Biography:

Harish Bhardwaj is a renowned Opometrist in Bahrain. Harish Bhardwaj is working as Opometrist at King Abdulla Medical City Bahrain. He publishes many articles in reputed journals.

Abstract:

Aim:  To describe a case report of a patient with tectonic corneal grafts in both eyes who was unable to achieve functional vision with spectacles or soft contact lenses. The patient was with fit with Atlantis scleral lens in the left eye, and was able to have comfort and reasonably good vision.

Case summary: A 67 years old male diabetic patient with keratoconus who underwent tectonic grafts in both eyes for bilateral spontaneous corneal perforations. He visited our cornea clinic complaining of extremely poor vision; he couldn’t drive and was unable to find his way independently.

Examination showed: vision in the right eye counting fingers at 3 meters and left eye vision was 0.1. Slit lamp examination showed bilateral patch grafts inferiorly that were bulging forward. He was pseudophakic in both eyes. Dilated fundus examination with high resolution-retinal OCT scan showed vitero-macular traction and epiretinal membrane in the right eye. He had normal foveal contour in left eye. The patient underwent right eye pars plana vitrectomy with membrane peeling, endolaser and silicone oil. Few weeks later he had penetrating keratoplasty in the same eye. Post operatively his vision with multiple pin-holes in the right eye was fluctuating at 0.05. The patient was referred the contact lens clinic. Atlantis scleral contact lens fitting was done to the left eye. (Boston, XO materials). The patient’s vision with this contact lens reached up to (0.5). This is considered a reasonable good vision that is suitable for driving according to international standards.

Conclusion:  This patient had tectonic grafts and was initially considered legally blind. After his contact lens fitting in the left eye he was able to drive and to lead normal life. This case report shed the light on the importance of scleral contact lenses in management of severe corneal distortions. It also demonstrates that scleral contact lenses can provide reasonable vision even in patients with tectonic corneal grafts.   

Biography:

Sameh Saad Mandour  has completed his PhD at the age of 33 years from Menoufia University. He is an oculoplastic surgeon. He has published more than 20 papers in reputed journals.     
 

Abstract:

Objective: To evaluate the safety and effecacy of Maximal levator muscle resection technique for treatment of moderate to severe simple congenital blepharoptosis with poor levator function.

Background: Surgical options for the correction of congenital ptosis with poor levator function include frontalis suspension and maximal levator resection. The choice between both remains controversial. However, levator resection approach is more physiological.

Patients and methods:This prospective study included 29 eyelids of 20 patients who underwent maximal levator resection procedure and their ages ranged from 3-8 years. Patients presented with ptosis were examined and enrolled from January 2018 to January 2019, from the outpatient ophthalmic clinic of Menoufia University Hospital. Follow up was done up to 6^th months postoperative to evaluate the functional and cosmetic results and to report complications.

Results: There is statistically significant increase of mean postoperative margin to reflex distance-1 (MRD-1) in comparison to preoperative MRD-1 (p < 0.05). Successful outcome of maximal levator resection procedure was achieved in  86.21 % (25/29) at the end of follow up period. The most common complications were under-correction in 10.3% (3/29) and overcorrection in 3.4% (1/29).

Conclusion: Maximal Levator resection procedure is effective in the treatment of congenital blepharoptosis with poor levator function.

Biography:

Hatem A Saeed is working as a professor of ophthalmology at faculty of medicine in Cairo University, Egypt

Abstract:

Aim of work: To evaluate the intra-operative technical advantages and difficulties of secondary implantation of posterior chamber intraocular lens following pars-plicata lensectomy versus limbal irrigation aspiration as well as postoperative results in aphakic children.

Subjects and Methods: Twenty eyes of 17 children were enrolled in this study .The age at the initial cataract surgery ranged from 4 months to 3 years. The age at the second surgery ranged from 4 -8 years (mean of 6 ±1.414). Twenty aphakic eyes divided into 2 groups: Group 1 included 10 eyes who underwent secondary implantation of PCIOL in the ciliary sulcus following pars-plicata lensectomy. Group 2 included 10 eyes who underwent secondary implantation of PCIOL in the ciliary sulcus following limbal irrigation aspiration. During preoperative ophthalmic examination; particular attention was given to the presence of: posterior synechiae to the posterior capsular rim, pupillary irregularity, extent of pupillary dilatation and the presence of any trapped cortical matter inside the capsular adhesions. Intra-operatively ; certain parameters were evaluated including :the need to dissect posterior synechiae to the posterior capsular rim threatening the enlargement of posterior capsular opening with vitreous prolapse, the need to dissect capsular adhesions to remove trapped cortical matter, the need to perform sulcus dissection and reformation, the ease of lens implantation and the final lens centration .Postoperatively; the degree of postoperative reaction, centration of the implant and the pupil regularity were reported.

