Case series about physiological astigmatism and the impact of pterygium surgery.

Introduction: Pterygium is a benign conjunctival fibrovascular neoformation progressively encroaching on the cornea, it can cause corneal distortion and induce astigmatism, or aggravate pre-existing physiological astigmatism, which is defined as ≤ 0.50 D and not requiring optical correction. The radical treatment of pterygium is purely surgical, with conjunctivo-limbal grafting and conjunctival autografting emerging as the surgical techniques of choice. The main objective of the study was to investigate whether pterygium surgery does not worsen the preoperative physiological astigmatism. Material and methods: This is a prospective cohort study conducted in the ophthalmology department of the Mohammed V Military Hospital in Rabat over a period of 12 months, including 43 stage II/III/IV pterygia that were operated on by conjunctival autograft by the same surgeon. First, we looked for an association between pterygium surgery and variations in astigmatism. For quantitative variables we used the Wilcoxon test. In a second step we split the file into two distinct groups according to the value of preoperative astigmatism≤ 0.5 D or >0.5 D in order to detect the impact of pterygium surgery on physiological astigmatism. Statistical analysis of the data was performed by comparing the distribution of these characteristics. Results: The median astigmatism was 1 D (0.25; 2.50). 35% of our population had preoperative astigmatism ≤0.5 D. The Wilcoxon test showed that there was a statistically significant difference between preoperative and postoperative astigmatism (p = 0.001). The paired sample T-test showed no statistically significant difference between the preoperative and postoperative outcome in the physiological astigmatism population (p = 0.53). Conclusion: Many studies have shown the benefits of pterygium excision on astigmatism, but few studies have specified the impact of this surgery on physiological astigmatism. Our study showed that pterygium surgery does not alter physiological astigmatism.

Case series about severe corneal abscesses: Epidemiological, clinical and microbiological study (about 37 cases).

Introduction: corneal abscess is an infiltration of the layers of the cornea of infectious origin, it is an ophthalmological emergency, the objective of our study is to determine the epidemiological, microbiological and evolutive characteristics of corneal abscesses. Patients and methods: Retrospective, descriptive study of 37 patients hospitalized for corneal abscesses between January 2017 and February 2021 at the military hospital of Rabat. Results: The average age of the patients in our study was 42 years. The median time before the consultation was 6 days. The most frequent risk factor was contact lens wear at 32.43%. Ocular trauma was reported in 13.51% of cases. Initial visual acuity was less than one tenth in all patients. Culture was positive in 67.56% of cases. The most common germ was Staphylococcus aureus with 32.43%, followed by Pseudomonas aeruginosa with 16.21% of cases. The prognosis was relatively good with prompt and adequate management. Conclusion: A good preliminary analysis of the risk factors, the mode of infection, and the adapted research of the incriminated germs allow a secondary adequate management of the severe corneal abscesses.

A case report of a severe form of cogan syndrome.

INTRODUCTION: the Cogan syndrome is a very rare, systemic disease that affects young adults. Very few cases are described in the literature. We report the case of a patient with a severe form of Cogan syndrome. CASE PRESENTATION: This is a young patient who presented with a painful left red eye and bilateral visual impairment evolving for 5 years with ENT signs such as right hypoacusis and vertigo. Clinical examination in this patient found bilateral hypertensive panuveitis, vertigo of peripheral origin and hypoacusis on the right. The patient is currently on corticosteroid therapy with stabilization of the lesions. DISCUSSION: This pathology is characterized by ocular and audio-vestibular involvement with sometimes other visceral manifestations. The etiopathogeny is not well known, the evolution is marked by the functional prognosis (visual and auditory) and the vital prognosis (aortic insufficiency). The treatment is essentially based on corticotherapy and the treatment of complications. CONCLUSION: It is a very rare condition that should be considered when there are suggestive signs, because the evolution is severe without appropriate care. This underlines the importance of early management and the need for optimal follow-up to avoid the occurrence of complications that are disabling or even fatal.