Eye trauma during the 2011 Egyptian revolution.

BACKGROUND: Cairo university hospitals are at the heart of Cairo with close proximity to Tahrir (Liberation) square and had received the vast majority of casualties during the Egyptian revolution. The aim of this study was to analyze the eye injuries during the uprising. DESIGN: Retrospective cohort study. METHODS: Data were obtained from patients' paper records, interview with treating ophthalmologists, and whenever possible patients were interviewed and examined. An electronic medical template had been specially developed for recording these data. Main outcome measures were the flow of patients and their demographics, diagnoses, visual acuities pre and post interventions, investigations and management. Whenever required results were compared at 95 % confidence interval. RESULTS: There were 184 patients (mean age 27.3 ± 9.6 years) with 195 injured eyes of whom 96.7 % were males and 11 patients had both eyes injured. Seventy seven percent of patients had been admitted within 24 h of injury. Open globe injuries comprised 87 % of the eyes of which 147 eyes received 259 imaging investigations. The presenting visual acuities were worse than 3/60 in 72.5 % of eyes which were even worse post interventions and that was significantly dependent on the presenting vision. Wound repair was the primary intervention in 85 % of eyes while 50 % of the secondary interventions were vitrectomies. CONCLUSIONS: Presenting visual acuity is a valid prognostic factor in the setting of mass eye casualty. Management of open globe injuries continues to pose difficult challenges especially bilateral ones.

Evaluation of corneal functional optical zone after laser in situ keratomileusis.

PURPOSE: To evaluate the corneal functional optical zone (FOZ) after laser in situ keratomileusis (LASIK) using a primary 6.0 mm ablation diameter without a transition zone. SETTING: University-based practice. METHODS: In this retrospective study, 76 eyes of 53 patients who had LASIK for myopia were evaluated. The size of the preoperative and postoperative FOZ was compared in each eye. Preoperative refraction, attempted correction, and achieved correction were correlated with the preoperative and postoperative FOZ using regression analysis. RESULTS: After LASIK, the FOZ decreased a mean 1.2 mm +/- 0.67 (SD) (P < 0.0001). The size of the FOZ was correlated with the preoperative manifest refraction, attempted correction, and achieved correction (P <.0001). The FOZ reduction was significantly correlated with the preoperative manifest refraction, attempted correction, and achieved correction (P <.05). Before LASIK, there was no correlation between the FOZ and the preoperative manifest refraction (P = 0.9427). CONCLUSIONS: Spherical aberrations exist within the laser ablation zone and are related to the amount of myopic treatment. This has implications for patients with large pupil diameters under mesopic conditions. Future studies are necessary to understand the implications in patients with high refractive errors.

Evaluation of tear film following Intacs for myopia.

PURPOSE: To evaluate the effect of intrastromal corneal ring segments (Intacs, Keravision) placement on the tear film quality as a measure of dry eye status. METHODS: Seventeen eyes of ten patients underwent Intacs placement for the correction of myopia with spherical equivalent refractions ranging from -1.75 to -3.25 D (mean, -2.43 +/- 0.56 D). Dry eye grade values were measured preoperatively and at 1 day, 1 week, and 1 month postoperatively using the Kowa-DR-1 interferometer. RESULTS: Preoperatively, the 17 eyes had a mean dry eye grade of 2.18 +/- 0.39 (range, 2 to 3). One day postoperatively, the 14 eyes measured had a mean dry eye grade of 2.64 +/- 0.63 (range, 2 to 4; P = .03). At 1 week the 17 eyes had a mean dry eye grade of 2.41 +/- 0.71 (range, 2 to 4; P = .25) and at 1 month, 2.18 +/- 0.39 (range, 2 to 3; P = .75). CONCLUSIONS: There was transient dry eye following Intacs placement, but the tear film quality was restored within 1 week of surgery.