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Eiman Abd El Latif,1 Asaad Nooreldin,2 Mohammed Shikhoun Ahmed,3 Mohamed Elmoddather,2 Wael El Gendy4 1Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt; 3Department of Ophthalmology, Sohag Teaching Hospital, Sohag, Egypt; 4Department of Ophthalmology, Memorial Institute for Ophthalmic Research (MIOR), Giza, EgyptCorrespondence: Eiman Abd El Latif 5 Soliman Mahmoud Street, Cleopatra 12311, Alexandria, EgyptTel +211 4867-2963Email iman2omar@gmail.comPurpose: To report the causes of uveitis in a referral ocular inflammation clinic in Upper Egypt.Methods: Retrospective medical chart review of all uveitis cases visiting a referral uveitis clinic during the period between January 2015 and January 2020.Results: A total of 982 patients were included. Uveitis was bilateral in 51.7% of the patients. Anterior uveitis was the most common type, followed by posterior uveitis, affecting 34.4% and 25.6% of the study cohort, respectively. About one-third of our patients were beneath the age of 18, and among that group, no specific etiology of uveitis could be determined in about a quarter of the patients by the end of the study period, and juvenile idiopathic arthritis was the most common disease entity.Conclusion: In conclusion, the present report attempted to illustrate the most common causes of uveitis in Upper Egypt. Tuberculosis followed by sarcoidosis were the two leading causes of uveitis in our group of patients.Keywords: Egypt, uveitis, tuberculosis, sarcoidosis, idiopathic

Eiman Abd El Latif,1 Marwa Abdel Kader Fouly Galal,2 Mohamed A Tawfik,3 Mohamed Elmoddather,4 Asaad Nooreldin,4 Hassan Shamselden Yousef4 1Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 2Department of Ophthalmology, Research Institute of Ophthalmology, Cairo, Egypt; 3Memorial Institute for Ophthalmic Research, Cairo, Egypt; 4Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, EgyptCorrespondence: Eiman Abd El LatifDepartment of Ophthalmology, Faculty of Medicine, Alexandria University, 5 Soliman Mahmoud Street, Cleopatra, Alexandria 12311, EgyptTel +20 211 4867-2963Email iman2omar@gmail.comPurpose: To report the clinical experience of uveitis associated with Behçet’s disease in a cohort of Egyptian patients.Methods: The present study is a retrospective analysis of the medical charts of patients with Behçet’s disease, who were referred to a tertiary eye care center in Egypt between June 2010 and June 2018.Results: The current study included 1301 eyes of 681 patients with Behçet’s disease. The mean age of the patients at the time of referral was 27.2 ± 3.9 years. Panuveitis was the most common presentation. About 28% of all involved eyes had a final visual acuity < 20/200, by the last follow-up visit.Conclusion: Behçet’s disease is an important cause of uveitis in Egypt, and despite the fact that the prognosis of Behçet’s uveitis has globally improved in recent years, the visual outcome in Egypt is still not favorable especially in case of delayed referral to tertiary centers.Keywords: Egypt, uveitis, Behçet’s disease, Alexandria, hypopyon

Background: DALK is agolden method for treatment of keratoconus with preservation of endothelium. femtosecond laser-assisted DALK (F-DALK) is a new technique used nowadays to overcome difficulties of an old one. Aims: To contrast the results of manual deep anterior lamellar keratoplasty (M-DALK) with (F-DALK) in keratoconus studied cases. Subjects and methods: This prospective interventional research was carried out between January 2021 and December 2022. 36 eyes of 36 studied cases with advanced keratectasia were enrolled in this research and all underwent either manual (17 patients) or (F-DALK) (19 patients) at Tiba Eye Center, Assiut, Egypt. They were done by single surgeon. Results: There was significant improvement in visual acuity at one month, 3 months, six months and 1 year post-operatively in 2 groups. Postoperatively, healing had been more evident post-operatively after the 6th month than after 1st and 3rd month. Side cut healing was more evident in the (F- DALK) patients than manual DALK studied cases with a statistically significant difference among the 2 groups (P 0.02). 12 eyes (63.2%) and 4 eyes (23.5 %) of F-DALK and M- DALK cases presented wound healing patterns Grade 4 respectively. Conclusion: Comparable visual and refractive results are obtained with both techniques; however, corneal wound healing patterns at the side cut were more noticeable with femtosecond assisted DALK. This observation suggests that, when femtosecond technology has been utilized to conduct the side cut for DALK, an active cornea wound healing may allow earlier suture removal. [ABSTRACT FROM AUTHOR]

