bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the effect of umbilical cord blood serum therapy in resistant infected corneal ulcer
Authors: Elsawy Mahgoub H. , Hasby Hesham A. , Khater Mohammad M. , Ghoneim Ahmed M. 
Published: June 2024

Background
Corneal wound healing involves several complex pathways that can be targeted by drugs with varying mechanisms of action. Infected corneal ulcers represent a special challenging situation facing ophthalmologists due to resistance to treatment and visual impairing complications.

Purpose
The aim of this study was to evaluate the efficacy of umbilical cord blood serum (CBS) as an adjunctive therapy for resistant infected corneal ulcers.

Patients and methods
This prospective cohort study included 40 eyes having infected corneal ulcer resistant to specific medical treatment for 2 weeks. The patients were recruited from the Cornea Unit at Tanta University Hospital, Tanta, Egypt. They were divided into two groups, 20 cases each. Group A cases were treated with umbilical CBS as an adjunctive therapy together with medical treatment based on culture and sensitivity testing, while group B cases continued the conventional medical treatment only till the complete healing was achieved. The results of the two groups were compared regarding the duration of healing and best-corrected visual acuity improvement.

Results
Visual acuity improvement was achieved with one or more line gain in 14 (70%) cases in group A compared to 6 (30%) cases in group B, with a statistically significant difference (P = 0.008). Healing was achieved in 16 (80%) cases of group A in 2–4 weeks compared to 14 (70%) cases of group B that achieved healing in a longer duration of 3–6 weeks, with a statistically significant difference (P = 0.001). Amniotic membrane transplantation AMT was required in 4 (20%) cases in group A due to thinning compared to 6 (30%) cases in group B.

Conclusion
Umbilical CBS was safe and effective when applied to the cornea as an adjunctive therapy in cases of resistant infected corneal ulcers where it accelerated healing with better visual outcome results.
Intraocular pressure changes following small-incision cataract surgeries in a tertiary care center: a prospective study
Authors: Varghese Leena M. , Hegde Vidya , Lukose Sumi 
Published: June 2024

Aim
This study aims to identify the pattern of intraocular pressure (IOP) changes after uneventful small-incision cataract surgery (SICS) in previously normotensive eyes, to know the cause for these postoperative changes, and to correlate the preoperative anterior chamber depth (ACD) to the postoperative IOP change.

Patients and methods
A prospective study was conducted at Yenepoya Medical College, Mangalore, India on 87 non-glaucomatous eyes that underwent an uneventful SICS with posterior chamber intraocular lens implantation. The IOP was measured preoperatively and postoperatively on days 1, 3, and weeks 1, 3, and 6. We tried to identify the cause of the IOP change. The preoperative and postoperative ACD change was also noted and correlated with the IOP change.

Results
The mean preoperative IOP was 14±1.81 mm Hg. On the first postoperative day (POD-1), 54% of the eyes showed a statistically significant rise in IOP (mean IOP=17.03±7.17 mm Hg, P=0.0002), and 28% showed a mean fall in IOP of 9.28 mm Hg. On the third postoperative day (POD-3), the IOP showed a statistically significant rise (14.82±3.93 mm Hg, P=0.028) compared with the preoperative value. At the end of the first postoperative week (POW-1), the IOP showed a statistically nonsignificant rise (P=0.66). By the third postoperative week (POW-3), the IOP decreased to 13.82±2.83 mm Hg, with a statistically nonsignificant difference compared with the preoperative IOP (P=0.45). However, there was a statistically significant decrease in the IOP (P=0.0001) in the sixth postoperative week (POW-6). Postoperatively, there was a statistically significant increase in ACD from 3.01±0.31 to 3.23±0.36 mm (P=0.0001) by the POW-3. The preoperative ACD showed a statistically significant moderate negative correlation with late postoperative IOP (r=−0.7394, P<0.0001).

Conclusion
After SICS, at the end of 6 weeks, there was a statistically significant decrease in the mean IOP with an increase in the ACD. A moderate negative correlation existed between the preoperative ACD and late postoperative IOP. It was found that 2.3% of the eyes were steroid responders and showed a rise in IOP at POW-3.
Recent modified technique for levator muscle tucking in blepharoptosis surgery
Authors: ElSamkary Mahmoud A. , Roshdy Maged M. , Karim Marwa A. 
Published: June 2024

Purpose
The aim of this study is to introduce a new modification on the classic technique of levator muscle tucking for correction of mild to moderate blepharoptosis and to evaluate its functional and aesthetic outcome.

