Normal range values of ocular axial length in adult Sudanese population

Background: The axial length is one of the essential ocular biometric parameters which is to be done prior to any cataract surgery based on ultrasound. These ocular axial length [OAL] values can be influenced by sex, age, race, ethnicity, genetics, and refractive errors

Objectives: The aim of this study is to determine the normal ranges values of OAL in adult Sudanese population and to define the effects of age, gender, and tribal ethnicity on axial length

Materials and Methods: This is descriptive multi-center hospital-based study, carried out over a period of 6 months from January 2015 to June 2015. The study takes place in five study areas: Three in Khartoum and two in Omdorman. These centers are Khartoum Eye Hospital, Makkah Eye Complex, Alwalidain Eye Hospital, and Omdurman Military Hospital and Sudan Eye Center. The study population was recruited from patients presenting to the mentioned five Hospitals Biometric Departments or volunteers who accepted to be enrolled in the study. One thousand Sudanese adults participants [n = 1000], 507 female and 493 male, with ages ranging from 18 to 105 years were included. Patients with vitreoretinal diseases, intraocular surgery, recent trauma and staphyloma were excluded. All participants underwent systematic OAL measurements by A-scan ultrasonography. Effect of age, gender, and tribal ethnicity on OAL was analyzed

Results: The study showed that the average axial length was 23.09 mm ranging from 18.13 mm to 29.09 mm. It was longer in males [average 23.29], ranging from 20.31 mm to 28.48 mm and shorter in females [average 22.81], ranging from 18.31 mm to 29.09 mm. In the four main Sudanese tribes, the Nubian group had the longest axial length [23.23 mm], followed by the African group [23.15 mm], and then the Arab group [23.09 mm]. Bejja group had the shortest axial length [22.85 mm]

Conclusion: OAL in Sudanese adults was within the international standard but with a wider range [18.13-29.09 mm]. Males' OAL was longer than the OAL of females. No significant age OAL variations, but the tribal ethnicity factor was clear, so tribal ethnicity had a major influence on Sudanese OAL

Posterior dropped crystalline lens by a car battery explosion ocular trauma

To report a case of right posterior dropped crystalline lens by a car battery explosion ocular trauma, in which the diagnosis was missed on initial ocular B-scan ultrasonography. Ocular injuries can be severe enough to compromise the vision, temporarily or permanently, depending on the type and mode of trauma itself; besides the urgency and competency of their managements. They often happen due to cars, sport, bombings, work, or war-related accidents. They can be penetrating or nonpenetrating injuries due to sharp or blunt impact causes; both can damage the structures at the front or at the back of the eye, with deferent degrees of severity. The prompt and competent emergency actions are the ophthalmic surgeons' challenges to save the vision. One of the not-uncommon eye traumas is due to the car battery explosions, which can lead to crystalline lens anterior or posterior dislocation. This case study will report the presentation and management of a posterior dropped crystalline lens by a car battery explosion, in which the diagnosis was missed on initial ocular B-scan ultrasonography

Assessment of the rates of posterior capsule opacification after phacoemulsification cataract surgery by comparing the Nd: YAG Laser capsulotomy rates

Posterior Capsule Opacification [PCO] is defined as the presence of any opaque posterior capsule after cataract surgery causing impaired visual acuity that warranted Nd: YAG [Neodymium-doped Yttrium Aluminum Garnet laser] posterior capsulotomy. Different methodologies have been used in experimental and clinical studies for the assessment of PCO rates; by the presence or absence of PCO within the central visual axis, by comparing the Nd: YAG capsulotomy rates, or by using optical coherence tomography [OCT-1]

Hospital Setting: Makkah Eye Complex of Khartoum, Sudan

Objective: To determine the rate of posterior capsular opacification after uneventful phacoemulsification [Phaco] cataract surgery done at Makkah Eye Complex [MEC], Khartoum; between the first June 2012 and 31st May 2013; by comparing the Nd; YAG laser for clinically significant PCO and the total number of patients who underwent phacoemulsification cataract surgery; both done at MEC between the first June 2012 and 31st May 2013. Then PCO rates were assessed by comparing these Nd: YAG capsulotomy rates with the total number of patients who did their phacos in MEC, regardless to the time lapse after the original surgery or any other factors

Results: Nine hundred ninety eyes [990] of 990 adult patients, 520 [52.53%] were males and 470 [47.47%] were females, with a mean age of 59.26 years; were identified after 10457 [n=10457] phaco cataract surgeries done at MEC between the first June 2012 and 31st May 2013. The rate of Nd: YAG laser posterior capsulotomy after phacoemulsification cataract surgery was computed to be 9.47%

Conclusion: The Rates of Posterior Capsule Opacification after uneventful phacoemulsification cataract surgery at MEC was found to be 9.47%

Optic atrophy post long standing severe papilledema as unreported side effect of antimalarial drug 'ALRRAGEMAT [Fansidar [Sulfadoxine and Pyrimethamine]+ artesunate]

