Volumetric assessment of volume stable collagen matrix in maxillary single implant site development: A randomized controlled clinical trial.

INTRODUCTION: The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect. MATERIALS AND METHODS: Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery. RESULTS: A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm3) in VCMX and (186.38 ± 57.52) (mm3) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups. CONCLUSION: The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.

Treatment of class I Sibert alveolar ridge defects with volume stable collagen matrix. A case report.

INTRODUCTION AND IMPORTANCE: The soft tissue volume and its stability around dental implants are important for the final aesthetic outcome. CASE PRESENTATION: A 39-year-old female was referred for dental implant placement for her missing tooth. Following attachment of the cover screw VCMX was used to simultaneously augment buccal ridge defect. Patient was seen 2 weeks after surgery for follow up where sutures were removed. After 3 months, patient received her final crown and been on follow up for 9 months where a successful well-functioning restoration with clinically healthy soft tissue and optimal profilometric outcome were maintained. CLINICAL DISCUSSION: This approach is relatively simple, less invasive and time saving as it eliminates the need for another surgical donor site to manage the defect. CONCLUSIONS: The present report showed that VCMX was effective in soft tissue augmentation at implant sites in aesthetic zone. CLINICAL RELEVANCE: Within the limits of this study, the positive results suggest that the volume stable collagen matrix (VCMX) may be a reliable option in treatment of siebert class I ridge defects. VCMX was associated with less amount of pain or discomfort and reduced patient morbidity.

Correlation of the macular microvasculature to the axial length in pediatric patients with high axial refractive errors.

AIMS: To compare the vascular density (VD) of the macular superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), and the foveal avascular zone (FAZ) among high hyperopic, high myopic, and emmetropic children using optical coherence tomography angiography (OCTA). METHODS: This was a cross sectional comparative study of otherwise healthy children with different refractive errors. Patients were recruited from Cairo University Children's Hospital. OCTA imaging was performed using the RTVue XR Avanti device with AngioVue software. Both the 3 × 3 and 6 × 6 mm macular scans were utilized. Automated measurements were obtained from the built-in machine software. Axial length (AL) measurements were done using Lenstar LS 900 optical biometer. RESULTS: Ninety eyes from 51 healthy children were included. Among high myopes, there was significant thinning of the parafovea (p < 0.001). SCP-VD was also lower in high myopes in all areas except the fovea (all p < 0.001). The DCP-VD was significantly lower in high myopes in the parafovea and perifovea. High hyperopes had lower subfoveal CC-VD. Despite high myopes showing a significantly lower OCTA signal strength, linear regression analysis revealed that AL was an independent and significant predictor for the FAZ-area, as well as parafoveal and perifoveal SCP and DCP-VD. CONCLUSION: High myopia results in a reduction of VD in both the SCP and DCP, which can be non-invasively detected and monitored using OCTA. While lower VD may, in part, be attributed to lower OCTA image quality, our findings demonstrate that AL independently and significantly predicts macular vascular parameters on OCTA in children.

Effectiveness of thyme honey in the management of xerostomia in geriatric patients with end-stage renal disease: a randomized controlled clinical trial with a biochemical assessment.

BACKGROUND: Taking into consideration the value of the oral health condition in geriatric people with end-stage renal disease (ESRD) associated with xerostomia and believing that salivary stimulants or substitutes could potentially be used to manage this condition. This study aimed to evaluate the clinical effectiveness of thyme honey as oral rinse in geriatric patients with ESRD using the subjective dry mouth score as a primary objective and to assess the effect of thyme honey on the salivary nitric oxide level, salivary flow rate, and salivary ph in addition to objective dry mouth score as a secondary objective. METHODS: This was a single blinded randomized controlled trial with two equal arms, the interventional arm (thyme honey oral rinse) and the control arm (saline). Twenty-eight geriatric patients with ESRD undergoing hemodialysis complained of xerostomia were recruited from the renal dialysis center. Patients in both arms followed the same administration protocol either with thyme honey oral rinse or saline. The following clinical parameters (the subjective and objective dry mouth scores, salivary flow rate, salivary ph, and salivary nitric oxide (NO) levels) were evaluated for both groups at different intervals (baseline, 1 week, and 1 month). RESULTS: In the current study, it was found that both the subjective and objective dry mouth scores were significantly lower after one month of using thyme honey oral rinse (1.86 ± 0.66B) and (2.21 ± 0.43B) respectively, than the control group (3.07 ± 0.73B) and (3.07 ± 0.83B), respectively with a (p < 0.001). Also, the salivary flow rate was significantly higher after one month of using thyme honey oral rinse (1.56 ± 0.51A), than the control group (0.78 ± 0.27A) with a (p < 0.001). For the NO levels, there was a significant increase in measured value after 1 month in the intervention group (p < 0.001), while for the control group the change was not statistically significant (p = 0.166). CONCLUSIONS: The results of the current study have revealed the efficacy of Thyme honey oral rinse in the management of xerostomia in geriatric patients with ESRD. Trial registration The ClinicalTrials.gov Identifier for this study is NCT05247008.

