recurrence of pterygium after different modalities of surgical treatment

To assess and compare the recurrence rate of pterygium after limbal stem cell transplantation versus amniotic membrane transplantation [AMT] as ocular surface reconstructing measures in recurrent pterygium, also evaluation of the use of antimetabolite drugs as adjunctive therapy for AMT. Prospective randomized comparative study included 60 eyes of 48 patients with recurrent pterygia. Informed consents were taken from all patients. Primary pterygium excision was performed 6-15 months ago; the cases were divided randomly into three equal groups: Group 1: included 20 eyes with excision of the pterygium and application of limbal stem cell transplantation with conjunctival autograft, group 2: included 20 eyes with excision of the pterygium followed by AMT and group 3: included 20 eyes in which surgical excision of pterygium was followed by intra-operative application of low-dose of MMC [0.05%] for 3 min then using AMT. The study included 36 males and 12 females of age ranged from 28 to 52 years. The recurrence rate was 2 eyes in group 1 [10%] [limbal stem cell transplantation + conjunctival autograft], 6 eyes in group 2 [30%] [AMT] and 4 eyes [20%] in group 3 [MMC + AMT]. The rate of recurrence was significantly different between the three groups [P < 0.001]. Limbal stem cell transplantation together with conjunctival autografting proved to be more effective in prevention of pterygium recurrence and in rapid restoration of normal epithelial morphology. MMC in addition to AMT decreases the incidence of recurrence

Pascal laser versus conventional laser for treatment of diabetic retinopathy

To compare the safety and efficacy of Pascal laser photocoagulation in comparison with the conventional laser photocoagulation in the treatment of diabetic retinopathy. A prospective randomized case series study was done on 120 procedures done in 120 patients divided into two main groups, group A, patients undergoing focal or modified grid macular laser and group B, patients undergoing panretinal photocoagulation [PRP]. Each of the two groups were subdivided into two subgroups randomly in the first we used conventional laser photocoagulation [groups A1 and B1] and in the other we used Pascal laser photocoagulation [groups A2 and B2]. Procedures in groups A1,2 and in groups B1,2 had successful outcomes. Significantly higher powers were required with the Pascal [groups A2 and B2] than with conventional laser [groups A1 and B1] [p<0.001] in eyes that underwent PRP and focal/modified grid macular treatment with both systems. No adverse events were noted in all groups. The Pascal photocoagulator is safe, rapid, effective, with rapid learning and had short exposure time. Although the shorter pulse duration of the Pascal necessitates the use of a higher power, it is not associated with adverse effects

Intravitreal bevacizumab for pediatric exudative retinal diseases

To detect if intravitreal bevacizumab can reduce retinal exudation, improve visual and anatomical outcomes, and facilitate the treatment in various pediatric exudative retinal diseases. Prospective, non-randomized, case series of nine eyes of pediatric exudative retinal diseases less than 18years old which included six eyes with juvenile diabetic retinopathy, two eyes in children with Coats' disease, and one eye with myopic choroidal neovascular membrane [CNV]. All eyes received only intravitreal bevacizumab injection 1.25mg/0.05ml as the primary treatment. The need for adjuvant ablative procedures, including laser photocoagulation or cryotherapy, were performed and recorded. The need for supplementary intravitreal bevacizumab injection was recorded. The changes in pre-and post-operative best-corrected visual acuity [BCVA] and central macular thickness [CMT] were recorded. Serial optical coherent tomography [OCT] and fundus flourescein angiography [FFA] were performed to follow treatment efficacy. The study included 19 eyes of 11 patients with age equal to or less than eighteen years with exudative retinal diseases including type I DM [n=sixteen eyes], Coats' disease [n=2 eyes], and due to myopic CNV [n=1 eye]. Mean pre-injection log MAR for all was 0.605 +/- 0.174 and mean post-injection for all log MAR was 0.284 +/- 0.247. While mean pre-injection log MAR for DR and myopic CNV patients was 0.576+0.152 SD and mean post-injection log MAR for DR and myopic CNV patients was 0.229+0.189 at one year. Serial OCT measurements showed that mean CMT for all eyes was 355.8 +/- 35.3 micro m SD at baseline, which was decreased to 222.42+26.2 micro m SD. The two eyes of Coats' disease needed another two supplementary intravitreal bevacizumab injections. No ocular or systemic complications related to bevacizumab were noted during the entire course of follow-up. Intravitreal bevacizumab appears to be a well-tolerated treatment for pediatric age group with various exudative retinal diseases. It has the potential as an adjuvant therapy for ablative procedures to improve final visual and anatomical outcome

Value of fresh amniotic membrane graft in management of resistant corneal ulcer in al-Qassim Region

The use of fresh amniotic membrane graft is not common in the presence of preserved human amniotic membrane eye bank. We reported a case with the successful use of fresh amniotic membrane as a final step for the management of resistant corneal ulcer at King Saud Hospital, Unayzah, Al-Qassim region, Saudi Arabia