ABSTRACT.Purpose: To elucidate the role of heat shock protein-70 (HSP70) and hypoxia inducible factor-1a (HIF-1a) in diabetic retinopathy (DR) patients. Design and methods: A comparative study was done on the serum level of both HSP70 and HIF-1a in 50 patients with type 2 diabetes mellitus (T2DM) without DR, 50 patients with T2DM and DR and 70 healthy control subjects.Results: HSP70 and HIF-1a were significantly increased in T2DM patients compared to controls and increased in patients with T2DM & DR compared to T2DM patients without DR (p < 0.0001). HSP70 did not differ among the patients with different stages of DR, while HIF-1a increased significantly in grades 3 and 4 DR patients compared to grades 1 and 2 DR patients. A strong correlation was found between HIF-1a and the development of DR (r = 0.835, p = 0.00) but not with HSP70. HIF-1a can be used as a predictor for development of DR but not HSP70. Conclusions: Our study was the first that investigated both HSP70 and HIF-1a in humans and was the first that measured their levels in serum of patients with DR. The study suggested that HSP70 might have a protective function in T2DM patients rather than a therapeutic function. HIF-1a had an upper hand in the development and progression of DR. Induction of HSP70 and blockage of HIF-1a could lead to the development of novel prophylactic and therapeutic strategies for DR and potentially other diabetic complications.

No abstract

In this study we evaluate the visual outcomes, safety, efficacy, and stability of implanting of second sulcus intraocular lens (IOL) to correct unsatisfied ametropic patients after phacoemulsification. Methods. Retrospective study of 15 eyes (15 patients) underwent secondary intraocular lens implanted into the ciliary sulcus. The IOL used was a Sensar IOL three-piece foldable hydrophobic acrylic IOL. The first IOL in all patients was acrylic intrabagal IOL implanted in uncomplicated phacoemulsification surgery. Results. Fifteen eyes (15 patients) were involved in this study. Preoperatively, mean log⁡MAR UDVA and CDVA were 0.88 ± 0.22 and 0.19 ± 0.13, respectively, with a mean follow-up of 28 months (range: 24 to 36 months). At the end of the follow-up, all eyes achieved log⁡MAR UDVA of 0.20 ± 0.12 with postoperative refraction ranging from 0.00 to −0.50 D of attempted emmetropia. Conclusions. Implantation of the second sulcus SensarAR40 IOL was found to be safe, easy, and simple technique for management of ametropia following uncomplicated phacoemulsification.

The aim of this study is to examine and analyze the contribution of corneal and lenticular components of total astigmatism (TA) in infants and young children and to determine whether there is any compensation for astigmatism by the lenticular component or not. The study was conducted on 614 eyes of 307 infants and young children. Cycloplegic refraction and keratometric measures using the Hand-held Autokeratometer (Nidek Co. Ltd., Hiroishi, Japan) were done for the study group under general anesthesia in Paediatric Ophthalmology Center, Sohag City, Egypt. We divided the sample into high astigmats (total cylinder ≥ 1.00 D; mean, 1.99 ± 0.89 D; n = 431 eyes; 70 %) and normal astigmats (total cylinder ≤ 0.75 D; mean, 0.55 ± 0.22 D; n = 183; 30 %). The prevalence of corneal astigmatism (CA) ≥ 1.00 D was (73 %), any degree of lenticular astigmatism (LA) was (85 %), (LA > 0.25 D = 72 %) TA was predominantly with the rule (n = 499 eyes, 81 %). Eyes with against the rule astigmatism were (n = 33 eyes, 5.3 %) and eyes with oblique astigmatism were (n = 82 eyes; 13.3 %). Gender or age differences in TA, CA, LA, or type of astigmatism were not significant. The prevalence of astigmatism found in this population of newlyborn infants and young children was relatively high, primarily corneal, and WTR astigmatism with high prevalence of oblique astigmatism. LA was much less than previous reports (mean = -0.0044 D), associated with more hyperopic eyes and eyes with high TA. The data suggest that a compensatory process exists between CA and LA to decrease the amount of TA.

There is a good agreement in ACD and K-readings between Pentacam and IOLMaster, making them interchangeable in biometry and phakic IOL power calculation, but they are not interchangeable regarding WTW line measurement; the difference will affect the phakic IOL diameter, which would affect lens safety.

Purpose: To determine the incidence of postoperative complications following combined trabeculotomy trabeculectomy with mitomycin C (CTTM) for congenital glaucoma (CG), in addition to documentation of some unusual complications and possible ways to manage these complications safely with minimal morbidity. Methods: A retrospective observational study was performed on 190 eyes with CG had a CTTM procedure. Included eyes were operated upon between February 2015 and February 2020 in Sohag University Hospitals. Medical records were reviewed and postoperative complications were reported. Incidence of postoperative complications and their management were the main outcome measures Results: Early complications developed the form of shallow anterior chamber (AC) (16.3%), hyphema (10.5%), serous choroidal detachment (2%), hemorrhagic choroidal detachment (2%). Unusual and rare complications occurred in the form of iatrogenic Cushing syndrome, unilateral toxic keratopathy developed, vitreous hemorrhage (VH), intercalary staphyloma and decompression retinopathy Late complications included: high postoperative intraocular pressure (IOP) (16.5%), thin cystic blebs (13.1%), hypotony disc edema (2%), cataract (3.2%), one eye developed blebitis and one eye developed endophthalmitis. Conclusion: Surgical management of CG is full of complications in early and late postoperative periods such as shallow AC, hyphema and thin cystic blebs. Some unusual and rare complications developed such as iatrogenic Cushing syndrome, unilateral toxic keratopathy, vitreous hemorrhage, intercalary staphyloma and decompression retinopathy. If identified early; all these complications could be managed properly leading to a successful and favorable outcome.

PurposeTo evaluate the efficacy and safety of a closed-chamber air bubble capsulotomy technique to prevent the Argentinean flag sign (AFS) in patients with white and intumescent cataracts.SettingSohag University, Faculty of Medicine, Ophthalmology Department, Sohag, Egypt.DesignProspective interventional noncomparative case series.MethodsEighty-two eyes of 80 patients with white and intumescent cataracts were included. Eyes with any ocular pathology other than cataract or eyes subjected to previous intraocular surgery were excluded. Needle capsulorhexis was performed under a large air bubble tamponade without capsular staining. Efficacy of the technique was assessed intraoperatively by successful completion of capsulorhexis. Safety of the technique was assessed by the occurrence of intraoperative or postoperative complications.ResultsComplete capsulorhexis by the closed-chamber air bubble technique was successful in 75 eyes (91.5%), while capsulorhexis extension occurred in seven eyes. In four eyes with extension, the procedure was shifted to the standard technique of CCC (circular curvilinear capsulorhexis), using a viscoelastic device. A shift to extracapsular cataract extraction (ECCE) surgery occurred in the remaining three eyes, as the extension was so far-gone. No intraoperative or postoperative complications were observed.ConclusionThe closed anterior chamber air bubble technique for capsulorhexis is a novel, safe, and effective technique to prevent AFS in white and intumescent cataracts. It is also time-saving and cost-effective, with less likelihood of capsulorhexis extension. The technique is considered a valuable addition to previously described techniques.

No abstract