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Childhood glaucoma profile in Dakahelia, Egypt: a retrospective study

International Journal of Ophthalmology(English edition) 2018年第4期11卷 674-680页

作者： Tharwat H.Mokbel Eman M.El Hefney Sherein M.Hagras Ahmed A.ALNagdy Amani E.Badawi manal a.kasem Shereen M.El Shaer Mansoura Ophthalmic Center Faculty of Medicine Mansoura University Community and Public Health Department Faculty of Medicine Mansoura University

AIM： To analyze childhood glaucoma regarding its demographics, presentations, different causes and surgical modalities used among patients in Dakahelia and to apply the Childhood Glaucoma Research Network（CGRN） classification retrospectively to evaluate its ***： A retrospective study in which the medical files of all glaucoma patients 〈16 years old presented to Mansoura Ophthalmic Center, Mansoura University from 2014 to 2017, were retrieved and analyzed. Collected data included： age, gender, laterality, visual acuity（VA）, refraction, intraocular pressure（IOP）, corneal diameter, cup-disc ratio, types and number of surgeries and antiglaucomatous drugs（AGD） at the first and last visit. Prevalence of different subtypes was calculated and means of clinical features were ***： A total of 305 eyes of 207 patients were included classified into 6 groups： primary congenital glaucoma（PCG）, juvenile open angle glaucoma（JOAG）, glaucoma associated with systemic disease, glaucoma associated with ocular anomalies, acquired glaucoma and glaucoma following cataract surgery. PCG was the predominant type（55.1%） followed by acquired glaucoma（29.5%）. Males represented 63.8% of the whole studied patients. Glaucoma associated with ocular anomaly group showed the youngest age at diagnosis（21.9±30.0 mo）. The shortest corneal diameter was recorded in post cataract group（10.4±0.5 mm）. Highest cup-disc ratio was found in the PCG group（P〈0.0005）. Glaucoma associated with systemic disease presented with the highest baseline IOP（34.5±5.0 mm Hg）. All the cases with PCG were treated surgically with 21.8% required more than one surgery. The majority of the patients（74.2%） in the acquired group were treated medically. Combined trabeculotomy-trabeculectomy was the most frequent operation done, accounting for 34.5% of all primary surgeries. Ahmed valve implantation comprised 87% of the secondary surgeries. Acquired glaucoma group had the highest percent of eyes with good fin

关键词： childhood glaucoma classification Egypt epidemiology

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Launching a paradigm for first and redo-surgery in primary congenital glaucoma: institutional experience

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International Journal of Ophthalmology(English edition) 2019年第2期12卷 226-234页

作者： Tharwat H.Mokbel Eman M.El Hefney Sherein M.Hagras Amani E.Badawi manal a.kasem Ahmed A.Al Nagdy Sherief E.El Khouly Walid M.Gaafar Mansoura Ophthalmic Center Faculty of Medicine Mansoura University

AIM: To evaluate the outcome of the initial and the redo-surgeries for primary congenital glaucoma(PCG) correlated to its degree of severity. METHODS: A retrospective study involved patients with PCG presented between 2010 and 2018. Medical records were reviewed to assess the degree of the preoperative severity according to the intraocular pressure(IOP), corneal diameter and corneal edema. Success and failure rates were calculated for both first and redo-surgeries at 6 and 12 mo respectively then correlated to the severity of the cases. RESULTS: Complete records were retrieved for 272 eyes(153 patients) with PCG: 43 eyes were mild, 136 moderate and 93 severe. Combined trabeculotomy and trabeculectomy(CTT) had the highest success rate in moderate(96.4%) and severe cases(59.3%) while trabeculotomy had the highest success rate in mild cases(96.3%). Medical records of 88 eyes(63 patients) with recurrent PCG were analyzed, most with severe presentation(59 eyes). Ahmed glaucoma valve(AGV) was used in 67(76%) eyes and augmented trabeculectomy in 21(24%) eyes. At 12 mo, there was no statistically significant difference between both surgeries in total success rate(P=0.256). For mild cases, success rate was 100% for both surgeries. Severe cases had higher success rates following AGV(87%) than augmented trabeculectomy(20%). Preoperative severity of the disease was an independent factor affecting the failure rate in secondary trabeculectomy but not in AGV. Patients younger than 24 mo had higher probabilities of failure following both redo-surgeries with hazard ratio =1.325 and 0.37 for augmented trabeculectomy and AGV respectively. CONCLUSION: Preoperative assessment of the severity of eyes with PCG helps in the selecting the optimal primary and secondary surgery. For first surgery, trabeculotomy is more effective in mild cases whereas; CTT and augmented subscleral trabeculectomy(SST) are appropriate for moderate and severe cases. AGV proved to be superior to augmented SST in

