Incidence, Pathophysiology, Complications, and Management of Positive Vitreous Pressure During Penetrating Keratoplasty: A Literature Review.

Positive vitreous pressure (PVP) is common during open anterior segment surgery and penetrating keratoplasty (PKP) has a reported incidence rate of 40-50%. Despite adequate perioperative preventive precautions, positive pressure occurs during surgery and optimum management of PVP is required to avoid serious complications. Many pharmacological and mechanical approaches can be employed either preoperatively or intraoperatively to decrease vitreous pressure. Surgical techniques such as graft-over-host technique, the modified graft-over-host technique, techniques employed mattress sutures and needle, or Vitreous aspiration or vitrectomy can be effectively used to manage intraoperative PVP during PPK. This article reviews the incidence, risk factors, prevention, and different approaches to the management of positive vitreous pressure during PKP to analyze the available evidence in order to improve the safety profile of PKP and prevent sight-threatening complications.

Residents' Perceived Impact of COVID-19 on Saudi Ophthalmology Training Programs-A Survey.

PURPOSE: To evaluate the impact of the current pandemic on ophthalmology residency training in Saudi Arabia, focusing on its effects on clinical education, training, and the mental well-being of the trainees. METHODS: An online self-administered questionnaire was distributed among residents in the Saudi ophthalmology training programs between July 7 and 14, 2020. In this study, we explored residents' opinions regarding training disruption and virtual education. The patient health questionnaire (PHQ-9) was used to assess the COVID-19 pandemic's impact on their mental health. We used descriptive statistics for data analysis. RESULTS: Out of 183 registered ophthalmology residents, 142 participated in this study. Ninety-six participants (35.4%) were rotated at a specialized eye hospital during the COVID-19 pandemic, while 52 (19.2%) had rotations in the ophthalmology department at general hospitals. Those who rotated in both types of hospitals were 123 (45.4%). According to the participants, there was a significant decline in exposure to surgical and office-based procedures compared to emergency eye consultations (Friedman P <0.001). The COVID-19 pandemic's effect on mental health was reported by 100 (70.5%) participants. Eighty-five (55.4%) respondents were satisfied with the virtual method of education. CONCLUSION: COVID-19 pandemic has disrupted residents' clinical and surgical training in the Saudi ophthalmology training programs. Additionally, we believe that COVID-19 may have a negative impact on trainees' mental health. Fortunately, the current pandemic provided an innovative education method that will likely be used even after the pandemic.

Outcome Of MicroPulse® Transscleral Photocoagulation In Different Types Of Glaucoma.

PURPOSE: To evaluate the safety and efficacy of MicroPulse® transscleral cyclophotocoagulation (µP-TSCPC) up to 24-months follow-up using a standardized fixed protocol in patients with various types of glaucoma. METHODS: Prospective, nonrandomized, non-comparative interventional case series of µP-TSCPC performed by a single glaucoma surgeon at tertiary hospitals between May 2017 and May 2019. RESULTS: A total of 71 eyes of 68 patients (39 males, 29 females) aged 60.0 years (13-89 years) were treated with µP-TSCPC. The most common diagnosis was neovascular glaucoma. The safety index of corrected distance visual acuity (CDVA) was 1.0, i.e. there was no significant change in CDVA postoperatively compared to baseline CDVA. The median baseline IOP was 35.0 mmHg (21.0-70.0 mmHg), which was reduced to 16 mmHg (8-32 mmHg) at 12 months/last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The median reduction in IOP was 52% (0.0-89%) at 12 months/last follow-up postoperatively compared to baseline. The median number of medications was 5 (3-5) at baseline compared to 4 (2-4) at 12 months/last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The percent of eyes treated with systemic glaucoma medication was 62% (44) at baseline compared to 0% (0) at 12 months/last follow-up postoperatively. The postoperative surgical success of 90%, 91.4%, and 95.7% at 2 weeks, 3 months, and 6 months respectively then remains unchanged. No significant adverse events or complications were observed. CONCLUSION: µP-TSCPC demonstrated good efficacy and safety profiles with minimal vision-threatening complications in treating a variety of glaucoma types.