Oral Changes in Hospitalized COVID-19 Patients: A Cross-Sectional Multicentric Study.

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread over the globe, and several oral symptoms have been documented. However, it is unclear whether these lesions are the result of coronavirus infection or are secondary symptoms of the patient's systemic illness. The aim of this study was to collect data from various hospitals on COVID-19 patients with oral involvement in order to highlight different oral changes that may be manifested in those patients. Methods: This observational cross-sectional multicenter study used an online questionnaire covering oral signs and symptoms that were believed to be related to COVID-19 patients who were hospitalized in different hospitals in Egypt. Results: 94.3% of the 210 patients who participated in the current study developed oral symptoms. Altered taste sensation (56.2%), burning sensation (43.3%), and oral candidiasis (40%) were the most prevalent oral symptoms (34.4%) that were found in the studied sample. Conclusions: COVID-19 has a major influence on the oral cavity, with numerous oral symptoms that may impair quality of life. Thus, considering the need for support, pain control, and management for a better prognosis, the clinical dental evaluation of hospitalized patients with infectious diseases like COVID-19 should be addressed.

Evaluation of corneal epithelial thickness mapping using anterior segment OCT in children with vernal keratoconjunctivitis.

PURPOSE: To evaluate the corneal epithelial thickness by anterior segment OCT in children with vernal keratoconjunctivitis (VKC) compared to normal participants. PATIENT AND METHODS: A cross-sectional case control observational study was conducted on children aged from 5 to 18 years with VKC. The study included 142 eyes divided into two groups: 71 eyes of VKC group and 71 eyes of age matched control group. Anterior segment OCT epithelial mapping for the central 5-mm was done to evaluate epithelial thickness-based variables. RESULTS: Corneal epithelial thickness mapping showed significant superior thinning (51.07 ± 4.11) µm in VKC group compared to controls (52.54 ± 2.01) µm (p = 0.008), a decreased MIN epithelial thickness (45.99 ± 6.52) µm compared to controls (50.11 ± 1.91) µm (p < 0.001) and more negative (MIN-MAX) value (- 11.77 ± 9.38) indicating focal epithelial thinning compared to (- 5.80 ± 1.88) in controls (p = 0.001). In palpebral VKC, MIN epithelial thickness showed significant thinning (48. 38 ± 3.45) µm compared to controls (50.11 ± 1.91) µm (p = 0.001). Eyes with mixed VKC showed superior epithelial thinning (50.70 ± 4.59) µm compared to (52.54 ± 2.01) µm in controls (p = 0.025) and significant decreased MIN epithelial thickness (43.78 ± 7.83) µm compared to (50.11 ± 1.91) µm in control group. CONCLUSIONS: VKC is a disease primarily affecting the corneal epithelium. Corneal epithelial thickness mapping may be considered to assess the integrity of the ocular surface in eyes with VKC, and to detect corneal epithelial changes. Disease phenotype may influence the corneal epithelial changes, and the disease duration is another factor influencing these changes.

Clinical Comparison of the Volumetric Changes in Single Pontic Site Development through Connective Tissue Grafting Using Modified Pouch Technique versus Pouch Technique in the Maxillary Esthetic Zone: A Randomized Controlled Clinical Trial.