关键词： Ahmed glaucoma valve augmented trabeculectomy Egypt primary congenital glaucoma

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Does the scleral encircling band provide a protective effect against the progression of diabetic retinopathy?

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International Journal of Ophthalmology(English edition) 2019年第9期12卷 1408-1414页

作者： Hossam Youssef Abouelkheir Amani E Badawi Amr M.Abdelkader Amr El-Kanishy Sameh Saleh Waleed Ali Abou Samra manal Ali kasem Tharwat Mokbel Mansoura Ophthalmic Center Faculty of Medicine Mansoura University

AIM: To evaluate the effect of scleral encircling bands on the development and progression of diabetic retinopathy(DR) in diabetic ***: The medical records of diabetic patients who underwent unilateral retinal detachment(RD) surgery using scleral buckle and encircling band were reviewed retrospectively. Both eyes of patients were included in the study: one eye in each patient had a scleral buckle with encircling band(the operated eye) and the other one is the non-operated eye. The demographic characters, duration of diabetes and period between surgery and the last recall visit were retrieved from each patient. All the cases underwent fundus photo and fluorescein angiography(when indicated) to confirm the DR ***: Totally 25 patients fulfilled the inclusion and the exclusion criteria were become eligible for the study. A total of 50 eyes of 25 patients were enrolled in this analysis. The mean period of time passed from surgery with encircling band and the last reassessment visit was 12.5±2 y. Even though DR could develop in the operated eyes, it was at a less degree of severity compared to the non-operated eyes of same patients(P=0.027).CONCLUSION: Scleral encircling bands have protective effects against the development and progression of DR.

关键词： diabetic retinopathy scleral encircling bands retinal detachment

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Changes of anterior segment parameters after horizontal rectus muscles recession versus resection

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Annals of Eye Science 2020年第1期5卷 15-21页

作者： Amani E.Badawi manal Ali kasem Tharwat Mokbel Eman A.Awad Mansoura Ophthalmic Center Faculty of MedicineMansoura UniversityMansouraEgypt

Background:To record the corneal,and anterior chamber depth changes after performing recession versus resection of horizontal recti ***:Consecutive patients who underwent isolated lateral rectus muscle recession or resection February 2014 to January 2015 were prospectively *** error(spherical equivalent);K1,K2,and mean k reading,anterior and posterior corneal elevation;and anterior chamber depth were measured(Pentacam)before,1 month,and 3 months after *** who could not maintain reliable fixation and those with a history of eye surgery were ***-and postoperative measurements were compared by analysis of ***:A total of 36 eyes of 23 patients(average age,16 years)were *** muscle recession was performed in 24 eyes;and resection was performed in 12 *** significant changes in mean keratometry of recession group *** anterior elevation,and central anterior chamber depth were significant when both groups are compared at first month after *** became regressive at the end of the third *** a significant change of central anterior elevation ***:In recession group,the mean K was the only statistically significant variable by the first postoperative *** the both groups,the anterior corneal elevation,and central anterior chamber depth revealed a significant difference by the end of the first postoperative *** 3 months,all parameters showed a statistical insignificant difference between the recession and resection groups except the anterior corneal elevation.

关键词： Strabismus cornea parameters anterior chamber Pentacam

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