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Background: Corneal diseases are major causes of severe visual impairment and blindness in developing countries, unfortunately. Keratoplasty, which is a major treatment modality, is either nonexistent or at its infancy in these climes. Indications for penetrating keratoplasty (PKP) and the short-term success and survival rates vary in different geographical locations. We sought to evaluate the indications and short-term success rates of penetrating keratoplasty (PKP) in a Nigerian Private Practice Setting in South South Nigeria. Patients and Methods: It was a retrospective audit of 12 patients that had undertaken PKP in the hospital by December 2017. Data obtained from medical records included demographic information like age and sex. Others included preoperative diagnosis, indications for surgery, and pre- and postoperative best corrected visual acuity (BCVA) of subjects. Other information included intraocular pressure pre- and postoperatively, levels of corneal clarity, presence of other ocular comorbidities, and documentation of preoperative graft failure risk assessments. All patients in the series had optical penetrating keratoplasty, performed by a single experienced surgeon for purpose of vision restoration. Results: The mean age of the patients was 50.1 years, with a standard deviation of ± 15.5 years. The indications for PKP were bullous keratopathy seven (58.3%) and five corneal scars (41.7%). The etiological distribution was six patients with pseudophakic bullous keratopathy, one patient was postuveitic bullous keratopathy, three patients were postinfectious corneal scar, and two patients were postmeasles adherent leucomatous corneal scar. Pre-PKP 10 patients (83.4%) were corneal blind on the affected eye and the corneal clarity grades were 2 patients (16.7%) in grade 0, 7 patients (58.3%) in grade 1, and 3 patients (25.0%) in grade 2. At 6 months post-PKP, three patients (25.0%) remain blind in the affected eye, two patients (16.7%) in pre-PKP blind category moved to SVI, one patient (8.3%) with SVI and five patients (41.7%) with blindness at pre-PKP had respectively moved to MVI, and one patient (8.3%) with MVI at pre-PKP had regained normal vision. At 6 months post-PKP, corneal clarity improved from grades 0–2 to grades 3 and 4, in 25% and 75% of the patients, respectively, compared to the pre-PKP grades 0, 1, and 2, in 16.7%, 58.3%, and 25.0% of patients, respectively. Conclusion: In this study, bullous keratopathy and corneal scar were the main indications for penetrating keratoplasty. The short-term (6 months) success and survival of corneal grafts were reasonably good.

Background: Cataract is the leading cause of blindness in developing countries. Phacoemulsification is beyond the reach of many in these resources limited setting. Manual Small Incision Cataract Surgery (SICS) is a safe, low-cost, high-quality alternative. This is a review of outcome of SICS performed by trainee Surgeons during the first SICS training course in our centre. Patients and Methods: Eleven experienced Extracapsular Cataract Extraction (ECCE) surgeons from training centers across Nigeria were selected for a weeklong SICS training and conversion course. A review of visual outcome and complications of surgeries performed by these trainees on adult subjects is here reported. Results: Eighty-two eyes met the inclusion criteria. Male to female ratio was 1.4:1. Intraocular lenses were implanted in 80 eyes (97.5%). Visual outcome at 3 months post-operatively was good in 58 eyes (70.7%), borderline in 20 (24.4%), and poor in 4 (4.9%) subjects. The most common late post-operative complication, resulting in poor outcome was uncorrected aphakia in 2 (2.4%) eyes. Conclusion: The outcome did not meet World Health Organization (WHO) recommendations but was better than that reported for ECCE in the country. Conversion to SICS may not be difficult for competent ECCE surgeons as trainees achieved reasonable dexterity with acceptable post-operative outcome and complications profile in one week. To maximize patient safety and good outcome, a longer training period is recommended.

Background: Glaucoma is a common cause of blindness in developing nations. The objective of this study is to determine the severity of primary open angle glaucoma and audit health records of glaucoma patients in our center. Materials and Methods: A retrospective case note search of glaucoma patients from out-patient clinic was carried out between January 2001 and December 2010. Data analysis included descriptive statistics and exact binomial 95% confidence interval (CI) calculated for the mean estimates. Results: Seventy-six patients (152 eyes), comprising 49 (64.5%) males and 27 (35.5%) females were included in the study. The age ranged from 15 to 88 years (mean: 54.2 ± 14.5). Forty-five (59.7%) presented with normal vision and 10 (13.2%) had visual acuity 0.6 0.9 = 35 (46.1%) and left eyes were 15 (19.7%), 29 (38.2%), 28 (36.8%), respectively. Mean intraocular pressure (right eyes) at presentation was 20.3 mmHg (95% CI, 17.4-23.3) and reduced to 13.4 mmHg (95% CI, 10.7-16.0) at the last readings while left eyes from a mean of 20.3 mmHg (95% CI, 16.9-23.8) reduced to 12.1 mmHg (95% CI, 10.0-14.3). The mean presenting CDR were 0.79 (95% CI, 0.74-0.83) and 0.73 (95% CI, 0.68-0.79) in right and left eyes, respectively. CDR showed statistical significance with age ( p 2 -test) but not with sex ( p = 0.807). Conclusion: Late presentation of glaucoma cases is a major problem in Calabar. We recommend public enlightenment, case detection, and early treatment to reduce ocular morbidity.