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PURPOSE: To evaluate the causes and long-term outcomes after intrastromal corneal ring segment (ICRS) explantation in the King Khaled Eye Specialist Hospital. METHODS: This was retrospective cohort study. Two groups were analyzed: Group one, ICRS surgery done in our hospital (n = 41) and group two, surgery done outside but removed in our hospital (n = 29). Causes and postoperative management after ICRS removal were analyzed. For statistical analysis, groups were analyzed into two subgroups of causes of ICRS removal: Visual disturbance versus extrusion/infection/neovascularization (NV) subgroups; and two subgroups of postoperative treatment: Corneal transplant (CT) versus Contact lens (CL)/eyeglasses subgroups. RESULTS: The most common cause of ICRS removal in group one was visual disturbance (45.2%) while in group two was extrusion (41.2%). CL is the preferable management after explantation. 76% of ICRS removal occurred during the first 4 years. In group 1, there was significant worse preimplantation visual acuity (P = 0.02) in CT subgroup versus CL/eyeglasses. CT subgroup had lower pachymetry of 437.4 µm (P = 0.04) and higher myopia of 8.05 (P = 0.03) than CL/eyeglasses subgroup. For group two, there was a significant improvement in uncorrected visual acuity in visual disturbances subgroup after explantation (P = 0.004). After explantation, visual disturbances subgroup had higher myopia -4.4 than extrusion subgroup -1.15 (P = 0.004). CONCLUSION: Seventy-six percent of ICRS removal occurred during the first 4 years. High myopia and pachymetry lower than 437 um were associated with visual disturbances and further management with corneal transplantation. High myopia was also associated with visual disturbances in surgeries done outside our hospital.
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Background The visual system becomes more susceptible to conditions causing abnormal binocular interaction or blurred visual input as it matures during the first six years of life. Therefore, detection and treatment of visual impairment at a young age can lower the burden of the condition in adulthood. According to estimates, there are 19 million children worldwide with visual impairment, and 1.4 million children suffer from blindness. One of the strategies to address blinding eye conditions and visual impairment is through health promotion. For children, the efficient way of intervention is through parents and their school environment. Therefore, the establishment of an effective health promotion model for addressing childhood blindness requires awareness building of parents and health care practices. Few studies were undertaken in Saudi Arabia to focus on the awareness of parents about childhood eye diseases and visual impairment. The aim of this study is to assess parents' awareness and perception of children's eye diseases in Madinah, Saudi Arabia. Methods This cross-sectional study was conducted in Madinah, Saudi Arabia, from January to December 2021. A self-administered questionnaire was randomly distributed to parents of children aged 15 and younger via WhatsApp. The survey consisted of four main sections: socio-demographic data, knowledge about eye care, knowledge about eye diseases, and eye care practice. Results The knowledge about eye diseases in children was of excellent grade in 20 parents (3.6%), good in 101 (18.2%), and poor in 434 (78.2%). Knowledge was good in 287 parents (51.7%) for amblyopia, 65 (11.7%) for childhood cataract, and 69 (12.4%) for childhood glaucoma. The attitude regarding children wearing spectacles and undergoing ophthalmic surgery when needed was positive in 427 (76.9%) and 474 (85.4%) parents, respectively. Over half of the participants (58.6%) had visited an ophthalmology clinic for the examination of their children. Doctors, campaigns, and social media were the preferred modes of receiving knowledge. Participants aged 51 years or over (p = 0.022), with a higher income level (p = 0.004), of Saudi origin (p = 0.036), and those with a child with an eye disease (p = 0.001) had significantly higher knowledge scores about childhood eye diseases. Conclusion The levels of knowledge, practice, and attitude among parents regarding pediatric eye diseases were unsatisfactory. Health promotion through utilizing parents' preferred modes of media could improve the eye care of children in the study area.
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PURPOSE: To assess the clinical characteristics of Duane Retraction Syndrome (DRS) in Al-Medina region, in patients attending a pediatric ophthalmology clinic at Ohud Hospital. METHOD: A cross-sectional observational study was conducted from October 2017 to June 2018 at Ohud Hospital, Al-Medina region, Saudi Arabia. Data was collected using a sheet containing eighteen simple items which include demographic data, family history, surgical history, the clinical characteristics of the disease and the physician's treatment plan. Twenty patients were included in this study. RESULTS: All twenty patients included in the study were diagnosed with DRS type I. Male and female were symmetrical in numbers as both 10 (50.0%) respectively. The mean age of the subjects was 8.7â¯years (SD 9.6). 95% of the subject were unilaterally affected while five percent of them were affected both sides of the eyes. 75% of the patients were affected on the left eye while 20% were affected on the right side. 35% of the patients had amblyopia in the affected eye. 25% of the patients had an abnormal head position. Abnormal eye movement (upshoot and downshoot) more common when the right eye is affected (p-0.035). 75% of the patients were orthotropic while 30% had esotropia. 75% of patients were positive of parents' consanguinity. 16 patients (80.0%) were from Al-Medina city while four of them (20.0%) were from the different area of Al-Medina region (Al Hejeria, Al Henakia, Omluj, Yatmah). CONCLUSION: This cross-sectional observational study is the first one that evaluates DRS in Al-Medina region. Associated abnormal eye movement more common when the right eye is affected. Parents' consanguinity may play a role in the occurrence of DRS as it is not considered as a rare disease in our region. Therefore, more studies are needed to establish the relationship between the occurrence of DRS and parents' consanguinity in our region. Also, further studies are needed to establish the relationship between abnormal eye movement and the involvement of the right eye.
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PURPOSE: To evaluate refractive status and identify predictors of surgical success following a combined silicone oil removal/cataract surgery with intraocular lens (IOL) implantation procedure. METHODS: In this single-armed, retrospective study, we reviewed patients who underwent vitreoretinal surgery followed by a combined silicone oil removal/cataract surgery procedure between 2009 and 2013. Preoperative data included patient demographics, refractive status, IOL power, and axial length (measured with the IOL Master). Postoperative data were obtained from the 8-week follow-up visit and from the last follow-up visit attended that included refractive error (RE) evaluation (e.g., myopic, hyperopic, and astigmatic). Associations between variables and refractive status were examined. Blindness was defined as a best-corrected visual acuity (BCVA) worse than 3/60. RESULTS: Nighty-eight eyes were ultimately included in analyses. Following surgery, 37.0% of eyes achieved BCVA better than 6/18. The incidence of blindness (BCVA worse than 3/60) was reduced from 47.0% before surgery to 17.3% after surgery. Additionally, 33.7% of eyes did not require refractive correction. Forty-two percent of eyes were under-corrected (>0.5 D hyperopia) following surgery. Age, gender, silicone oil viscosity, axial length, IOL type, initial vitreoretinal pathology, surgeon, and IOL calculation formula were not significantly associated with surgical outcomes (all P > 0.05). CONCLUSION: A combined silicone oil removal/cataract surgery with IOL implantation procedure restored functional vision in approximately one-third of cases. However, nearly half of patients were under-corrected. Unfortunately, we did not identify any factors that predicted surgical success.