Purpose To evaluate and compare the visual outcome after femtosecond laser-assisted keratoplasty (FLAK) versus conventional penetrating technique. Settings and design This is a nonrandomized prospective comparative study that included a total of 30 eyes of 30 patients (16 females and 14 males) who underwent keratoplasty at three private eye centers in Assiut city, Egypt. These patients were divided into two groups: group I included 15 patients who were subjected to femtosecond laser-assisted penetrating keratoplasty and group II included 15 patients who were subjected to conventional penetrating keratoplasty (PKP). Patients and methods Visual outcome and intraoperative and postoperative complications were evaluated over a 18-month follow-up period. Statistical analysis Statistical analysis was performed using SPSS program. Student t test, paired sample t test, and χ2 test were used for the comparisons. Results Both uncorrected and best-corrected visual acuity showed marked improvement in both groups at 1, 3, 6, 12, and 18 months postoperatively. However, FLAK group showed statistically better uncorrected and best-corrected visual acuity at 3, 6, 12, and 18 months compared with conventional PKP group (all P

Purpose The aim of this study was to assess the safety profile and efficacy of a new implantable phakic contact lens (IPCL V2.0) in patients with a high degree of myopia. Patients and methods This is a prospective study that was carried out to evaluate the surgical outcome of IPCL V2 implantation in 46 eyes of 32 patients with a high degree of myopia. The refractive results, visual acuity (LogMar values), endothelial cell count of the cornea and intraocular pressure were evaluated at baseline and at 1, 6, and 12 months postsurgery. Any complications either during or after surgery were assessed. Results A significant improvement in the uncorrected distance visual acuity was achieved. It improved from 1.2±0.21 at baseline to 0.36±0.20 at 12 months postoperatively (P=0.002). The index of efficacy [uncorrected distance visual acuity at 12 months postoperatively/corrected distance visual acuity (CDVA) at baseline) was 1.1 and the safety index (CDVA at 12 months/CDVA at baseline] was 1.5. The mean spherical equivalent at baseline was −13.8±4.1 diopters (D) and improved to −0.6±0.7 D at 12 months postoperatively (P

From the canonical and rotating-wave transformations, we obtained the effective lower-polariton Hamiltonian depending on the applied magnetic field from the coupling of one of the quantum-well excitons and photons in a semiconductor microcavity. When the pump field is circularly polarized, the nonlinear interaction can induce a strong polariton blockade near the resonant peaks, which can be suppressed by a large pump in weak magnetic field situations. Thus, the platform behavior in the variation of the polariton occupation proves the polariton quantum blockade. On the other hand, when the pump field is linearly polarized, we achieve a single-photon emitter whose polariton polarization can be adjusted by an applied magnetic field. Polaritons with opposite spins, on the other hand, are anti-bunching in the lower excitation regime and become bunching only in weak magnetic field situations and a high excitation regime. Our findings constitute a potential step toward the realization of strongly coupled polaritonic systems. [ABSTRACT FROM AUTHOR]