Aim: The aim is to compare the volumetric changes between pouch technique versus the modified pouch technique in pontic site development using connective tissue graft in patients that have Seibert class I ridge defects in the maxillary esthetic zone. Methodology. This randomized, controlled, double-blinded, parallel-grouped clinical trial included sixteen patients with a single pontic site in the maxillary esthetic area presenting Seibert Class I ridge defects. Patients were randomly assigned into two equal groups: test group (n: 8) received soft tissue augmentation with connective tissue graft using the modified pouch technique and control group (n: 8) received soft tissue augmentation with connective tissue graft using pouch technique. The volumetric evaluation was carried out by taking impressions at baseline, 3 and 6 months after the surgery. Keratinized tissue thickness was also measured at baseline, 3 and 6 months after the surgery. Visual analogue scale (VAS) was recorded by the patients at day 3, day 7, and day 14 after the surgery. Results: The test group had more increase in soft tissue volume than the control group at baseline, 3 months, and 6 months. The keratinized tissue width at baseline in the test group had a higher value than that of the control group. At 3 months, both groups had the same mean value, while at 6 months, the test group had a higher value than the control group. Regarding postoperative pain, the visual analogue scale shown at day 3 in the test group had a higher value than that of the control group, while at day 7, the control group had a higher value than the test group. At day 14, both groups had the same mean value. Conclusions: Soft tissue augmentation using both the traditional pouch technique and the modified pouch technique led to successful soft tissue volume augmentation in pontic site development in Seibert Class I ridge defects with no statistically significant difference between the two techniques.

Flipped autograft: A novel approach for management of wound dehiscence in implant dentistry. A case report.

INTRODUCTION AND IMPORTANCE: This case report describes a novel technique for management of peri-implant wound dehiscence that involves using auto graft from the same surgical site to seal the dehiscence defect. CASE PRESENTATION: A 21-year-old female was referred for extraction of a non-restorable lower left first molar and replacement by immediate dental implant. Following attachment of the cover screw bone graft biomaterial and collagen membrane was secured over the biomaterial and buccal flap was coronally positioned and sutured. Patient was seen 1 week after surgery for follow up where a minor wound dehiscence was discovered with some biomaterial particles exposed. Patient was advised to continue strict oral hygiene control and to wait for another week. After 2 weeks of the implant placement surgery patient came back for dehiscence management visit where an innovative flipped autograft technique was performed to seal the dehiscence defect. CLINICAL DISCUSSION: Healing by primary intention was achieved that led to uneventful healing and hence a successful well-functioning restoration with clinically healthy soft tissue and optimal aesthetic outcome. CONCLUSIONS: Peri-implant wound dehiscence can be successfully treated by the novel flipped autograft technique that yielded great aesthetic and functional results.

Clinical Comparison of MEBO and Hyaluronic Acid Gel in the Management of Pain after Free Gingival Graft Harvesting: A Randomized Clinical Trial.

AIM: This study aimed to compare the effect of MEBO versus 0.2% hyaluronic acid gel (Gengigel®) applied to the palatal donor site on postoperative pain reduction and wound healing after free gingival graft harvesting. Methodology. Thirty-nine patients with different mucogingival defects were included in this study for harvesting a free gingival graft (FGG) for soft tissue augmentation. Patients were randomly assigned into three equal groups: group I (MEBO), group II (0.2% HA Gengigel®), and group III (control). Postoperative pain was recorded by using the Visual Analogue Scale (VAS). Analgesic consumption was recorded for 7 days postoperatively. Wound size was measured at baseline and on days 3, 7, 14, and 21. Postoperative healing of the palatal wound was assessed by the VAS score for color match on days 3, 7, 14, 21, and 42. RESULTS: Results of this study showed significant postoperative pain reduction for the three groups; MEBO showed statistically significant less VAS score compared to the other two groups, while HA showed statistically significant less VAS score compared to the control group. Both MEBO and HA showed statistically significant less total analgesic consumption. No statistically significant difference was observed between groups for wound size. MEBO showed statistically significant higher VAS for color match. CONCLUSIONS: Both treatment modalities could reduce postoperative pain following harvesting of FGG and improve the palatal wound healing. However, MEBO showed better outcomes in terms of postoperative pain and color match.

Effect of Using a Plastic Stent with Apically Repositioned Flap in Peri-Implant Soft Tissue Augmentation: A Randomized Controlled Clinical Trial.

