Open Access Original Research Article

Effect of Continuous 0.5% Ganciclovir Eye Drop Treatment in Secondary Glaucoma Associated with Cytomegalovirus Anterior Uveitis

Takaaki Otsuka, Katsuhiko Yokoyama, Takako Nakamuro, Yuji Sakino, Satoko Nakano, Kenichi Kimoto, Toshiaki Kubota

Ophthalmology Research: An International Journal, Page 13-21
DOI: 10.9734/or/2021/v14i130179

Purpose: The purpose of this study was to investigate the treatment outcomes of secondary glaucoma caused by cytomegalovirus (CMV)-anterior uveitis (AU) with continuous 0.5% ganciclovir eye drop.

Study Design: Retrospective observational study.

Place and Duration of Study: Department of Ophthalmology, Oita University Hospital, between January 2012 and December 2017.

Methodology: Nineteen eyes of 19 patients with secondary glaucoma associated with CMV-AU diagnosed by a polymerase chain reaction analysis from human aqueous samples were enrolled. They were treated with continuous 4-times-daily topical 0.5% ganciclovir in addition to topical steroids and anti-glaucoma medications. We performed glaucoma surgery for patients with poorly medically controlled intraocular pressure (IOP).

Results: Anterior chamber inflammation and IOP were controlled without systemic ganciclovir or glaucoma surgery during the follow-up period (mean: 59.2±27.0 months) in 9 (47%) eyes. Five (26%) eyes required systemic ganciclovir and ten (53%) eyes required glaucoma surgery. Patients were divided into two groups for the comparison: one group requiring glaucoma surgery and one treated with medication. The mean IOP and number of anti-glaucoma medications at the first visit were significantly higher in the surgery group than in the medication group. The mean number of IOP spikes per year (IOP >30 mmHg) was 1.4±0.9 in the surgery group and 0.4±0.5 in the medication group. The recurrence of anterior chamber inflammation was suppressed in both groups. The cumulative survival rate after glaucoma surgery was 80% at 12 months and 70% at 36 months.

Conclusion: The anterior chamber inflammation and IOP were controlled with continuous 0.5% ganciclovir eye drop treatment in half of the patients with CNV-AU. A high IOP at the first visit and frequent IOP spikes were risk factors for additional glaucoma surgeries.Cytomegalovirus

Open Access Original Research Article

Effect of the COVID-19 Pandemic on Contact Lens Wear in Greece

Aristeidis Chandrinos, Dorotheos-Dimitrios Tzamouranis

Ophthalmology Research: An International Journal, Page 22-29
DOI: 10.9734/or/2021/v14i130180

Purpose: This study demonstrates the actions that took over the contact lens (CL) wearers in Greece after the COVID-19 pandemic.

Methods: The study includes nameless web-based survey used to measure participants demographics, CL wear history, and custom wear activity of CL in a stage of noticeable risk of infection due to CL wear during the COVID-19 pandemic.

Results: During the lockdown A’ in Greece about half of the participants (42.5%) believe that the perception risk of infection using CL was extremely effective (29%) and very effective (13.5%). Only a minority (18 %) of the participants do believe that the use of CL increases the risk of COVID-19 infection. Another population (43%) do not agree with this opinion and more than a third of them (39%) resemble that are not affected by this opinion or are less informed.

Conclusion: This study presents the likelihood of reducing or ceasing the use of CLs during the COVID-19 pandemic lockdown and a relationship between the perceived risk of infection and CL use. There was also a predisposition to alter the frequency of CL wear. All eye care practitioners should give more advice to their patients that continue to wear CL and assist them to act in accordance with the new rules of handling and in favour of occasional CL wear.

Open Access Original Research Article

Evaluation of the Use of Intraoperative Subconjunctival Injection of Triamcinolone Acetonide and Limited Peritomy during Bare Scleral Pterygium Excision

Alaa M. Abdelhafez, Samir Yehia Saleh, Abdelsalam Abdalla Mohamed, Ahmed F. Omar

Ophthalmology Research: An International Journal, Page 30-39
DOI: 10.9734/or/2021/v14i130182

Aims: To evaluate the efficacy and safety of subconjunctival injection of triamcinolone acetonide (TA) and limited peritomy during bare scleral pterygium excision in preventing pterygium recurrence.

Study Design: A prospective non-randomized interventional case series.

Place and Duration of Study: All surgeries were done at the department of ophthalmology of Assiut university hospital (27 eyes) and Alforsan eye center in Assiut (3 eyes), Egypt, between November 2017 to December 2019.