Aim To compare amniotic membrane graft versus conjunctival autograft for the management of primary pterygium. Design A prospective, randomized study. Patients and methods Fifty eyes of 50 patients with primary pterygium were prospectively included in this study and were randomized into two groups. Group I included 25 patients who underwent surgical excision and limbal-conjunctival autograft transplantation; group II included 25 patients who underwent surgical excision and human amniotic membrane graft transplantation. Recurrence rate, refractive changes, and complications were evaluated and compared between both groups. Results Recurrence after surgical excision was observed in eight patients with an overall recurrence rate of 16% (8/50) in both groups. The recurrence was slightly higher in the amniotic membrane group, about 20% (five cases) than the conjunctival autograft group which was about 12% (three cases). The recurrence was higher in the first 3 months postoperatively which was about 62% (5/8) in both groups and increased to about 100% (8/8) at 6 months postoperatively. No recurrence was observed in either group after 6 months. Visual acuity improved in 22 and 23 patients while it remained unchanged in three and two patients in group I and group II, respectively. Conclusion Conjunctival autograft should be considered as the first choice for pterygium excision even in recurrent pterygia. Amniotic membrane graft can be considered as a first choice for patients with advanced and diffuse conjunctival involvement or for those who probably will need the conjunctiva for glaucoma-filtering procedure in the future.

Background Stress response to tracheal extubation causes autonomic or endocrine disturbances such as hypertension, tachycardia, and arrhythmias that may be potentially dangerous in patients with cardiovascular disease. It is better to avoid the occurrence of stress response by preemptive therapy. Various pharmacological methods are used to suppress this response, but none of them is 100% effective. So, it is desirable to use a drug with rapidly recognizable and easily treatable adverse effects. Aim The aim of this study was to compare the effects of labetalol, fentanyl, and lidocaine in suppressing hemodynamic stress response to tracheal extubation. Patients and methods This prospective, randomized, controlled, double-blinded study was conducted in multicenter Fakhry Hospital, Al Hussain University hospital and Al Zahra University hospital on 80 patients classified as American Society of Anesthesiologists physical status I or II who were undergoing elective general surgery under general anesthesia between January 2017 and June 2017. These 80 patients were randomized through computer-generated and sealed opaque envelope method into four equal groups, each of them with 20 patients. All patients received a standardized anesthetic protocol. Fifteen minutes before extubation, patients received either labetalol 0.25 mg/kg or fentanyl 2.0 µg/kg or lidocaine 2% 1.5 mg/kg or isotonic saline. All patients were extubated by anesthesiologists who were blinded to the studied drugs, and all were continuously monitored for 20 min after extubation. The primary outcome was hemodynamic changes, heart rate (HR) and mean arterial blood pressure (MAP), which were recorded before and after extubation. The secondary outcomes were respiratory rate and oxygen saturation (SpO2), which were recorded after extubation on room air, and the degree of sedation after extubation, as assessed by Ramsay sedation score. Results The results of our study reveal that HR and MAP were comparable in all the groups until 10 min before extubation. Later, there was an increase in HR and MAP in lidocaine and saline groups. There was statistically significant decrease in HR and MAP in labetalol and fentanyl groups at 5 min before extubation, at extubation, and 5 and 10 min after extubation, in comparison with lidocaine and saline groups. Moreover, there was a statistically significant decrease in HR and MAP in labetalol group at 5 min before extubation, at extubation, and 5 and 10 min after extubation, in comparison with fentanyl group. Conclusion We conclude that both labetalol and fentanyl effectively blunt hemodynamic response to tracheal extubation in patients undergoing elective surgeries under general anesthesia and can be safely used. Labetalol at dose of 0.25 mg/kg is a better agent than fentanyl (2.0 µg/kg) and lidocaine (1.5 mg/kg) in attenuating the sympathetic response to tracheal extubation. However, patients in the fentanyl group showed greater degree of sedation without any deleterious effects.