OBJECTIVES: This study aimed to clinically assess and compare the width of peri-implant keratinized mucosa following the use of a readymade plastic stent with apically repositioned flap versus conventional apically repositioned flap with papillary sparing incisions during single-stage implant placement protocol. MATERIALS AND METHODS: A total of 20 patients were enrolled in this study. In the test group, a prefabricated implant-retained stent was clipped on the healing abutment after implant surgery to reposition the keratinized tissue buccoapically. In the control group, simple interrupted sutures were applied instead of using a stent. After the surgical procedure, the width of the buccal keratinized mucosa was measured at the mesial, middle, and distal aspects of the healing abutment. The change in the width of the buccal keratinized mucosa was assessed at 3 months and 6 months. RESULTS: No statistically significant difference was found between the stent group and control group in 6 months' interval where p=0.840, where both groups showed the same mean value of 4.70 ± 0.35 and 4.70 ± 0.63, respectively. The percent of change in the width of KM was found to be higher in the stent group than in the control group with no statistical significance. CONCLUSION: The use of a readymade plastic stent in combined full/partial-thickness apically repositioned flap shows to be effective in increasing the width of KM compared to the conventional technique. This trial is registered with NCT03754894.

Effect of Locally Delivered Melatonin as an Adjunct to Nonsurgical Therapy on GCF Antioxidant Capacity and MMP-9 in Stage II Periodontitis Patients: A Randomized Controlled Clinical Trial.

OBJECTIVES: Periodontitis is characterized by inflammatory destruction of periodontal tissue, loss of attachment, and bone resorption. The increase in reactive oxygen species (ROS) is responsible for the oxidative damage occurring in periodontal tissues. Melatonin has important immunomodulatory, anti-inflammatory, and powerful antioxidant functions. The current study was carried out to evaluate the effect of topical melatonin gel as an adjunct to nonsurgical periodontal therapy. METHODS: This split-mouth randomized controlled clinical trial was performed on 24 patients with grade II periodontitis. Two sites in each patient were randomly assigned; test sites were treated by nonsurgical therapy followed by intrapocket application of 5% melatonin gel. Control sites were treated by nonsurgical therapy followed by intrapocket application of placebo gel. Both the melatonin and placebo gel were applied weekly once for four weeks. Assessment of clinical parameters (PD and CAL) was done at baseline and 3 months after therapy. Total antioxidative capacity (TAC) and matrix metalloproteinase-9 (MMP-9) levels in GCF were also evaluated utilizing commercially available enzyme-linked immunosorbent assay kits (ELISA) at baseline and 3 months after therapy. RESULTS: Treatment with topical melatonin was associated with a reduction in periodontal inflammation reflected as an improvement in the clinical periodontal parameters. Melatonin-treated sites showed a more statistically significant percent reduction in PD and more statistically significant percent gain in CAL than the control site. Additionally, a significant increase in TAC and a significant decrease in MMP-9 levels in GCF were found in melatonin-treated sites in comparison to control sites. CONCLUSIONS: The adjunctive use of topical melatonin gel with nonsurgical periodontal therapy has potent anti-inflammatory and antioxidant activity in the treatment of grade II periodontitis patients.

Publisher Correction: Propolis-based niosomes as oromuco-adhesive films: A randomized clinical trial of a therapeutic drug delivery platform for the treatment of oral recurrent aphthous ulcers.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Expression of endocan and vascular endothelial growth factor in recurrent minor aphthous ulcers.

BACKGROUND: Recurrent aphthous ulcers (RAU) are common painful inflammatory lesions of the mucous lining of the mouth. Endocan, previously identified as endothelial cell specific molecule-1, is implicated as a vital player in the regulation of several inflammatory processes. A number of inflammatory cytokines and pro-angiogenic growth factors including VEGF upregulate endothelial cells synthesis and expression of endocan. MATERIAL AND METHODS: Clinical scores of pain and ulcer size as well as level of endocan and VEGF were determined in swaps from aphthous ulcer and contra lateral normal mucosa in 30 patients (nine males and twenty one females) with age ranging from 18 to 45 years and mean age is 31.5 years. RESULTS: In the early days of ulcer development, ulcer showed statistically significantly higher mean endocan (8.2 ±5.3) and VEGF levels (1220.7 ±294.6) than control healthy mucosal site (1.1 ±0.5) and (518.6 ± 61.7) respectively. An increase in endocan is associated with an increase in pain score and vice versa. A statistically significant positive correlation were also found between endocan and VEGF levels. CONCLUSIONS: Endocan and VEGF are strongly associated with the destructive phase of minor aphthous ulcers especially Endocan which was positively correlated with pain severity. Key words:Endocan, ESM-1, VEGF, Recurrent Apthous Ulcer.

