Successful management of a retained host Descemet's membrane after penetrating keratoplasty (PKP) - A case report.

INTRODUCTION AND IMPORTANCE: To report the 21st case showing the rare occurrence of retained Descemet's membrane (DM) following penetrating keratoplasty (PKP). We intend to investigate possible etiologies, expected sequelae, and outcome of neodymium-dpoed yttrium alumnium garnet (Nd: YAG) laser membranectomy. CASE PRESENTATION: Our case is a 74-year-old male who underwent PKP surgery in the right eye secondary to corneal decompensation following cataract surgery in addition to corneal thinning secondary to superficial keratectomy related to the pre-existing climatic droplet keratopathy (CDK). Postoperative assessment revealed a retro-corneal membrane within the anterior chamber, which was affecting his vision. CLINICAL DISCUSSION: Based on the post-operative course and the decreased vision as an indication for intervention, it was decided to excise the retained DM. Membranectomy with Nd: YAG laser was performed, and the patient's visual acuity measurement improved from 20/400 to 20/25. However, the endothelial cell count decreased from 1479 to 520 cells/mm2 (35 % loss) at 15 months post YAG membranectomy with clear graft. Histopathological examination confirmed the clinical suspicion of a retained DM, since it was absent in the submitted host corneal tissue in addition to the pre-existing CDK. CONCLUSION: Retention of DM following PKP is a rare but possible complication and high index of suspicion is required for proper diagnosis and management to obtain better visual outcome. Nd: YAG laser membranectomy was effective in excising the retained DM and improving vision. Endothelial cell loss following Nd: YAG laser membranectomy as a complication was observed and should be addressed during the treatment plan.

The impact of the COVID-19 pandemic on the prevalence of computer vision syndrome among medical students in Riyadh, Saudi Arabia.

PURPOSE: To estimate the prevalence of computer vision syndrome (CVS) among university medical students in Riyadh, Saudi Arabia, after establishing remote learning during COVID-19 pandemic and to compare settings of electronic device usage and patterns of CVS protective measures applied by students before and during this pandemic. METHODS: This is an observational descriptive cross-sectional study which included 1st to 5th year medical students who were actively enrolled at the governmental colleges of medicine in Riyadh, Saudi Arabia, during the COVID-19 lockdown. The sample size was estimated to be 287 medical students. Participants were asked to volunteer and fill an electronic online questionnaire. RESULTS: A total of 300 medical students were included in this study. 94.0% reported at least one symptom of CVS, while 67% reported having more than three symptoms. The most frequently reported symptoms were musculoskeletal pain (84.3%), headache (71.1%) and dry eyes (68%). Thirty-eight percent of the students experienced more severe symptoms, while 48% experienced more frequent symptoms during the COVID-19 pandemic. Risk factors for having three or more symptoms were being a female (p < 0.001) and using electronic devices for longer periods (6.8 h ± 2.8) during COVID-19 lockdown (p < 0.001). CONCLUSION: CVS prevalence during COVID-19 era among medical students is high. This necessitates increasing the awareness of CVS and its preventive measures.

Traumatic superio-nasal subconjunctival dislocation of posterior chamber intraocular lens. A case report.

INTRODUCTION AND IMPORTANCE: Intraocular lens (IOL) implantation after cataract surgery is routine procedure. Traumatic dislocation of the posterior chamber IOL into the subconjunctival space following blunt ocular trauma is rare and it is considered an ophthalmic emergency. CASE PRESENTATION: We present a case of a 71-year-old male that presented to our institution with traumatic dislocation of a posterior chamber IOL into the superior-nasal subconjunctival space following blunt trauma to his left eye after an accidental fall on his head. DISCUSSION: Trauma in a pseduphakic eye can be devastating. Early recognition and treatment of IOL dislocation are of paramount importance to prevent further damage and infections. Half ring sign (Psudophacocele) recognition help in identifying and localizing the dislocated IOL in subconjunctival space. CONCLUSION: Traumatic dislocation of posterior chamber IOLs have been rarely reported in the literature. Nevertheless, it could happen years after implantation.