Methodology: Thirty eyes of 26 patients who underwent pterygium excision with bare sclera combined with intraoperative subconjunctival TA injection and limited peritomy primary pterygium grade 2 (T2, 3 eyes) and grade 3 (T3, 30 eyes). All patients were followed up for 12 months after surgery. Pterygium recurrence and complications were the key outcome steps.

Results: Pterygium recurrence was seen in 3 eyes (10.0%) as following: grade 2 in one eye (3.3%) and grade 3 in two eyes (6.7%). Intraocular pressure elevation was observed in 9 eyes (30%). The IOP rise ranged from (22.4 to 37 mmHg). All eyes were successfully treated medically and reached normal values by the end of postoperative sixth month.

Conclusion: This procedure appears to be reasonably safe and successful in reducing pterygium recurrence.

Open Access Original Research Article

Facial Reanimation of the Eye Using Neurovascularised Flap of Platysma

Grace Hui Chin Lim, Kealan McLaughlin, Joanne Hui Yee Lim

Ophthalmology Research: An International Journal, Page 40-57
DOI: 10.9734/or/2021/v14i130185

Background: Dynamic reanimation is usually required to restore blink function in patients with chronic facial paralysis. In which case, platysma myocutaneous flap (PMF) is a good choice compared to gracilis flap. Platysma is a thin, pliable flap with matching skin colour to the eyelids. Despite this, it is underused.

Aim: To investigate the neurovasculature of platysma in order to find a common “window” containing nerves and blood vessels supply which is present in every individual. This will aid the plastic surgeons to reconstruct the neurovasculature of the flap for grafting onto the eyelids.

Methods: 3 fresh cadaver necks were dissected from 1 males and 2 females, aged 75-88 years old; (n=6 platysmas). 43 squared specimens (measuring 1.5cm x 1.5cm) surrounding any potential neurovascular structures were cut out, processed and analysed under high power microscope to confirm the presence of nerves and blood vessels. We also reviewed literature dated from 1999 to 2011.

Results: From the literature reviewed, the authors concluded that PMF provided excellent functional and aesthetic outcome. In this study, we discovered a “window” flap (ranging from "2.5cm x 3cm‟ to "8cm x 10cm‟) bilaterally on each cadaver. This window is supplied by submental branch of facial artery, drained by facial vein, anterior and external jugular veins, and extensively innervated by cervical branch of facial nerve.

Conclusion: We strongly advocate the use of PMF “window” by plastic surgeons in dynamic eyelids reanimation.

Open Access Review Article

Identifying Landmark Achievements in Primary Eye Care Promotion in Nigeria in Accordance with Alma – Ata Declaration of 1978: A Review

J. E. Moyegbone, E. U. Nwose, S. D. Nwajei, E. A. Agege, J. O. Odoko, E. O. Igumbor, O. A. Akuirene

Ophthalmology Research: An International Journal, Page 1-12
DOI: 10.9734/or/2021/v14i130178

Background: Alma Ata declaration form the bed rock that link primary health care (PHC) and health promotion to enable individuals and communities to increase control over the determinants of health. The declaration is meant to address the main health problems in the community by providing promotive, preventive, curative and rehabilitative services including visual impairment.

Objective: To evaluate the landmark achievement of eye health promotion for prevention of visual impairment in Nigeria.

Methods: A non-systematic review of published literatures was adopted to develop this narrative review. Literatures searches were done through PubMed, google scholar and biomed central. Search terms included primary eye care (PEC), health promotion and Nigeria. 45 articles were reviewed.

Results: Landmark achievement includes elimination of blinding trachoma and onchocerciasis as a public health problem following the treatment of 120 million people. Evaluation of the collaboration between Sightsavers, UK and the Ministry of Health in Sokoto State (Northern Nigeria) on VISION 2020 – Right to Sight program; showed an increase in the proportion of persons aged 50 years and over without visual impairment from 54.7% in 2005 to 77.3% in 2016. The prevalence of blindness in same age range declined from an estimated 11.6% to 6.8%, severe VI from 14.2% to 4.3% and moderate VI from 19.5% to 11.4%. A reduction in the estimated all‑age blindness prevalence by more than a half from 2.0% in 2005 to approximately 0.75% in 2016 was reported. No known similar evaluation was surveyed in the southern part of Nigeria to the knowledge of the researchers. However, non-integration of eye health promotional policy into PHC have left the Nigerian population in the miry clay of sustained prevalence of avoidable visual impairment.

Conclusion: Alma Ata Declaration called on all governments to formulate national policies, strategies and plans of action to launch and sustain primary healthcare, integration of PEC and eye health promotional policies into PHC system to reduce the public health burden of avoidable visual impairment.