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Biomedical subjects

A el-Maghraby

Publications and source records attributed to A el-Maghraby.

15 recordsLinked to original sources
PubMed1999

One-site versus 2-site phacotrabeculectomy: a randomized study.

PURPOSE: To compare 1-site and 2-site combined phacoemulsification with foldable intraocular lens (IOL) implantation and trabeculectomy. SETTING: El-Maghraby Eye Hospital, Jeddah, Saudi Arabia. METHODS: Seventy-six eyes with coexisting cataract and glaucoma were randomly assigned to have a mitomycin-C trabeculectomy in a superior quadrant combined with phacoemulsification and foldable IOL implantation through the same incision (1-site group) or a separate, temporal, clear corneal incision (2-site group). Postoperative evaluation included visual acuity, intraocular pressure (IOP), bleb assessment, and number of antiglaucoma medications. Follow-up ranged from 12 to 18 months. RESULTS: Mean preoperative IOP was 28.1 mm Hg +/- 7.1 (SD) in the 2-site group and 26.2 +/- 6.5 mm Hg in the 1-site group. At 6 months postoperatively, mean IOP was 16.9 +/- 4.3 and 16.8 +/- 3.8 mm Hg, respectively (P = .9) and at 12 months, 17.6 +/- 3.3 and 19.1 +/- 3.1 mm Hg, respectively (P = .044). Twenty-three of 39 eyes (59%) in the 2-site group and 14 of 37 (38%) in the 1-site group had clinically apparent filtering blebs at 12 months (P = .065). Postoperative astigmatic change and complications were comparable. CONCLUSION: Mitomycin-C trabeculectomy superiorly combined with separate temporal clear corneal phacoemulsification provided 1 year IOP control comparable to that with single-incision (1-site) combined cataract and glaucoma surgery.

Adult↗
PubMed1999

Fornix-based versus limbal-based conjunctival flaps in initial trabeculectomy with postoperative 5-fluorouracil: four-year follow-up findings.

PURPOSE: To evaluate the safety and efficacy of fornix-based conjunctival flap versus limbal-based flap in initial trabeculectomy with postoperative 5-fluorouracil. METHODS: 29 patients (58 eyes) with bilateral primary open-angle glaucoma (POAG) were included in the study. Patients were randomly assigned to have a fornix-based conjunctival flap in one eye and a limbal-based flap in the other, followed by subconjunctival injection of 5-fluorouracil. RESULTS: Mean intraocular pressure (IOP) 2 years after treatment was 12.9 +/- 12.25 mmHg in eyes with fornix-based conjunctival flaps and 13.1 +/- 16.81 mmHg in eyes with limbal-based conjunctival flaps. At 4 years, mean IOP was 14.7 +/- 9.61 mmHg in eyes with fornix-based conjunctival flaps and 15.1 +/- 7.29 mmHg in eyes with limbal-based conjunctival flaps. Cumulative success at 4 years (IOP < 21 mmHg) was 89.6% in eyes with fornix-based conjunctival flaps versus 86.2% in eyes with limbal-based conjunctival flaps with medications. Cystic leaking blebs occurred in two cases, both with limbal-based flaps. CONCLUSION: The efficacy of limbal- and fornix-based conjunctival flaps in initial trabeculectomy with postoperative 5-fluorouracil was not significantly different; however, in this study cystic leaking blebs were encountered only in eyes with limbal-based conjunctival flaps.

Adult↗
PubMed1998

The contribution of phacoemulsification to combined cataract and glaucoma surgery.

The refinements of small incision cataract surgery by phacoemulsification with foldable intraocular lens implantation and the pharmacologic modulation of wound healing have brought new options for the combined procedure. Phacoemulsification combined with filtering surgery has the potential advantage of requiring a smaller conjunctival and scleral incision, which may reduce inflammation and bleb scarring with the possibility of enhanced bleb formation and long-term intraocular pressure control. The smaller phacoemulsification incision also helps to reduce postoperative astigmatism and improve visual results. Following combined phacoemulsification and filtering surgery, a larger area of undisturbed or virginal tissue in the conjunctiva and at the limbus is spared for further glaucoma surgeries or revision if the initial procedure fails. The risk of suprachoroidal hemorrhage during phacoemulsification in this susceptible group of patients is minimized by maintaining a closed chamber during the procedure.

