Aims:The aim of the study was to report the incidence of retinopathy of prematurity (ROP) and severe ROP and identify the risk factors for their development in a large nursery in Kuwait.Materials and Methods:This was a retrospective, interventional, non-comparative, hospital-based study. Retrospective review of ROP records of premature babies having either birth weight of less than 1501 g or gestational age at birth of 34 weeks or less and born between January 2001 and August 2003.Statistical Analysis:By univariate and multivariate logistic regression analysis.Results:Out of the 599 babies studied, 38.9% developed ROP and 7.8% needed treatment for severe ROP. Multivariate analysis showed low birth weight (OR 13.753, 95% CI 3.66-51.54; (P < 0.001), gestational age (OR 13.75, 95% CI 3.66-51.54; P < 0.001), surfactant (OR 1.72, 95% CI 1.04-2.83; P = 0.032) and stay in the intensive care unit for longer than 15 days (OR 2.25, 95% CI 1.05-4.85; P = 0.033) to be significant for the development of any ROP. Low birth weight (OR 22.86, 95% CI 3.86-134.82; P = 0.001), bacterial sepsis (OR 3.27, 95% CI 1.51-7.05; P = 0.002) and need for surfactant (OR 4.41, 95% CI 0.94 -20.56; P = 0.059) were found to be the risk factors for severe ROP needing laser treatment.Conclusion:The incidence of both any ROP and ROP needing treatment are comparable to other studies. Low birth weight is the most important risk factor for both any ROP and severe ROP.

Purpose To report the results of pars plana vitrectomy (PPV) assisted by ophthalmic endoscope (OE) in severe ocular trauma cases which are unsuitable for PPV using wide-angle contact/non-contact lens due to media haze and/or disorganised anterior segment. Methods Prospective, non-comparative, interventional case series. Main outcome measured was anatomic status of the retina postoperatively, secondary outcome measured was functional status regarding vision, intraocular pressure and control of inflammation in cases of endophthalmitis. Results Fifty trauma cases were included in the study. Out of these, 43 eyes had open globe injuries (32 eyes without intraocular foreign body (IOFB), and 11 eyes with retained IOFB), and seven eyes had post-traumatic endophthalmitis. In the open globe injury group, 36 (83.7%) eyes reported improvement in vision. In endophthalmitis group, five eyes showed improvement in vision. Conclusions OE provided a clear view to conduct PPV in select trauma cases where delay in surgery due to hazy media or due to non-availability of donor cornea for simultaneous penetrating keratoplasty can lead to severe proliferative vitreoretinopathy changes.

Purpose:To report the incidence of endophthalmitis after intravitreal injection of bevacizumab and the outcomes of treatment of endophthalmitis at two centers in Kuwait.Subjects and Methods:The aliquots of bevacizumab were prepared under aseptic precautions and administered in the operating theater on the same day at both centers. All patients received antibiotic drops after injection of bevacizumab. Data were collected on the number of cases that received intravitreal bevacizumab (IVB) and those that developed endophthalmitis were identified at the two centers. All cases of endophthalmitis received an intravitreal antibiotic injection and additional treatments as warranted. Data were collected on the outcomes of endophthalmitis treatment.Results:There were 5 cases of endophthalmitis among a total of 5429 injections (0.09%: Confidence interval: 0.084–0.1). The incidence was 3 cases among 4690 (0.06%) and 2 cases among 739 injections (0.027%) at each center, respectively (P = 0.08). Four cases of endophthalmitis were culture-positive and organisms isolated were, coagulase negative Staphylococcus in 2 cases, Staphylococcus lugdunensis and Streptococcus pneumoniae in 1 case each. The final visual acuity was better than pre-IVB in 3 cases, same as pre-IVB in 1 case and worse in 1 case with streptococcal infection. No eyes developed phthisis bulbi or required enucleation.Conclusions:The incidence of endophthalmitis after intravitreal injection of bevacizumab using aliquots prepared in the operating room is comparable to other studies. There were no clusters of endophthalmitis cases.

Our case series suggest that Tisseel fibrin sealant in conjunction with pars plana vitrectomy can be used successfully for management of optic pit disk-associated macular detachments.

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This study was conducted to determine the feasibility, efficacy, and safety of internal limiting membrane peeling in the management of large macular moles. Two patients whose eyes had macular holes measuring 1,147 and 773 microns in diameter, respectively, were treated by pars plana vitrectomy with extended internal limiting membrane peeling and the injection of long-acting gas. Preoperative and postoperative assessment of the macular holes was done by optical coherence tomography. Postoperatively, the macular holes closed and there was improvement in visual acuity. Extended internal limiting membrane peeling can be performed to achieve surgical success in very large macular holes.

Vitreous shaving of sclerotomy sites using depressed vitrectomy significantly reduces vitreous incarceration. This may reduce the rate of sclerotomy-related complications following PPV in selected cases.

The ophthalmic microendoscope appears to be safe and effective in simultaneously providing illumination, video recording and a clear endoscopic view of the anterior chamber. This study demonstrates that in selected cases, anterior segment endoscopy is a useful adjuvant to cataract surgery.