Purpose The purpose of this study is to evaluate the efficacy of systemic antiparasitic medications alone or in combination with surgical aspiration in management of presumed trematode-induced anterior uveitis in children. Patients and methods Prospective case series. Children who presented with anterior chamber (AC) granuloma were included in the study. All patients received antiparasitic treatment and after 2 weeks; patients were divided based on their clinical improvement in terms of the baseline granuloma area into two groups: group A (<2.5 mm 2) who continued on antiparasitic medications only (n = 15) and group B (≥2.5 mm 2) who underwent surgical aspiration (n = 15). Basic demographics data, visual acuity (VA), corneal thickness, granuloma area and AC activity (cells and flare) were recorded and analysed. Systemic work-up including stool and urine analysis, full blood count, chest X-ray and schistosomiasis titre were performed. Results Thirty eyes of 30 patients were included in the study with a mean age of 13.4 ± 2.42 years. All patients were male. Patients were examined and followed at Mansoura Ophthalmic Center, Mansoura University. Both groups showed statistically significant improvement in VA, AC activity, corneal thickness and granuloma area (p-value < 0.001), which was achieved with medical treatment only in group A. However, in group B granuloma required aspiration and did not recur after that. Conclusion Presumed trematode-induced AC granuloma is common among children living in the rural areas of Egypt. Antiparasitic medication alone was found to be effective for small-sized granulomas. Surgical aspiration is an effective adjuvant procedure to treat large-sized ones.

The aim of this study was to assess corneal densitometry and visual outcomes after big-bubble deep anterior lamellar keratoplasty (BB-DALK) and manual dissection deep anterior lamellar keratoplasty in patients with keratoconus.Methods: This retrospective comparative observational study included 40 keratoconic patients who underwent DALK surgery: 22 eyes had BB-DALK (group I) and 18 eyes had failed BB technique and DALK was completed by manual dissection (group II). Best -corrected visual acuity (BCVA), corneal topographic parameters, residual stromal tissue thickness, and endothelial cell count were recorded at 1, 3, 6, and 12 months postoperatively. Densitometric analysis of different corneal layers and zones was performed using Scheimpflug tomography at each visit; values were recorded and compared between the 2 groups.Results: At 1 and 6 months postoperatively, BCVA was better in group I than in group II, but with no statistically significant difference. At 12 months, the visual acuities became nearly similar in both groups (0.30 6 0.13 vs. 0.30 6 0.14 logarithm of the minimum angle of resolution, P = 0.888). Regarding corneal densitometric analysis, the recorded values for the posterior corneal layer were significantly higher in group II compared with group I at 3, 6, 9, and 12 months postoperatively in the 0-to 2-mm zone (P , 0.001) and the 2-to 6-mm zone (P = 0.029, 0.028, 0.001, and ,0.001).Conclusions: Manual dissection DALK after failed BB technique may affect the interface stromal reflectivity up to 12 months postoperatively. However, this does not significantly affect the visual acuity in comparison with successful BB-DALK.

Purpose: to determine the correlation between the ABO blood groups and Rh factor with non-infectious uveitis.Methods: Cross-sectional study conducted on 175 Egyptian patients diagnosed with non-infectious uveitis. Venous blood sample (2ml) was taken from each patient to recognize the ABO and Rh blood group. Blood grouping results were collected and statistically analyzed.Results: Most of our uveitic patients were found to have blood group O (34.9%), while other ABO blood groups were represented as following: blood group A in 33.1%, blood group B in 22.3% and blood group AB in 9.7%. Rh factor was positive in 92.6% of the study participants. Most common etiologies of uveitis were Behçet's disease, idiopathic, Vogt-Koyanagi-Harada (VKH), juvenile idiopathic arthritis (JIA) and Ankylosing spondylitis (AS) in the following percentages: 28%, 21.1%, 21.1%, 13.7%, and 11.4%, respectively. Most Behçet's patients had blood type A+ or O+ (33/49, 67.3%), similar to those with idiopathic uveitis with higher preponderance of blood type A and O (26/37, 70.3%). Also, more than half of JIA cases have associated with blood type A+ and O+ (16/24, 66.7%). On the other hand, VKH patients had a higher prevalence of blood type O and B (27/37, 72.9%). AS cases had nearly equal distribution of different blood type A+, B+, AB+ and O+ (30%, 25%, 20% and 25%, respectively). Conclusion:Blood group O and A were most commonly associated with non-infectious uveitis. In addition, positive Rhesus factor was strongly associated with such cases.

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Settings This study was conducted in Mansoura Ophthalmic Center, Mansoura University, Egypt, during the period from January 2018 to January 2019. Purpose This study aimed to evaluate the visual outcomes, topographic features, endothelial cell densities (ECD), and complications of deep anterior lamellar keratoplasty using big-bubble technique (BB-DALK) in different corneal stromal pathologies. Patients and methods This was a prospective, interventional study that included 24 eyes of 24 patients having corneal stromal pathologies, not involving Descemet membrane (DM) and endothelium. The primary outcome measures were the clinical, visual, and topographic outcomes (uncorrected visual acuity, best-corrected visual acuity, K1, and K2) throughout the follow-up period, whereas the secondary outcome measures were the refractive outcomes, central corneal thickness, ECD, and intraoperative and postoperative complications. Results A total of 21 (87.5%) patients underwent uneventful BB-DALK, and three (12.5%) cases were complicated by intraoperative DM microperforation who developed DM detachment and double anterior chamber (AC) postoperatively. One of them resolved spontaneously and the other two cases required intracameral air injection. Uncorrected visual acuity improved from 1.55±0.26 (logarithm of minimum angle of resolution) preoperatively to 0.63±0.2 1 year postoperatively (P<0.001) and best-corrected visual acuity improved from 1.08±0.11 (logarithm of minimum angle of resolution) to 0.30±0.12 (P=0.017). Refractive cylinder improved from −7.79±1.75 to −2.85±2.01 at 12 months of follow-up (P=0.007). Average K reading changed from 60.00±7.77 preoperatively to 43.43±2.98 postoperatively (P<0.001). Total ECD was 2248.08±431.13 by the end of the first year, with a mean of 8.2% endothelial cell loss. Loosening of the sutures occurred in five (20.8%) eyes between third and sixth months postoperatively. Urrets-Zavalia syndrome occurred in one of the two cases who were complicated with postoperative double AC and required intracameral air injection. Conclusions BB-DALK is an effective and safe technique for treatment of different corneal stromal pathologies sparing endothelium and DM.