Patients and methods
This is a tertiary-center study that included 180 patients with mild to moderate ptosis with good levator function (≥8 mm) according to Beard’s classification. Patients with severe congenital, recurrent, mechanical, traumatic ptosis, third nerve palsy, Marcus–Gunn jaw winking syndrome, absent Bell’s phenomenon, or associated ophthalmoplegia were excluded. A recently introduced resection tucking procedure with a spindle excision of the levator aponeurosis was performed. The procedure outcome was assessed functionally by measuring the distance between the upper lid margin and the superior limbus in bilateral cases and accordingly they were classified as very good (2 mm), good (2–4 mm), and poor (5 mm) as well as comparing the preoperative to the postoperative margin reflex distance (MRD1) in unilateral cases. Assessing the aesthetic outcome was done by measuring the eyelid height symmetry, presence of lid crease, lid contour, and patients’ postoperative satisfaction.

Results
The success rate of the procedure was 92.1% [very good (77.7%) and good (14.4%), P < 0.0001]. The MRD1 improved significantly from a preoperative value of 3.28±0.44 mm to 4.44±0.57 mm postoperatively (P < 0.0001). Regarding the aesthetic outcome, symmetrical lid height was achieved in 86.1% of the unilateral cases and in 84% of the bilateral cases, while symmetry of the lid crease was reported in 88.8% of the cases and regularity of the lid contour in 91.6% of the cases. Postoperative patients’ satisfaction was reported by 83% of the patients. The time of procedure was 27.4±4.6 min/eye.

Conclusion
This modified technique of levator tucking was performed in a short time and proved to be an effective technique, with minimal complications and high aesthetic satisfaction outcome.
Evaluation of Optic disc vascular density in high myopia with optical coherence tomography angiography
Authors: Mahmoud Doaa A. , Mansour Mona N. , Kamel Rehab M. , Mohamed Sanaa A. 
Published: June 2024

Aim
This study aimed to investigate the correlation between the optic nerve (ON) vascular density (VD) and myopia severity as estimated by the spherical equivalent (SE) and the axial length (AL) in high myopia (HM) compared with normal eyes using optical coherence tomography angiography (OCTA).

Patients and methods
This prospective, cross-sectional study included 20 eyes of 10 patients having nonpathological HM (SE ≥ −6.0 diopters) and 20 eyes of 10 normal individuals as a control group (SE=±0.5 diopter). OCTA was used to measure the average capillary VD of the optic disc (OD) at the radial peripapillary capillary (RPC) and the entire disc volume (ONH) which was correlated with AL and SE.

Results
The mean SE was −11.25±4.55 diopters (D) in the myopic group compared with −0.04±0.28 D in the control group with a statistically significant difference (P
< 0.001), while the mean AL was 27.37±1.65 mm in the myopic group and 22.87±0.58 mm in the control group, a statistically significant difference (P
< 0.001). The average capillary VD of the RPC and the ONH in the myopic group (44.36±4.65 and 49.6±4.28, respectively) was significantly less compared with the control group (49.51±1.60 and 55.49±1.86, respectively) (P < 0.001). There was a highly significant negative correlation between the optic nerve VD both RPC and ONH and axial length (r =−0.755, P < 0.001). On the other hand, there was no statistically significant correlation between the SE and best corrected visual acuity and the ON VD.

Conclusion
The decrease in ON VD could be attributed to ocular axial elongation that occurs with high myopia. So, the AL elongation must be considered, rather than the SE.
Clinical profile of corneal ulcers at a tertiary care hospital, North-West Rajasthan, India
Authors: Meena Ritu , Kochar Anju , Ali khan Nabab , Lunia Gautam , Farooq Shaheen 
Published: June 2024

Background
Corneal ulcer is an inflammatory or more seriously infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma.

Aim
The aim of this study was to evaluate the clinical profile of corneal ulcers at Sardar Patel Medical College and associated group of hospitals, Bikaner, Rajasthan, India.

Patients and methods
This is a prospective, longitudinal, observational study that was conducted for two years from October 2020 to October 2022. It involved 100 clinically diagnosed corneal ulcer patients, recruited by consecutive sampling, attending the Outpatient Clinic at the Department of Ophthalmology, who were willing to participate in the study. Clinical evaluation included the sociodemographic aspects and the ulcer characteristics, including its location, shape, depth, presence of satellites, and hypopyon. Corneal scraping was performed in 60 cases with full aseptic measures after the instillation of topical anesthetic and the samples were sent to the Microbiology Department for further processing.