This study aims to build a radiation map and evaluate the radiological risk for humans and non-humans from soils in agricultural areas surrounding Blue Nile State, Sudan. The 226Ra, 232Th, and 40K radioactivity of soil samples were measured using gamma-ray systems (HPGe). The average values for 226Ra, 232Th, and 40K were 24.2 ± 7.3 Bqkg−1, 31.0 ± 8.2 Bqkg−1, and 376.4 ± 174.0 Bqkg−1, respectively. The radioactivity level was lower than the global averages of 226Ra (35 Bqkg−1), 232Th (45 Bqkg−1), and 40K (420 Bqkg−1). Human radiological risk exhibited that the average values of the dose rate and annual effective dose rates were 32.00 nGyh−1 and 40.08 µSvy−1, respectively. The average dose rate and annual effective dose rates were lower than the worldwide average absorbed dose rate of 60 nGyh−1, and ICRP recommended reference of 1.0 mSvy−1. Therefore, the radiological effects of 226Ra, 232Th, and 40K in the study area are negligible. On the other hand, the radiological risk for non-human organisms indicates that the projected total dose rate per organism in birds was lower than the background dose rates, which is in accordance with the background dose rates. However, the overall dose rate for amphibian, reptile, and mammal-large, mammal-small burrowing exceeds the background exposure rate. [ABSTRACT FROM AUTHOR]

Purpose: To report the causes of uveitis in a referral ocular inflammation clinic in Upper Egypt. Methods: Retrospective medical chart review of all uveitis cases visiting a referral uveitis clinic during the period between January 2015 and January 2020. Results: A total of 982 patients were included. Uveitis was bilateral in 51.7% of the patients. Anterior uveitis was the most common type, followed by posterior uveitis, affecting 34.4% and 25.6% of the study cohort, respectively. About one-third of our patients were beneath the age of 18, and among that group, no specific etiology of uveitis could be determined in about a quarter of the patients by the end of the study period, and juvenile idiopathic arthritis was the most common disease entity. Conclusion: In conclusion, the present report attempted to illustrate the most common causes of uveitis in Upper Egypt. Tuberculosis followed by sarcoidosis were the two leading causes of uveitis in our group of patients. [ABSTRACT FROM AUTHOR]

Purpose: To report the clinical experience of uveitis associated with Behçet's disease in a cohort of Egyptian patients. Methods: The present study is a retrospective analysis of the medical charts of patients with Behçet's disease, who were referred to a tertiary eye care center in Egypt between June 2010 and June 2018. Results: The current study included 1301 eyes of 681 patients with Behçet's disease. The mean age of the patients at the time of referral was 27.2 ± 3.9 years. Panuveitis was the most common presentation. About 28% of all involved eyes had a final visual acuity < 20/200, by the last follow-up visit. Conclusion: Behçet's disease is an important cause of uveitis in Egypt, and despite the fact that the prognosis of Behçet's uveitis has globally improved in recent years, the visual outcome in Egypt is still not favorable especially in case of delayed referral to tertiary centers. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy, safety and stability of standard epithelium‐off cross‐linking (SCXL) versus accelerated epithelium‐off cross‐linking (ACXL) and transepithelial epithelium‐on cross‐linking (TCXL) in the treatment of progressive keratoconus (KC) in children. Methods: This prospective multicentre controlled trial included 271 eyes (136 children) with grade 1–3 progressive KC who were randomized to undergo SCXL (n = 91, as a control group), ACXL (n = 92) or TCXL (n = 88). Uncorrected and corrected distance visual acuity, subjective refraction, pachymetry, keratometry and corneal topography measurements were recorded preoperatively and 6, 12 and 24 months postoperatively. Results: At 1 year, there was no significant difference in uncorrected distance visual acuity, refractive sphere, cylinder, spherical equivalent or Kmax between the ACXL and SCXL groups; however, during year 2, ACXL regressed while SCXL continued to improve. After 2 years, there were significant differences in all visual, refractive and keratometric components between SCXL and both ACXL and TCXL (p < 0.0001) and between ACXL and TCXL (p < 0.0001). KC progressed in 5.4% of patients who had ACXL and 28.4% of those who had TCXL but in none of those who had SCXL. Vernal keratoconjunctivitis was documented in 43.3% of eyes that progressed postoperatively. Conclusion: SCXL was more effective for paediatric KC and achieved greater stability than either ACXL or TCXL, and ACXL was superior to TCXL. SCXL also achieved marked improvement in both myopia and spherical equivalent; however, these refractive outcomes were unpredictable and uncontrollable. TCXL had a 28.4% failure rate within 2 years. SCXL is preferable for management of paediatric KC. [ABSTRACT FROM AUTHOR]