Results: Previous pars-plicata lensectomy offered several intra-operative technical advantages to secondary implantation compared to previous limbal irrigation aspiration regarding: Less posterior synechiae, less pupillary irregularity, better pupillary dilatation, absence of the need to perform capsular or sulcus dissection, less need to perform cortical clean up, easier IOL implantation and better final lens centration .Postoperatively; less reaction, better lens centration and less pupillary irregularity were reported in group 1.

Conclusion: Secondary implantation of PCIOL following pars-plicata lensectomy was easier with more intra-operative technical advantages and less difficulties and with better postoperative results compared to secondary implantation of PCIOL following limbal irrigation aspiration in aphakic children.

Biography:

Li Yun has her expertise in evaluation and passion in improving the pediatric ophthalmology clinical and translational research.

Abstract:

Case presentation: A male infant (gestational age 30 weeks, birth weight 1410g) presented for the screening of retinopathy of prematurity (ROP). On examination at age PMA 34 weeks (initial visit) a port wine stain was noted on his left eyelids and maxillary area, following the V1 and V2 distributions of the trigeminal nerve. From post menstrual age (PMA) 37 weeks, he was found to have progressive ROP (Zone 2 stage 3) in his left eye and received intravitreal ranibizumab at PMA 39 weeks to treat type 1 ROP. The ridge and neovascularization (NV) regressed satisfactorily, but diffuse choroidal hemangioma became evident at 40 weeks, with typical “tomato catsup fundus”. These clinical findings characterized Sturge-Weber Syndrome. At PMA 44 weeks, the baby was then noted to have increased bulbar conjunctival vascularization and retinal vascular tortuosity. Multiple vein-to-vein anastomoses in the peripheral retina and increased retinal vascular tortuosity are spotted on fundus photography and fluorescein angiography (FFA). The baby has a normal IOP thus far and is under close observation for further ocular changes. No leptomeningeal angiomatosis was noted from the MRI.

Discussion and conclusions: We describe a premature infant as a youngest SWS patient whose progressive multiple ocular vessel malformations was documented. The patient was also diagnosed with type1 ROP in his left eye at PMA 37. a lesson we should think and learn from this case is how we can differentiate the vascular abnormality in SWS and ROP. .morphology of the abnormal vessels, progression pattern and FFA under anesthesia is helpful in such situation

Biography:

Joanna SÅ‚omko has completed his PhD at the age of 28 years from Nicolaus Copernicus University in Bydgoszcz. She is adjunct, university teacher; she conducting and coordinating research projects in the areas: clinical and applied physiology, exercise physiology and neurophysiology. She is vice-chairman of Polish Society of CFS/ME Research. She has published more than 70 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

The aim of our work was to examine the level of minerals among patients with chronic fatigue syndrome (CFS). Our study included 9 patients (3 men and 6 women) diagnosed using the Fukuda criteria. The mean age of the patients was 33.33 ± 6.48 years and the mean disease duration was 3.94 ± 3.11 years. Hair samples 3-4 cm long, counting from the scalp skin, were taken.  from which external impurities were then removed based on recommendations of the International Atomic Energy Agency and pressure mineralization using microwave energy. Samples were then analysed for minerals using Atomic Absorption Spectrometer (AAS). We evaluated the levels of calcium, magnesium, zinc, copper, iron, sodium and potassium in the study and control group. The bioelectrical impedance method (BIA) was used to analyze body composition. We observed statistically significant differences in the levels of some minerals Ca (P = 0.0151), Mg (P = 0.0050), Zn (P = 0.0002), K (P = 0.0372), Na (P = 0.0321) compared to the control group composed from healthy volunteers. Moreover, a positive correlation was observed only between Fe level and length of history (R= - 0.71, p<0.05). Differences in mineral levels may be related to many different symptoms in the course of chronic fatigue syndrome. Appropriate regulation of mineral levels may lead to the relief of symptoms, but further research is needed.