Results
The maximum proportion (52%) of the study population were 41-60 years old, with 58% of the patients being males, and 75% from rural areas. Most of the ulcers (68%) were central or paracentral in location, with 38% being of ameboid shape and 48% being superficial. Based on etiology, 48% were fungal, 32% were bacterial, 16% viral, 1% parasitic, and 3% noninfective. The most common pathogen was Aspergillus fumigatus followed by Staphylococci and viral infection.

Conclusion
Corneal ulcers were found most commonly in males aged 40–60 years hailing from rural areas engaged in agriculture. The most common etiological agent was Aspergillus fumigatus followed by Staphylococci.
Monocanalicular versus bicanalicular annular intubation for treatment of lacrimal canalicular laceration
Authors: Khedr Marwa A. , Maali Elsadek A. , Tawfik Ahmed , Kotb Ahmed N. 
Published: June 2024

Purpose
The aim of this study was to compare the safety and efficacy of monocanalicular and bicanalicular annular intubation for treatment of lacrimal canalicular laceration.

Patients and methods
This is a retrospective review of the medical records of 52 patients for whom primary repair of lacrimal canalicular laceration was done. The patients were allocated into two groups. Group I included 26 patients who underwent primary repair with monocanalicular intubation while group II included 26 patients who underwent primary repair with bicanalicular annular intubation. Three months after removal of the stent, negative fluorescein dye disappearance test and patency of the canaliculus on lacrimal irrigation were defined as anatomical success, while functional success was defined as absence of epiphora. Complications like stent prolapse, granuloma formation, and medial canthal deformity were recorded.

Results
Complete anatomical success was achieved in 18 (69.2%) patients in group I and in 21 (80.8%) patients in group II, with no statistically significant difference (P=0.594). Complete functional success was achieved in 20 (76.9%) patients in group I and in 22 (84.6%) patients in group II, with no statistically significant difference (P=0.683). In addition, there was no statistically significant difference between the two groups regarding the postoperative complications including punctum granuloma, punctum slitting, and medial canthal region deformities (P>0.05).

Conclusion
Both monocanalicular intubation and bicanalicular annular intubation were safe and effective for treatment of lacrimal canalicular laceration with no statistically significant difference regarding the anatomical and functional outcomes as well as postoperative complications.
Herpes simplex keratitis following coronavirus disease 2019 vaccination: an observational study of forty-three cases with different presentations
Authors: Awad Ramy , Zaid Islam Abo , Awad Khaled , Elsherbiny Asmaa , Samaha Raymound , Elmassry Ahmed 
Published: June 2024

Objective
The aim of this study was to evaluate the cases diagnosed with different presentations of herpes simplex virus (HSV) keratitis following coronavirus disease 2019 (COVID-19) vaccination and to describe the relationship between the disease presentation, the type of vaccine, and the duration between vaccination and disease onset.

Patients and methods
This is a retrospective observational clinical study of HSV keratitis cases that was carried out by the Cornea Team at Alexandria Ophthalmology Hospital, Alexandria, Egypt, between March and September 2022. Full medical and ophthalmic history was taken, followed by a thorough ophthalmic examination. The vaccination data of the patients were recorded. The hospital records of the patients visiting the outpatient clinics, at that period, were collected regarding the number of vaccinated and nonvaccinated patients and the type of vaccine received.

Results
The study included 43 eyes of 43 patients. Typical dendritic corneal ulcer occurred in 21 (48.8%) eyes, while 5 (11.6%) eyes presented with a geographic ulcer, and 14 (32.6%) eyes were diagnosed as interstitial keratitis with or without ulceration. The remaining 3 (6.98%) eyes presented with disciform keratitis. Vaccination was previously received by 40 (93.02%) patients, while only 3 patients did not receive any vaccine. Oxford-Astra Zeneca vaccine was received by 14 (35%) patients, while the Pfizer-BioNTech vaccine was received by 13 (32.5%) patients, Sinovac vaccine by 10 (25%) patients, and other types of vaccines by three (7.5%) patients. The duration between the last dose received from the vaccine and the onset of symptoms ranged between 2 and 58 days (mean=18.35±13.3 days). Reviewing the hospital records, out of the 65 321 patients who visited the hospital during that period, 47% were nonvaccinated, and 53% were vaccinated with one dose or more of COVID-19 vaccine (Odds ratio=11.8207 indicating a significant association between HSV keratitis and vaccination).

