[Evaluation of the quality of life of patients fitted with scleral lenses using a Moroccan version of NEI-VFQ 25]. / Évaluation de la qualité de vie des patients équipés en verres scléraux à l'aide d'une version marocaine du NEI-VFQ 25.

PURPOSE: To evaluate the contribution of scleral lenses in terms of improving quality of life and vision. METHODS: We conducted a retrospective study of the quality of life (QOL) of patients fitted with scleral lenses, between November 2015 and November 2016 in the Marrakech university hospital department of ophthalmology. QOL was assessed before and after scleral lens (ICD) adaptation using a version of the National Eye Institute Visual Function Questionnaire 25 translated into the Moroccan dialect of Arabic. RESULTS: We included 48 patients (68 eyes). The main indications included severe corneal ectasia followed by post-keratoplasty eyes, post-traumatic corneas and patients with ocular surface disease. The average duration of scleral lens wear was 6 months, and the average wearing time was 12hours per day. BCVA increased from 0.8 to 0.2±0.5 LOGMAR. The average scores on the NEI-VFQ 25 of patients after scleral lens fitting were significantly higher, 80.5 versus 42.6 before wearing scleral lenses, thus an increase of 38.1. DISCUSSION: Quality of life has become a major issue in the healthcare field, which has seen a renewed interest in ophthalmology lately. The results of our study support the data from previous studies regarding the impact of scleral lenses on the quality of life of patients. CONCLUSION: High oxygen permeability scleral lenses are a satisfying therapeutic alternative, allowing a significant improvement in the quality of life of patients for whom the usual therapeutic means are limited.

Measurement of visual function among patients undergoing corneal transplantation using the VF-14 index in Morocco.

OBJECTIVE: To validate the Moroccan version of the VF-14 in candidates for keratoplasty and to assess their quality of life using this tool before and after transplantation. METHODS: This is a longitudinal prospective study that assessed 57 patients who underwent penetrating keratoplasty, recruited in the ophthalmology service in Marrakech over 5 years. The original VF-14 questionnaire was adapted into Moroccan dialect. The questionnaire was administered before and 2 years after transplantation. The VF-12 questionnaire was also used, deleting the last two items. Data analysis was performed using SPSS 16.0 software. Comparisons of VF-14 scores before and after transplantation used the Wilcoxon test for paired samples. RESULTS: In total, 57 patients participated in the study. The most frequent indication for surgery was keratoconus (44%). All patients underwent penetrating keratoplasty. Chronbach's alpha value was 0.989 for VF-14 and 0.990 for VF-12. The two scores were negatively correlated with logMAR visual acuity. The strongest correlation was found with VA in the fellow eye. The average best-corrected visual acuity of the eye scheduled for keratoplasty was 1.1±0.16 logMAR. The average of VF-14 was 53±3. After keratoplasty, the average best-corrected visual acuity of operated eye was 0.34±0.31. The average postoperative astigmatism was 3 D. After keratoplasty, an increase in VF-14 score was observed from 53.5 to 81.92 (P<0.001). In postoperative follow-up, graft rejection was noted in two patients and maculopathy in a single patient. DISCUSSION: Graft transparency, absence of complications, minimal astigmatism, and good visual acuity have long been indicators of a successful corneal transplant. However, this does not provide information on visual quality and its impact on everyday life. It is in this sense that the VF-14 was adapted into several languages, as reliable, valid and sensitive as the original Anglo-American version, to assess objectively and subjectively the quality of life of patients after keratoplasty. CONCLUSION: With advances in techniques and availability of better materials, surgical success in performing keratoplasty is increasing. At the same time, vision-related quality of life of corneal graft recipients deserves more attention from ophthalmologists.

[Management of corneal neovascularization prior to corneal transplantation: Report of 112 cases]. / La prise en charge des néovaisseaux cornéens avant greffe de cornée : à propos de 112 cas.

INTRODUCTION: The avascular nature of the cornea results from a balance between angiogenic factors and anti-angiogenic factors. Under pathological conditions, this homeostasis can be disturbed, resulting in the onset of corneal neovascularization. The purpose of our study was to report our experience in the management of corneal neovascularization prior to keratoplasty. MATERIALS AND METHODS: This is a prospective study of 112 patients with corneal neovascularization and candidates for possible corneal transplant. RESULTS: The average age of patients was 38 years, ranging from 15 to 72 years. The etiologies of neovascularization were dominated by ocular trauma (26.8 %). In total, 48.33 % of patients had superficial neovascularization, 18.52 % moderately deep and 33.2 % deep neovascularization. All patients received topical corticosteroids, 29.4 % received subconjunctival injections of bevacizumab, and 22.32 % intrastromal bevacizumab injections. Clinical course was marked by a decrease in the percentage of corneal neovascularization compared to the total corneal surface area, from 45 % (between 16 and 82 %) to 28 % (between 0 and 69 %) at Day 120. There was no statistically significant improvement in visual acuity. DISCUSSION: Corneal neovascularization is a major risk factor for graft rejection; its management is crucial prior to every keratoplasty. CONCLUSION: Corneal neovascularization can lead to increased risk of graft rejection. Proper management increases the success rate of penetrating keratoplasty.

[Ophthalmic manifestations after Lyell and Stevens-Johnson syndromes]. / Manifestations ophtalmiques au décours des syndromes de Lyell et de Stevens-Johnson.

PURPOSE: To describe the ocular complications at the end of serious drug eruptions such as Lyell syndrome or toxic epidemic necrolysis (TEN) syndrome, Stevens-Johnson syndrome (SJS), and SJS/TEN overlap syndrome; to analyze their relationship using disease severity scores. PATIENTS AND METHODS: A retrospective study carried out in the dermatology department in collaboration with the ophthalmopathy department in a series of 81 dossiers collated over a 10-year period. The severity of ophthalmological involvement was evaluated using the Foster score, and the drug eruption score was assessed using the Bastuji-Garin classification and the SCORTEN prognostic score. RESULTS: The average patient age was 36 years; the clinical forms seen were Lyell's syndrome in 57.8 % of cases, Stevens-Johnson syndrome in 32.8 % and overlap syndrome in 9.4 % of cases. According to the Foster classification, 34 % of patients were in stage I, 43 % in stage II, and 22 % in stage III. Stage I was seen in 50 % of cases presenting with overlap syndrome and in 42 % of patients with Stevens-Johnson, whereas stage III accompanied Lyell's syndrome in 27 % of cases, followed by SJS/TEN overlap syndrome in 16.6 % of cases. Photophobia persisted in 36 patients, and there were 17 cases of decreased visual acuity and 13 cases of eyelid malposition. Dry eye syndrome was noted in 39 cases and corneal perforation in 3 cases. DISCUSSION: The ocular manifestations of drug eruptions are daunting. It was suggested that ocular involvement is more serious when the peeled skin surface is extensive.