Discussion and conclusions: We describe a premature infant as a youngest SWS patient whose progressive multiple ocular vessel malformations was documented. The patient was also diagnosed with type1 ROP in his left eye at PMA 37. a lesson we should think and learn from this case is how we can differentiate the vascular abnormality in SWS and ROP. .morphology of the abnormal vessels, progression pattern and FFA under anesthesia is helpful in such situation

Biography:

Chai Fang is working in Shaanxi Ophthalmic Medical Center, Xi’an No. 4 Hospital, Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi’an, China.

Abstract:

Purpose: To report a case of coats-like ocular toxocariasis clinical feature and treatment.

Methods: We present a case of ocular toxocariasis that occurred in a 22-year- old man misdiagnosed with coats disease. The patient underwent a full ophthalmic examination, a complete blood count; blood chemistry tests for Toxocara immunoglobulin (Ig)G, Toxoplasma IgM, and Toxoplasma IgG; an assessment of total IgE levels; chest X-rays; measurements of angiotensin converting enzyme, antinuclear antibody, hepatitis B surface antigen antibody, and anti-hepatitis C virus antibody levels; and a questionnaire about eating habits and whether the patient had pets.

Results: The patients had a pets feeding history. The patient's left eye had a visual acuity of 0.3 and an intraocular pressure of 10 mmHg. Fundus examination showed a large amount of yellow-white submucosal exudation and exudative retinal detachment, epiretinal membrane traction macular edema, optic disc anterior membrane were all exsisted. Vitrectomy was performed. During the vitreous surgery, the vitreous body showed a thin gauze-like change, and the yellow-white granuloma was seen in the posterior pole. Through the intraoperative pressure, multiple granulation lesions were found in the peripheral retina. One week after vitrectomy, the retina was flat, the macular edema was reduced, and the visual acuity was increased to 0.5.

Conclusion: The history of pet feeding, gauze-like changes in the vitreous, and typical yellow-white granuloma are strong evidence for the diagnosis of ocular ascariasis. Detailed medical history inquiry, careful fundus examination, blood and intraocular fluid antibody monitoring, UBM examination can more accurately help our diagnosis, to avoid missed diagnosis and misdiagnosis.

Biography:

Ihab m. Osman is working as Assistant professor of ophthalmology. He has published more than 9 papers in reputed journals. He completed his Bachelor’s Degree in Medicine & Surgery ( M.B.Ch.B.) 2000. Faculty of Medicine, Alexandria University; Egypt and Master Degree in Ophthalmology ( M.Sc.) 2005

Abstract:

Purpose: To assess the safety and stability in cases of small incision lenticule extraction with collagen cross-linking (SMILE Xtra).

Methods: This study was a retrospective interventional comparative study that included 60 eyes of 30 patients divided equally into two groups: SMILE Xtra and SMILE alone.  inclusion criteria were patients >18 years of age, myopic error>6 D, thinner cornea<520 microns, and abnormal corneal topography. Outcome data were recorded including uncorrected distance visual acuity and corrected distance visual acuity (UDVA and CDVA), manifest refraction spherical equivalent (MRSE), central corneal thickness, average keratometry, endothelial cell density, corneal resistance factor (CRF), and corneal densitometry.  follow-up period was 24 months.

Results:There was a significant difference between the 2 groups regarding UDVA, CDVA, and MRSE at 1 month. In the SMILE Xtra group, 90% of eyes had  postoperative UDVA of 20/20 and 97% had UDVA of 20/30 at 24 months. At 24 months, 26 eyes (87%) vs. 25 eyes (84%) were within±0.50 D of attempted correction in SMILE Xtra and SMILE groups, respectively. Regarding stability, both groups showed improvement of MRSE at 1st month postoperatively and  remained  stable along the 24 months of follow-up. CRF and corneal densitometry were higher in the SMILE Xtra group along the whole follow-up period (p0.001).

Conclusion: Combining corneal cross-linking with SMILE procedure (SMILE Xtra) is a promising tool to prevent ectasia in high-risk patients. It is a safe and simple procedure that can be offered to patients undergoing SMILE with risk for ectasia.