Propolis-based niosomes as oromuco-adhesive films: A randomized clinical trial of a therapeutic drug delivery platform for the treatment of oral recurrent aphthous ulcers.

Oromuco-adhesive films for buccal delivery of Propolis extract (PPE) entrapped in niosomes, were prepared to treat oral recurrent aphthous ulcer (RAU). PPE was investigated for antimicrobial compounds. Niosomes composed of span60 and cholesterol were evaluated for particles size, polydispersity index (PDI), zeta-potential, entrapment efficiency and in vitro release. The formed oromuco-adhesive films containing niosomal PPE were evaluated for swelling, mucoadhesion and elasticity. 24 patients suffering from RAU were divided equally into medicated and placebo groups and participated in this study to examine the onset of ulcer size reduction, complete healing and pain relief. Ultra-performance liquid chromatography-high resolution mass spectrometry revealed the presence of pinocembrin, pinobanksin, chrysin and galangin as antimicrobial flavonoids with total content of 158.7 ± 0.15 µg quercetin equivalents and phenolic content of 180.8 ± 0.11 µg gallic acid equivalents/mg. Multilamellar niosomes of 176-333 nm displayed entrapment efficiency of 91 ± 0.48%, PDI of 0.676 and zeta potential of -4.99. In vitro release after 8 h from niosomal dispersion and films were 64.05% and 29.09 ± 0.13% respectively. Clinical results revealed duration of film adherence from 2-4 h in the two groups. The onset of ulcer size reduction in medicated group was attained within second and third day, complete healing was achieved within first 10 days of treatment and pain relief lasted for more than 4-5 h, in contrast to the placebo group. This oromuco-adhesive films which offer controlled and targeting drug delivery can be proposed as a new therapeutic strategy in the treatment of oral recurrent aphthous ulcer.

Vitrectomy with scleral buckling versus with inferior retinectomy in treating primary rhegmatogenous retinal detachment with PVR and inferior breaks.

PURPOSE: To evaluate anatomic and functional outcomes of patients treated with pars plana vitrectomy (PPV) with scleral buckling versus PPV with inferior retinectomy for treatment of cases of primary rhegmatogenous retinal detachment (RRD) associated with proliferative vitreoretinopathy (PVR) and inferior retinal breaks. METHODS: Retrospective, comparative, interventional, single-center study. Fifty-one eyes of fifty-one patients with primary RRD associated with inferior breaks and PVR grade C1 or more were reviewed over 3 years. Twenty-one eyes underwent PPV with encircling band 360° and thirty eyes underwent PPV with primary inferior retinectomy. The primary outcome was final anatomic success. Secondary outcomes included change in visual acuity, primary anatomical success, the mean number of operations, and incidence of postoperative complications. RESULTS: Primary anatomical success of 85.7% was achieved in buckle group compared to 83.3% in retinectomy group (p = 0.82). Mean duration of follow-up and mean number of operations was 9.8 ± 2.26 and 9.97 ± 2.44 months; 1.24 ± 0.62 and 1.3 ± 0.75 in buckle group and retinectomy group, respectively, achieving final anatomical success of 95.2% for the buckle group and 90% for the retinectomy group with no statistical significant difference (p = 0.49). Although visual acuity (logMAR) was better in the buckle group in the 1st month, it became nearly equal thereafter during the follow-up period (p = 0.5). CONCLUSION: Similar anatomical and functional outcomes were achieved by combining PPV with scleral buckle or inferior retinectomy for treatment of primary RRD with PVR and inferior breaks.

Effect of Topical Nepafenac on Central Foveal Thickness following Panretinal Photocoagulation in Diabetic Patients.

