Use of Mitomycin C in treatment of adult epiphora with blocked nasolacrimal duct

Evaluation and comparison of the safety and efficacy of low dose of mitomycin C [0:2 mg/ml] with lacrimal probing and silicone intubation in adult epiphora, were performed in 46 eyes of 36 adult patients suffering from epiphora due to nasolacrimal duct obstruction. They were divided into 2 groups:-Group I: included 25 eyes treated by probing of NLD with adjunctive washing the duct with MMC. Group II: included 21 eyes treated by silicone intubation after lubricating the tube within MMC. All patients were followed up for at least 6 months. In group I, NLD remained open in 18 eyes [72%] 6 months after the procedure, repeated procedure was successful for 3 eyes [12%] of the remaining 7 eyes with recurrent obstruction during follow up time, an overall patency rate 84% with no complications during follow up. In group II, NLD remained open with surgical success rate in 20 eyes [95.2%] and over drainage of tears from nose was observed in one case. Patient satisfaction was assessed at the end of follow up period in two groups and proved that, watering was disappeared completely in 15 eyes [group I] and 14 eyes [group II], mild improvement in 6 eyes in each group and no improvement in 4 eyes [group I] and one eye [group-II]. Probing of NLD with low dose of MMC in adult epiphora is a simple, effective and minimally invasive technique. Use of low dose of MMC together with NLD intubation is advantageous and carries less risk in adults

Comparison of low dose intraoperative mitomycin C, postoperative mitomycin C drops and conjunctival autograft in primary pterygium

Comparison the safety and efficacy of low dose intraoperative MMC [0.02%], postoperative MMC [0.02%] drops and conjunctival autograft transplantation were done on 48 eyes of 39 patients with primary pterygium. Their age ranged from 21 to 68 years, they were 29 males and 10 females. All patients underwent complete ophthalmological examination including visual acuity, slit lamp biomicroscopy of anterior segment. Patients divided into 3 groups after excision of pterygium. Group I: 16 eyes with intraoperative MMC [0.02%]. Group II: 15 eyes with postoperative MMC drops [0.02%]. Group III: 17 eyes with application of conjunctival graft. Follow up period ranged from 8-15 months [mean +/- SD: 10 +/- 3.2 years]. In eyes treated with intraoperatival MMC, 2 eyes [12.5%] had delayed epithelial defects and recurrence occurred in one eye [6.25%]. In eyes treated with postoperative MMC drops, 3 eyes [20%] had punctate keratitis, delayed epithelial defect observed in one eye [6.6%] and recurrence occurred in one eye [6.6%]. In eyes treated with conjunctival autograft transplantation, 4 eyes [23.52%] had graft oedema, 2 eyes [11.76%] had wound dehiscence, granuloma was seen in one eye [5.88%] and recurrence occurred in one eye [5.88%]. Intraoperative low dose of MMC [0.02%], postoperative MMC drops [0.02%], and conjunctival autograft transplantation are equally effective as adjunctive treatment to primary pterygium with no statistical difference in recurrence rates and neither associated with severe complications

Hang-back versus conventional recession of medial rectus muscles

Forty five patients were included in this study. 25 patients with mean age 4.3 years who underwent conventional medial rectus recession [CR], 10 had infantile esotropia and 15 had acquired esotropia. 20 patients with mean age 5.2 years who underwent hang - back medial rectus recession [HBR], 8 had infantile esotropia and 12 had acquired esotropia. No statistical significant difference in success rate [correction within 10 prism diopters] was noted between two groups. The six months success rate was 84% for CR compared to 85% for HER. In infantile esotropia the success rate was 90% for CR and 87.5% for HBR. In acquired esotropia, the success rate was 80% for CR and 83.3% for HBR. Over correction occurred in 2 cases [8%] of CR and in one case [5%] of HER. Undercorrection was noted in 2 cases [8%] of CR and in 2 cases [10%] of HBR. Hang- back recession of medial rectus muscle is safe, easier to perform and is a satisfactory alternative to conventional recession surgery

Management of traumatic cataract in children

Fifteen eyes of 14 patients with an age ranged between 8 and 17 years, suffering from traumatic cataract underwent extra-capsular cataract extraction with posterior chamber intraocular lens implantation,the preoperative visual acuity was ranged between light perception and 3/60. Postoperative visual acuity was 6/18 or better in 11 eyes out of 13 eyes after we excluded 2 eyes with corneal opacities. Uveitis [33.3%] was the main early postoperative complication and opacification of posterior capsule [40%] was the main late postoperative complication