Malaria kills over 3,00 children and many adult each day in Sub-Saharan Africa, tropical clinicians suffer a lot from the increasing rates of malaria drug resistance. So different new drugs combinations started to be seen in drug markets. Alrragimat as known by the Lay people and found in any local grocery: fansidar [Sulfadoxine and Pyrimethamine] + Artesunate [Generic Name: Artesunate] generally the drug is well tolerated. But adverse effects can occur like: CNS - Headache, peripheral neuritis, mental depression, convulsions, ataxia, hallucinations, tinnitus, vertigo, insomnia, apathy, fatigue, muscle weakness, nervousness, GIT, haemetologic, hepatic, Pulmonary infiltrates, drug fever, chills, toxic nephrosis with oliguria and anuria, periarteritis nodosa, LE phenomenon, renal failure…etc.. No, clear ocular toxicity was reported in the literature

adverse events of ophthalmic surgery among sudanese patients at makkah eye complex operating room

Background rPatient safety is an area of growing interest among healthcare providers worldwide. It is a distinct healthcare discipline that emphasizes the reporting, analysis, and prevention of medical errors which often lead to adverse healthcare events. Although Operating Rooms [OR] is high-risk environments, and most of the [patient surgical safety] protocols have focused on them, still some non-surgical events may occur within the operating roomvs corridors. This leads to more panoramic look to the entire surgical pathway safety, to ensure reliable, safe care for patients

Objective: To determine the rate and nature of adverse events [AEs] for ophthalmic surgical patients and staff at Makkah eye complex operating room [MECOR], and provide proposed solutions for preventing such events

Methods: Database review of all AEs reported by the head of operating room at MEC during the period from 1st June 2012 to 1[st] June 2013was done .Then grouped into six categories Failures of equipments, Incorrect event, Adverse Events, Infection, Systemic events and OR/Staff Adverse Events; each includes 'real adverse events' or just 'close calls

Results: Only 147adverse events [0.56%] were reported from MECOR; from a total of 26,429 ophthalmic surgeries done at MEC between 1[st] June 2012 and 1[st] June 2013. 107[0.405%] were adverse events and 40[0.151%] were close calls. Failures of equipments were 37cases [14%]. Incorrect event were only 2 Close call cases [0.0076%]. Real Adverse Events were 96 [0.363%] Fifty nine cases [0.223%] were 'Minor Adverse Events'. While the 'Major Adverse Events' were 37 cases [0.1399%] in total. All the other 36 [0.136%] major adverse events cases were Pars Plana Vitrectomies [PPV] for different reasons. 9 cases [0.034%] were due to serious infections; 5 Endophthalmitis [0.0189%] and 4 were corneal cases [0.015%].Two systemic events [0.008%] and one wet-floor accidents [0.004%] were reported, but there were no sharp/needle prick, post local anaesthesia or fire events occurred

Conclusion:This study indicates that MECOR incidents reporters are reasonably aware of the benefits of reporting OR AEs to improve their OR patienfs safety. Also give an indicator that the ophthalmic surgeries at MECOR are unlikely to yield serious AEs more than International figures

Sub-tenon versus intravitreal triamcinolone acetonide injection for severe diabetic

Objective: To compare the efficacy and safety of Sub-Tenon [STTA] and Intravitreal Triamcinolone Acetonide injection [IVTA] for severe Diabetic Clinically Significant Macular Edema [DCSME]. Setting: Makkah Eye Complex [MEC], Khartoum, Sudan

Materials and Methods: Retrospective studies of 30 eyes of 30 patients were included in this study from 21[st] of July, 2010 to the 3[rd] of January, 2011. Six eyes received 40mg Sub-Tenon Triamcinolone Acetonide injections [STTA] and the other 24 eyes of another 24 patients received 4mg Intravitreal Triamcinolone Acetonide injections [IVTA]. Visual acuity [VA], intraocular pressure [IOP], Slit Lamp biomicroscopic examinations for anterior and posterior segments were all done. Fundal Florescence Angiography [FFA] and Optical Coherence Tomography [OCT] were done for all 30 patients pre and post to injections. The same above patient's data [VA, IOP, 78D Funduscopy, FFAs and OCTs] were collected from the follow up visits for a mean of 3 months

Results: There were 24 patients in the IVTA group, 18 females and 6 males. Six patients were in the STTA group, 4 females and 2 males. The age mean was 5o.5 years, ranging from 19 years up to 72 years. Mean duration of Diabetes mellitus [DM] was 12.5 years ranging from 10 to 27 years, and the mean follow up period was 2.84 months [almost 3months]. The [VA] mean in the IVTA group had increased from 0.215 to 0.263 with an increase percentage of 22.3%, however in the STTA group the [VA] mean had increased from 0.132 to 0.173, with an increase percentage of 31.44%. No increase in IOP was noticed except in one patient from the STTA group. The reduction of the OCT central foveal thickness [CFT] was almost the same in both groups. Two patients from the IVTA group developed early cortical cataract. Two patients from the same group had minimal subconjunctival haemorrhage and reflux of the drug

Conclusion: Both IVTA and STTA injections for the treatment of DCSME were found to be successful and relatively safe. There was a noticeable increase in VA in both groups [26.85%] with some better effects of the STTA [31.4%] over IVT [22, 3%] in 3 months follow duration