A Prospective Comparative Study between Implantable Phakic Intraocular Contact Lens and Implantable Collamer Lens in Treatment of Myopia in Adults.

Purpose: To compare implantable collamer lenses (ICLs) and acrylic implantable phakic contact lenses (IPCLs) in the treatment of myopia in adults, as regards refractive outcome and adverse effects. Methods: Prospective, randomized comparative study with phakic intraocular lenses (IOLs) was carried out for treatment of myopia. Patients were randomized into two groups: one for ICL and the other for IPCL. Preoperative assessments included a full examination, pentacam, endothelial cell count, and biometry. We compared the adverse effects and refractive outcomes between both groups. The study was registered in clinical trials and the registration number is NCT04624035. Results: Sixty eyes of sixty patients (28 in the ICL group and 32 in the IPCL group) with a follow-up period of 12 months. The mean preoperative spherical equivalent was -12.7 ± 3.4 D and -13.6 ± 4.4 D in the ICL and IPCL groups, respectively (P=0.37). The mean postoperative spherical equivalent value was ±0.4 ± 0.2 D and ±0.6 ± 0.1 D in the ICL and IPCL groups, respectively. Uncorrected visual acuity (UCVA) has improved from 1.3 ± 0.06 to 0.15 ± 0.02 Log MAR in the ICL group (P < 0.001) and from 1.3 ± 0.02 to 0.15 ± 0.01 Log MAR in the IPCL group (P < 0.001). The mean endothelial cell count was reduced by 3.3% in the IPCL group and by 3.2% in the IPCL group. Conclusion: Both ICL and IPCL are effective methods to correct high myopia in adults with no statistically significant differences between the two lenses as regarding adverse effects.

Combined phacoemulsification and viscocanalostomy with Ologen implant versus combined phacoemulsification and viscocanalostomy.

BACKGROUND: To study the efficacy of the biodegradable collagen implant Ologen® as an adjuvant in phaco-viscocanalostomy in patients with coexisting cataract and primary open angle glaucoma. METHODS: This prospective, interventional, randomized clinical study was done at Alpha Vision Center, Zagazig, Egypt. Patients with coexisting cataract and glaucoma were randomized to receive either phaco-viscocanalostomy (Phacovisco group) (39 eyes) or phaco-viscocanalostomy with Ologen® implant (OloPhacovisco group) (40 eyes). Follow-up period was 2 years. Nd:YAG laser goniopuncture was done in cases where the intraocular pressure (IOP) was elevated above 21 mmHg after discontinuation of corticosteroid eye drops at any follow-up visit. RESULTS: No significant operative or postoperative complications (other than failure) were encountered in either group. At 2 years follow-up, the mean IOP level was statistically significantly decreased in the OloPhacovisco group (p = 0.02) and complete success occurred in 23 eyes (59.0%) in the Phacovisco group and in 32 eyes (80.0%) in the OloPhacovisco group. There was a statistically significant higher success rate regarding complete success in patients that received Ologen® implant (p = 0.04). CONCLUSIONS: Ologen® implant improved the success rate of phaco-viscocanalostomy. Larger studies with longer follow-up periods may be required to confirm these findings. TRIAL REGISTRATION: This trial was retrospectively registered on 20/12/2018 under the number ( NCT03782051 ).

Conjunctival Autograft Combined With Either Preoperative Mitomycin C Injection or Intraoperative Local Mitomycin C Over the Medial Rectus Muscle Tendon in Primary Pterygium Surgery.

PURPOSE: To evaluate and compare the recurrence rate and complications of conjunctival autograft (CAG) combined with preoperative mitomycin C (MMC) injection versus CAG with intraoperative local MMC over the medial rectus muscle tendon in primary pterygium. STUDY DESIGN: Randomized prospective study. METHODS: This study included 108 eyes of 108 patients with primary fleshy or growing pterygium. All patients were from rural areas and less than 50 years old. Fifty-three patients were treated with injection of 0.1 mL of 0.15 mg/mL MMC into the body of pterygium followed 1 day later by pterygium excision and CAG (group I), and 55 patients were treated with pterygium excision and local application of 0.2 mg/mL MMC for 2 min over the medial rectus tendon followed by CAG (group II). The minimum follow-up period was 18 months. RESULTS: Two patients from group I and one patient from group II did not complete the follow-up period and were excluded. There were no statistically significant differences between the two groups regarding age, sex, laterality, or follow-up period. Recurrence occurred in 2 eyes in group I (3.92%) and 1 eye in group II (1.85%); (P=0.52). All recurrences occurred in male patients of less than 30 years of age. No significant complications were encountered in both groups. CONCLUSIONS: Both preoperative MMC injection followed 1 day later by pterygium excision with CAG, and pterygium excision and intraoperative local application of MMC on the medial rectus tendon are successful in treating primary pterygium with low recurrence rate and few complications.

Amniotic membrane graft to conjunctival flap in treatment of non-viral resistant infectious keratitis: a randomised clinical study.

PURPOSE: To evaluate and compare the results of bipedicle conjunctival flap (CF) and cryopreserved amniotic membrane graft (AMG) in the treatment of non-viral infectious keratitis resistant to medical treatment. METHODS: This prospective randomised interventional study included 40 eyes of 40 patients with resistant non-viral infectious keratitis. Twenty eyes received CF and 20 eyes received AMG. In the CF group, there were 12 eyes with fungal keratitis, 7 eyes with bacterial keratitis and 1 eye with Acanthamoeba keratitis. In the AMG group there were 13 eyes with fungal keratitis, 5 eyes with bacterial keratitis and 2 eyes with Acanthamoeba keratitis. In the CF group, three ulcers had descemetocele and four ulcers were perforated. In the AMG group, four ulcers had descemetocele and two ulcers were perforated. In CF, 360° peritomy was done and a bipedicle CF from the upper conjunctiva was dissected from Tenon's capsule, mobilised to cover the cornea and sutured to episclera. In AMG, one or two layers of AM were trimmed to fit the ulcer and sutured to the cornea. The follow-up period was 6 months. RESULTS: Successful results were observed in 18/20 eyes (90%) in each group. Postoperatively, no significant differences between the two groups were found regarding success rate (p=1.0), epithelialisation time (p=0.75) or visual acuity improvement (p=0.84). CONCLUSIONS: CF and AMG are effective in treatment-resistant infectious keratitis. They could restore ocular surface integrity and provide metabolic and mechanical support for corneal healing. For large corneal perforation, it may be better to use another procedure such as penetrating keratoplasty to restore ocular integrity.