ABSTRACT
We conducted a prospective study to determine the best treatment option for patients with low-to-moderate spherical myopia or myopic astigmatism who are considered equally eligible for LASEK with mitomycin-C [MMC] and LASIK with either mechanical microkeratome or femtosecond laser flap creation. Forty-six adult patients [86 eyes] who underwent LASEK with MMC [16 patients, 31 eyes], and mechanical microkeratome LASIK [13 patients, 23 eyes] or Femtosecond LASIK [17 patients, 32 eyes] were assessed for clinical outcomes 1, 3 and 6 months post-operatively. Six months after surgery, all eyes in all three groups were within 1 D of the intended refractive change. UCVA 20/20 or better was achieved in 96% of eyes undergoing LASEK with MMC 88% of eyes in the mechanical microkeratome LASIK and 72% of eyes in the Femtosecond LASIK group at 6 months. Mean spherical equivalent was -0.12 +/- 0.22 D, -0.09 +/- 0.28 D and -0.25 +/- 0.28 D in the three groups, respectively [p = 0.077]. Patients in the LASEK with MMC group had less high order aberrations at 3 and 6 months compared to the two LASIK groups. None of the three procedures were associated with early- or late-onset complications or loss of 2 or more lines after surgery. After an initially slower visual improvement, LASEK with MMC, and to lesser extent, LASIK with mechanical microkeratome, produced better visual acuity and less corneal aberrations compared to Femtosecond LASIK at 3 and 6 months after surgery. These observations deserve further investigation in a randomized controlled trial
ABSTRACT
To evaluate the visual outcomes, complications and retention of threadless type I Boston keratoprosthesis [KPro] in Saudi Arabia. Retrospective analysis of four eyes of four patients [one female and three males; age range: 48 to 72 years] who underwent Boston type I threadless KPro implantation between January and December 2009. In the median follow-up of 11 months [range 6 to 14 months], visual outcomes were satisfactory. Preoperative diagnosis included two patients of post-trachoma dense vascularized corneal scarring, one patient of corneal alkali burn and one patient of repeated failed corneal grafts. All patients demonstrated significant improvement in vision; with pre-operative visual acuity of hand movements [HM], counting fingers and HM improved to best corrected visual acuity [BCVA] of 20/200, 20/60, 20/50 and 20/30 on their last follow-up visits respectively. None of the patients developed glaucoma as a result of the procedure. No retro-prosthetic membrane developed till the last follow-up visit. One of the four patients had a corneal melt [due to severe dryness associated with trachoma] 6 months after the KPro implantation and underwent a successful KPro revision. Despite the relatively poor prognosis expected in alkali burn eye, the patient attained the maximum BCVA [20/30] of the four eye series on the last follow-up visit at six months. In consistent with the earlier reports from other parts of the world, all the 4 eyes had a significant increase in vision after Boston type I KPro implantation. However, patients require close lifelong follow-up to manage any complications
ABSTRACT
Rosacea is a dermatologic condition that affects the midfacial region. Ocular rosacea is most frequently diagnosed when cutaneous signs and symptoms are also present. Ocular manifestations are essentially confined to the eyelids and ocular surface. Ocular involvement ranges from minor irritation, dryness, and blurry vision to potentially severe ocular surface disruption including corneal ulcers, vascularization and rarely perforation. We present a 49'year-old Saudi Arabian female with the diagnosis of rosacea who presented with a peripheral corneal performation. The perforation was successfully managed by surgical repair, oral doxycycline and topical steroid. The final best corrected visual acuity was 20/30 after treatment. Early referral to an ophthalmologist and careful long-term followup are recommended