PURPOSE: To evaluate effectiveness of topical nepafenac in reducing macular edema following panretinal photocoagulation (PRP). DESIGN: Prospective randomized double-blinded controlled study. METHODS: Sixty eyes of 60 patients having proliferative or severe nonproliferative diabetic retinopathy had PRP. Patients were then divided into two groups: nepafenac group (30 eyes) receiving 1% topical nepafenac eye drops for 6 months and control group (30 eyes) receiving carboxymethylcellulose eye drops for 6 months. Best-corrected visual acuity (BCVA) and macular optical coherence tomography were followed up at 1, 2, 4, and 6 months after PRP. RESULTS: BCVA was significantly better in nepafenac group than in control group at all follow-ups (P < 0.01). At 6 months post-PRP, logMAR BCVA was 0.11 ± 0.04 (equivalent to 20/26 Snellen acuity) in the nepafenac group and 0.18 ± 0.08 (equivalent to 20/30 Snellen acuity) in the control group (P < 0.01). Central foveal thickness (CFT) increased in both groups from the first month after PRP. Increase in CFT was higher in control group than in nepafenac group throughout follow-up, but the difference became statistically significant only after 4 months. No significant ocular adverse events were reported with topical nepafenac. CONCLUSION: Topical nepafenac can minimize macular edema and stabilize visual acuity following PRP for diabetic patients.

Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses Are Reduced in Children With Type 1 Diabetes With No Evidence of Vascular Retinopathy.

PURPOSE: To determine whether type 1 diabetes (T1DM) in children with a mean age of 12.21 ± 3.04 years affects the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) when compared to age- and sex-matched healthy children. METHODS: Forty-six children with T1DM with no diabetic retinopathy (DR) and 50 normal age- and sex-matched controls underwent full clinical ophthalmic and spectral-domain optical coherence tomography (SD-OCT) examination. Using RTVue Fourier-Domain OCT (version 6.11.0.12) average, superior, and inferior RNFL and GCC thicknesses (in µm) were measured. Mean values of patients and the control group were compared. RESULTS: In children with T1DM with no DR, the mean average RNFL thickness was 110.9 µm ± 10.46, and the mean GCC thickness was 95.59 µm ± 5.13; both were significantly thinner than the control group (115.62 µm and 99.30 µm, respectively). The retinal nerve fiber layer and GCC thickness showed no correlation to either age of onset, duration of the disease, or glycosylated hemoglobin (HbA1c). A positive correlation was found between the daily insulin dose and the average RNFL thickness (r = 0.378, P = 0.01). The average GCC in children with dyslipidemia was thinner than those with normal lipid profile (91.29 ± 6.46 µm, 97.11 ± 3.59 µm, respectively) with a P value of 0.011. CONCLUSIONS: Thinning of the RNFL and GCC in children with T1DM with no DR compared to healthy controls suggests that neurodegenerative changes occur in the absence of vascular changes. It also shows that neurodegeneration is not related to either disease duration, onset, or control.

Effect of lens status on intraocular pressure in siliconized eyes.

PURPOSE: To evaluate the effect of lens status on intraocular pressure (IOP) in siliconized eyes and also on the emulsification of silicone oil. PATIENTS AND METHODS: A total of 31 eyes of 31 patients with retinal detachment were operated on with pars plana vitrectomy and silicone oil injection: 16 phakic (Group A) and 15 pseudophakic (Group B). During the 6-month follow-up period, IOP was measured: 1 day postoperative, then at 1 week, 1 month, 2 months, 3 months, and 6 months postoperative. At the end of the follow-up period, gonioscopy was carried out to check emulsified silicone at the anterior chamber angle and also the presence of emulsified silicone on the back of the cornea when the patient was lying down. RESULTS: There was no significant difference between both groups until the first week (P value = 0.15). Starting from the first month, the difference was statistically significant, with mean IOPs in Groups A and B of 14.9 mmHg and 18.2 mmHg, respectively, up to the sixth month (P value = 0.002), with a mean IOP in Groups A and B of 14.4 mmHg and 19.4 mmHg, respectively. Emulsified silicone was clinically stated in twelve cases (80%) in Group B and in three cases (19%) in Group A. CONCLUSION: There is a higher incidence of increased IOP and emulsification of silicone oil in pseudophakic eyes than in phakic eyes.