Background
Acquired inflammatory punctual stenosis is a disease commonly presented with epiphora and most common cause is long term treatment with preservative containing topical eye drops. The inflammation causes a decrease in the clearance of the medication and preservative, and their continued use will result in more inflammation and stenosis, and therefore a longer clearance time resulting in a higher concentration and longer transit time, leading to a vicious cycle.
Objective
This study was conducted to compare between the effectiveness of topical preservative free steroids eye drops and preservative free artificial tears in treatment of punctal edema in Egypt.
Methods
This prospective comparative study comprised 40 eyes with punctal edema. Group A: 20 eyes Patients in this group received preservative free hydrocortisone 2.5% eye drops 4 times daily for 1 week with tapering over 3 weeks and followed up after 1 month. And after 3 months. Group B: 20 eyes Patients in this group received one of the preservative free artificial tears available in market 4 times/day for 1 month. All subjects were subjected to history taking, slit lamp examination, Flourescene dye disappearance test for diagnosis and follow up once/month for 3 months and measuring the punctual diameter pretreatment, after 1 month and after 3 months. From treatment.
Results
Comparing the two groups, the study found that there was no statistically significant difference found between the two studied groups regarding punctual diameter pretreatment, at 1 month and at 3 months and a highly statistically significant symptomatic improvement after 3 months in preservative free steroids group more than the preservative free artificial tears group.
Conclusion
The present study compared the effectiveness of topical preservative free steroid eye drops and preservative free artificial tears as regards increase in punctual diameter and symptomatic improvement and found a statistically significant increase in symptomatic improvement in preservative free steroid group more than the preservative free artificial tears group as after 3 months and statistically significant increase in punctual diameters in both groups in comparison to control group.
Background
Primary congenital glaucoma (PCG) is a leading cause of childhood blindness in Egypt. The discovery of the underlying genetic causes has led to far greater understanding of disease mechanisms. Cytochrome P450, family 1, subfamily B, polypeptide 1(CYP1B1) gene mutations usually inherited in an autosomal recessive manner are one of the major etiologies behind PCG. Gene screening aids early diagnosis of PCG which is a key factor in managing and preventing blindness from the disease.
Aim
This study aims to screen for CYP1B1gene mutations in PCG patients and study its possible impact on surgical outcome of PCG.
Methods
Twenty-four PCG patients enrolled in this study underwent trabeculotomy, and were followed up at a 3 month interval for a year. Patients’ demographic details were recorded, and their genomic DNA was screened for CYP1B1 mutations. Genotypic impact on surgical outcome was compared between the group of patients who harbored mutations and the group unsolved with mutations.
Results
Six different disease causing CYP1B1 mutations were identified in 13 (54.17 %) of affected patients who exhibited more surgical failure at the last follow up visit.
Conclusion
This study further endorses CYP1B1 mutations as a possible etiological and prognostic factor for PCG.
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