICCE. The third group were 20 cases who were complicated by vitreous loss during either ECCE or ICCE, 10 of them were diabetic, 10 were non diabetic. All cases were followed up for 12 weeks for evidence of clinical cystoid macular oedema [CMO] where fluorescine angiography was done in all suspected cases. In the groups of ECCE non diabetics, no cases of CMO were found while only one case was found in diabetic patients. In the group of ICCE one case was found among the non diabetic patients, 2 cases were found in the diabetic patients. In the group of vitreous loss 4 cases were found, 1 in the non diabetics 3 in the diabetics. CMO proved to be of higher incidence in diabetic patients and this incidence increased in ICCE than in ECCE and much increased with vitreous loss. It is better to shift to ECCE in diabetic patients and utmost care should be taken to avoid vitreous loss in these patients

Hidden inflammatory glaucoma as a major factor in corneal graft failure and its management

Postkeraloptasty glaucoma is a serious sight-threatening problem as it is the most common cause for graft failure from devitalization of graft endothelium and hence delayed visual rehabilitation. We had faced the problem of intraocular pressure elevation in our series of penetrating keratoplasty done at Ain Shams University Hospital from the year 1990 to 1993; we selected six cases of them to explain the problem and its management. The cases were post-inflammatory vascularized corneal scar, post-herpetic dense vascularized corneal opacity, post-traumatic corneal scar, aphakic bullous keratopathy and congenital endothelial hereditary dystrophy. Prekeratoplasty, the intraocular pressure varied from 14-20 mmHg and angle assessment was difficult because of the dense opaque corneas. In the first week postoperative abnormal rise of intraocular pressure occurred, and varied from 25-40mmHg. The management was in the form of medical treatment of post keratoplasty glaucoma, discontinuing of steroid therapy, in refractory cases trabeculectomy and cyclocryotherapy were performed two weeks before regrafting. Oversize donor buttons were used in post-inflammatory, interstitial herpetic and aphakic regrafting

Effect of partial trasectomy on the stability of the precorneal tear film

The Precorneal tear film is formed of three components. We chose to study the most superficial oily layer which is secreted by the meibomian glands. Ten cases of trichiasis entropion were selected from the out-patient ophthalmic clinic of Ain Shams University Hospital during the year 1984. We did for every case before and after Snellen's operation [partial tarsectomy] Schirmer's tear that test No. 1 and tear film break up time [B.UT.]. The results were diminution of Schirmer's test No. 1 and Shortening of tear film break up time after Senllen's operation by two weeks. This indicates that the oily layer is important for stabilization of the precorneal tear film

Diurnal variation of ocular tension in non-glaucomatous subjects

The ocular tension varies rhythmically through the twenty four hour period of the day in normal eyes. The cause of this variations in unknown. In this work ocular tension was measured by applanation and Scheiotz indenation tonometers for 100 subjects [195 eyes]. This was done on spaced interval over twenty-four hour for each patient. It was found that the ocular tension is highest in the morning 8 a.m. and declines gradually to reach the lowest values by the end of the day 10 p.m. The mean variation of ocular tension is recorded to range from 3.1 to 4.2 mm Hg. This suggests that glaucoma clinics should be held in the morning