Conclusion
Reactivation of HSV keratitis may follow COVID-19 vaccination with different presentations of herpetic keratitis. The Oxford-AstraZeneca and the Pfizer-BioNTech vaccines were significantly associated with HSV ocular infection more than any other type of vaccine.
Tape, fix, and inject: a novel one-person technique of intravitreal injection for the treatment of retinopathy of prematurity under topical anesthesia
Authors: Ahmed Islam S.H. , Farag Marwa 
Published: June 2024

Aim
The purpose of this study was to describe and evaluate a novel one-person intravitreal injection (IVI) technique for the treatment of retinopathy of prematurity (ROP) under topical anesthesia.

Patients and methods
This is a retrospective study that was conducted on 44 babies who had IVI for the treatment of severe ROP under topical anesthesia. The swaddled baby’s head and body were fixed to the operating table with strips of adhesive tape, obviating the need for an assistant to hold the baby still. The calibers were used both to fix the globe and to determine the site of the injection by measuring the distance of 1.5 mm from the limbus.

Results
The mean gestational age of the patients was 29.6±1.5 weeks, with a mean birth weight of 1085.2±239.4 g. The mean procedure duration (between the insertion of the lid speculum at the beginning of the procedure and its removal at the end) for the right eye (64.9±15.6 s) was less than for the left eye (66.4±15.1 s), but the difference was not statistically significant (P=0.29). Inadvertent head movements occurred in 2 (4.5%) cases, with a large postmenstrual age of 37 and 38 weeks at treatment. None of the cases had inadvertent eye movements.

Conclusion
The technique seems safe and effective, especially in patients with a smaller postmenstrual age at the time of the injection. Additional care should be taken during taping of the head and the body in larger babies. Alternatively, giving sedation or general anesthesia may be a safer option.
Vascular endothelial growth factor gene polymorphisms and age-related macular degeneration in an Egyptian population
Authors: Aly Marwa Abdel Kareem Mohamed , El Deen Mahrous Hanan Salah , Desouky Lubna Mohamed Ibrahim , Nabil Karim Mahmoud 
Published: June 2024

Purpose
The aim of this study was to investigate the role of −1154 guanine (G)>adenine (A) and +405 G>cytosine (C) vascular endothelial growth factor (VEGF) gene polymorphisms as possible risk factors for neovascular age-related macular degeneration (nAMD) and to evaluate their role in patients’ response to anti-VEGF therapy.

Patients and methods
The study included 50 nAMD patients and 64 age and sex-matched healthy volunteers. Polymerase chain reaction-restriction fragment length polymorphism was performed to assess the VEGF −1154 G>A and +405 G>C polymorphisms in relation to AMD.

Results
Hypertension was reported in 40 (80%) cases compared to 14 (21.9%) of the controls, with a statistically significant difference (P < 0.001). Heart disease was also reported more significantly in patients (13 = 26%) than in controls (7 = 10.9%), P = 0.036. In addition, smoking was detected in 39 cases (78%) compared to 10 (15.6%) controls, a statistically significant difference (P < 0.001). Molecular analysis of VEGF −1154 G>A and VEGF +405 G>C gene polymorphisms yielded nonstatistically significant difference between cases and control groups. Assessment of genotype frequency of VEGF −1154 among responders and nonresponders yielded nonstatistically significant difference. However, genotype frequency of VEGF +405 among responders and nonresponders revealed a statistically significant difference, with the GG genotype associated with better response to anti-VEGF therapy (61.1% responders versus 28.6% nonresponders according to visual acuity and optical coherence tomography parameters, P = 0.037).

Conclusion
Smoking, hypertension, and heart disease were critical risk factors for the development of AMD. The VEGF +405 G>C genotype was found to be an important predictor for response to anti-VEGF therapy.
Efficacy of subtenon steroid injection alone or in combination with topical steroid in the management of trematode-induced anterior granulomatous uveitis
Authors: Zaky Marwa Aly , Elkholy Mahmoud Ali Wafeek , Ellakwa Amin Faisal , El Ghoubashy Esraa Samy 
Published: June 2024

Background
Presumed trematode-induced uveitis is a newly recognized cause of intraocular granulomatous inflammation in children, usually presenting with single or multiple pearl-like white nodules in the anterior chamber (AC) with or without subconjunctival lesions or corneal opacities.

Objective
The aim of this study was to evaluate the efficacy of subtenon steroid injection alone or in combination with topical steroid in the management of trematode-induced anterior granulomatous uveitis.

