Phacoemulsification in patients with corneal opacities using slit illumination of the surgical microscope.

Performing phacoemulsification in eyes with corneal opacities is challenging even with expert surgeons. Several techniques have been described to improve intraoperative visualization through opacified corneas. This retrospective interventional case series included 10 eyes of 10 patients with coexisting senile cataract and corneal opacity who underwent phacoemulsification with intraocular lens (IOL) implantation under slit illumination of the surgical microscope. Uneventful phacoemulsification with IOL implantation was achieved in all eyes without intraoperative complications. Slit illumination reduced the light scattering and reflection from the corneal opacity, enhanced the red reflex, and improved depth perception simultaneously in different steps of phacoemulsification. Phacoemulsification was safely performed in eyes with corneal opacity under slit illumination of the surgical microscope. It can be considered as a viable option for improving intraoperative visualization in patients with corneal opacities without additional instrumentation.

Epidemiology, Etiologies, and Complications of Playtime Open Globe Injuries in Children.

PURPOSE: To study the epidemiology, etiologies, and complications of playtime open globe injuries in children at the Assiut University Hospital, Egypt. METHODS: This prospective cross-sectional study enrolled children with open globe injury who were admitted to Assiut University Hospital during a 6-month period (January to July 2016). All causes of trauma that occurred during playtime (at home, outside home, at the club, or at school) were recorded and analyzed. RESULTS: Eighty-one children (age = 18 years and younger; mean ± standard deviation age = 8.35 ± 4.84 years) were admitted with open globe injury, and 32 of them (39.51%) sustained ocular trauma during playtime. The majority of children were boys (n = 23, 71.88%). The causes of trauma during playtime were: playing with sharp objects (n = 11; 34.38%), playing with a wooden stick (n = 7; 21.88%), falling on the ground (n = 5; 15.63%), trauma by a stone (n = 2; 6.25%), trauma during running (n = 1; 3.13%), playing with a plastic toy (n = 1; 3.13%), and unknown causes (n = 5; 15.63%). The sites of globe perforation were corneal (n = 23; 71.88%), corneoscleral (n = 8; 25%), and scleral (n = 1; 3.13%). CONCLUSIONS: Playtime trauma that causes open globe injury and visual disability is avoidable and constituted approximately half of the open globe injuries in this study population. Corneal involvement occurred in almost all open globe injuries. Parental supervision for children during playtime is crucial to injury prevention. Children should avoid playing with sharp, dangerous objects and desist from playing or running on unsafe ground. [J Pediatr Ophthalmol Strabismus. 2021;58(6):385-389.].