Effect of Bandage Contact Lens Exchange on Pain and Healing After Photorefractive Keratectomy-A Randomized Control Trial.

OBJECTIVE: To evaluate the corneal re-epithelialization and patient-perceived pain after bandage contact lens (BCL) exchange on day one, after photorefractive keratectomy (PRK). METHODS: A randomized controlled trial, of all patients who underwent bilateral transepithelial-PRK (trans-PRK) or bilateral alcohol debridement and PRK (A-PRK), between March and October 2019. One eye of each patient was randomly assigned to BCL exchange on the first postoperative day (exchange group) and the BCL was not exchanged in the fellow eye (control group). Patients were evaluated daily until healing was complete. At each visit, the corneal epithelial defect was measured, and a questionnaire was used to assess pain, photophobia, and excessive tearing. P<0.05 was statistically significant. RESULTS: The study sample was comprised of 56 patients (mean age 27.2±5.7 years). Trans-PRK was performed in 20 (34.5%) and A-PRK in 36 (64.3%) patients. At day 3, 40 (71.4%) eyes of the exchange group healed completely compared with 38 (67.9%) eyes of the control group (P=0.5). At day-1 follow-up, the pain score was 1.87±1.4 in the exchange group and 2.29±1.3 in the control group (P=0.009). The mean pain score was 1.58±1.4 among patients who underwent A-PRK and 2.35±1.2 among patients operated by trans-PRK (P=0.04). CONCLUSION: The epithelial healing did not vary when BCL was exchanged one day after refractive surgery. However, postoperative pain score after PRK was lower at day 1, when the BCL was exchanged. Compared with A-PRK, trans-PRK group demonstrated a higher pain score in the early postoperative phase.

Pediatric open-globe injury in a university-based tertiary hospital.

BACKGROUND: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. METHODS: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. RESULTS: A total of 213 patients were identified. Male-female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. CONCLUSIONS: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.

Relationship of body mass index to sleep duration, and current smoking among medical students in Tabuk City, Saudi Arabia.

BACKGROUND: Being overweight is associated with cardiometabolic risk, and lifestyles including smoking and good sleep hygiene are also implicated. We aimed to assess the dietary habit, time spent on social media, and sleep duration relationship to body mass index (BMI) among medical students in Tabuk, Saudi Arabia. METHODS: A cross-sectional study was conducted among 147 clinical phase medical students in the Medical College, University of Tabuk (Saudi Arabia) from January 2018 to May 2018. A checklist questionnaire was used to measure variables such as age, sex, smoking, level of exercise, whether taking meals and snacks regularly, eating fast food, fruit and vegetable consumption, sleep duration, time spent on social media, and breakfast skipping. Data were analyzed by IBM-SPSS version 20, using one-way ANOVA and Pearson's production-moment correlation (r). A p-value of less than 0.05 was considered statistically significant. RESULTS: Participants consisted of 51% males, mean age (Mean ± SD) was 22.90±1.27 years, sleep duration was 7.50±2.17 hours, time spent on social media was 5.54±3.49 hours, body mass index was 24.8±5.19, and breakfast skipping, fast food consumption, smoking, and regular exercise were reported in 52.4%, 87.7%, 12.9%, and 36.1% respectively. A significant negative correlation was evident between BMI and sleep duration (r= -0.185, p=0.025), cigarette smokers were more likely to be obese compared to their counterparts (27.28±6.85 vs. 24.10±4.98, p=0.018). No significant statistical relationship was evident between BMI, breakfast skipping, fast food, fruit and vegetable intake, and time spent on social media. CONCLUSION: BMI was higher among smokers and those with shorter sleep duration, there was no association between BMI and other students' characteristics. Measures to smoking quitting and good sleep hygiene are recommended.

Risk factors for developing congenital nasolacrimal duct obstruction.

OBJECTIVE: To identify potential risk factors for developing congenital nasolacrimal duct obstruction (CNLDO). STUDY DESIGN AND METHODS: A cross-sectional study. A quantitative questionnaire was distributed to a sample of mothers attending the Pediatrics Clinic at King Khalid University Hospital, Riyadh, Saudi Arabia. RESULTS: A total of 756 mothers responded to our questionnaire. Of the 756 filled questionnaires, 389 (51.67%) were male children. 5.3% of the mothers lived in non-urban settings. CNLDO was reported in the children attending the clinic by 17.1% (129/756) of their mothers. Average age (±SD) of infants when persistent tearing was noticed was 3.2 ± 2.7 months, while average age (±SD) of resolution was 9.6 ± 3.7 months. Of the children with CNLDO, 37.2% (48/129) still have persistent tearing at the time of distributing the questionnaire. Among the group with CNLDO, 17% (22/129) of their mothers have experienced an infection during pregnancy (p = 0.022). Within the same group, 14.7% (19/129) of the affected children were reported by their mothers to have other children with CNLDO which was statistically significant (p = <0.001). CONCLUSION: CNLDO could have a genetic predisposition and maternal infection is a possible risk factor for developing CNLDO. Surgical management awareness should be emphasized to relieve children from this relatively common and benign condition.