Patients and methods
This is a prospective comparative study, that included the children who presented with AC granulomas at the Uveitis Unit at Tanta Ophthalmology Hospital, Tanta, Egypt. The patients were divided into two groups: Group A, who received subtenon steroid injection only, and Group B, who received both subtenon steroid injection and topical steroid eye drops. The basic demographic data, visual acuity (VA), granuloma site and size, and AC activity (cells and flare) were recorded and analyzed. A systemic work-up, including stool and urine analysis, full blood count, chest X-ray, and schistosomiasis titer, was performed. The patients were followed up on the first day, at 2 weeks, 1, and 3 months

Results
The study included 30 eyes of 30 patients. The mean age of the patients was 13.4±2.42 years, and 87% of the patients were males. Group B patients demonstrated statistically significant better improvement in VA, AC activity, and granuloma site and size compared to Group A patients (P<0.001). The granuloma in group A did not change in size and continued to exhibit AC activity.

Conclusion
The combination of subtenon and topical steroid was found to be more effective in the treatment of granuloma than the subtenon injection alone.
Modified technique for corneal laceration repair using amniotic membrane
Authors: Elkadim Mohamed , Elgohary Asmaa M , Alhelaly Mai Brakat , Abdelhalim Tamer I. 
Published: June 2024

Background
Water-tight closure of lacerated corneal wounds may require a lot of sutures and result in significant corneal scarring and irregular astigmatism.

Aim
The aim of this study was to describe the technique of amniotic membrane (AM) onlay strip for corneal lacerations repair and to evaluate its outcome.

Patients and methods
This is a retrospective case series that included eight eyes with traumatic corneal lacerations. A strip of AM was applied to the corneal surface to cover the wound which was then sutured with 10/0 Nylon sutures involving the membrane. The sutures were well-spaced, and the suturing was avoided in the visual axis. Average keratometric (K) reading, keratometric astigmatism (KA), manifest refractive astigmatism (RA) in diopters (D), and spectacle or soft contact lens best corrected visual acuity (BCVA) were assessed 2 months after suture removal.

Results
Transient postoperative hypotony was encountered in five cases (62.5%). The average K was 44.61±2.81 D, KA 2.20±0.71 D, and RA 1.78±0.73 D (range=1–3 D). The postoperative LogMAR BCVA was 0.39±0.18 (range=0.22–0.70).

Conclusions
The application of AM inlay strip during repair of corneal lacerations was associated with good visual outcome possibly due to the reduction of wound and suture related corneal astigmatism.
Urinary metabolites as exposure biomarkers of benzene, toluene, ethylbenzene, and xylene in footwear workers and assessment of pulmonary function
Authors: Yadav Anupa , Saha Asim , Chakrabarti Amit , Nengzapum Geoffrey , Das Anirban , Das Surajit 
Published: June 2024

Aim:
This pilot cross-sectional study focused on biological monitoring of the benzene, toluene, ethylbenzene, and xylene (BTEX) urinary metabolites trans, trans-muconic acid (tt-MA), s-phenyl mercapturic acid (SPMA), hippuric acid (HA), mandelic acid (MA), and methylhippuric acid (MHA) and measured the effects of workplace BTEX exposure on pulmonary function of workers engaged in footwear manufacturing.

Materials and Methods:
Urinary metabolites tt-MA, SPMA, HA, MA, and MHA concentration in urine samples of study participants (N = 35) were analyzed by reverse-phase high-pressure liquid chromatography. Pulmonary function parameters were measured by spirometer and peak flow meter. Demographic information and work exposure information of study participants were collected by questionnaire interview.

Results:
In exposed workers, concentration of urinary SPMA, tt-MA, and HA was significantly higher (P < 0.01, in all) than the control group. Reduction in both force expiratory volume in 1 s (Forced expiratory volume in one second) and peak expiratory flow rate (PEFR) were inversely associated (P < 0.01) with growing years of age among all workers. Inverse association was measured between urinary tt-MA and decline in forced vital capacity and PEFR (P < 0.05, for each) in workers. Based on the questionnaire interview, workers were not found to be aware of workplace exposure hazards.

Conclusions:
Exposure biomarkers of benzene (tt-MA and SPMA) and toluene (HA) were significantly higher in workers than the control group. Study results evident the presence of occupational exposure to benzene and toluene in footwear workers. Deterioration in FEV1 and PEFR were also measured among all workers with growing years of age. The sample size was small in the present study, so further research required to confirm our results.