Antimetabolites↗
PubMed1997

Lens capsule inclusion in trabeculectomy with cataract extraction.

PURPOSE: To deliberately include a flap of anterior lens capsule in the trabeculectomy site to determine whether it aids filtration in a glaucoma bleb. SETTING: El-Maghraby Eye Hospital, Jeddah, Saudi Arabia. METHODS: The study comprised 23 consecutive patients (25 eyes) with dense cataract and uncontrolled glaucoma despite maximum medical therapy. Combined trabeculectomy, planned extracapsular cataract extraction, posterior chamber intraocular lens implantation, and inclusion of the anterior lens capsule under the trabeculectomy scleral flap were performed. Follow-up ranged from 6 to 72 months. RESULTS: All eyes had improved visual acuity mainly because of cataract removal. Best spectacle-corrected visual acuity in 20 eyes ranged from 20/40 to 20/20. A diffuse filtration bleb was achieved in most cases. Postoperative intraocular pressure (IOP) was 20 mm Hg or less in 80% of eyes. Five eyes required additional topical timolol therapy. None required additional carbonic anhydrase inhibitor therapy. CONCLUSION: The combined procedure appeared to be a sound method of providing visual rehabilitation and adequate IOP control. The use of the capsular wick seemed to help maintain glaucoma filtration.

Aged↗
PubMed1996

Transscleral fixation of posterior chamber intraocular lenses in the absence of capsular support.

PURPOSE: To evaluate the safety and efficacy of a modified technique of transscleral fixation of posterior chamber intraocular lenses (IOLs) in the management of unilateral aphakia and in cases of IOL exchange. SETTING: El-Maghraby Eye Hospital, Jeddah, Saudi Arabia. METHODS: This prospective study comprised 41 eyes of 41 patients who had transscleral fixation of a posterior chamber IOL using a modified technique. Of these patients, 36 had unilateral aphakia and 5 had pseudophakia requiring lens exchange. Patient age ranged from 40 to 80 years. Follow-up was 12 months. RESULTS: Uncorrected visual acuity improved in all patients. Best corrected visual acuity was unchanged in 87.8% of patients, improved by two to four Snellen lines in 9.8%, and decreased by one or two Snellen lines in 2.4%. Most complications were minor and managed medically; only two patients required further surgical intervention. CONCLUSION: Our modified technique is safe and effective. We recommend evaluation of longer term results.

Adult↗
PubMed1996

Intraoperative mitomycin-C versus postoperative topical mitomycin-C drops for the treatment of pterygium.

BACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of two different regimens of mitomycin-C (MMC) application as adjunctive chemotherapy in the treatment of pterygia. PATIENTS AND METHODS: One hundred fifty-six patients underwent pterygium excision using the bare sclera technique. They were randomly assigned to have either 0.1 mg/ml of MMC applied to the bare sclera for 3 minutes intraoperatively, or 0.05-mg/ml drops applied topically for 2 weeks postoperatively. The mean follow-up period was 11 months (range 7 to 17). RESULTS: Complications with the intraoperative MMC included 5 cases of recurrence (5.75%), 2 cases of superficial punctate keratitis (SPK), and 3 cases of delayed conjunctival wound healing. Topical MMC led to 6 cases of recurrence (6.9%), 5 cases of SPK, 4 cases of delayed conjunctival wound healing, and 2 cases of mild iritis. CONCLUSION: A single, intraoperative application of MMC is a simple, effective alternative adjunctive treatment for pterygium.

Administration, Topical↗
PubMed1995

Excimer laser in-situ keratomileusis (LASIK) under a corneal flap for myopia of 2 to 20 D.

BACKGROUND: We report the results of a recent technique of keratomileusis for myopia: excimer laser in-situ keratomileusis (LASIK). METHODS: We studied retrospectively 88 eyes of 63 patients that received LASIK with the Chiron Automated Corneal Shaper and the Summit OmniMed excimer laser under a hinged corneal flap without sutures. RESULTS: Mean follow-up was 5.2 months. Mean spherical equivalent of the manifest refraction before surgery was -8.24 diopters (D)(range -2.00 to -20.00 D). Mean spherical equivalent refraction after surgery was +0.22 D (SD, 1.42 D). Of 40 eyes with a baseline refraction from -2.00 to -6.00 D, 25 (63%) had a refraction within +/- 0.50 D and 37 eyes (93%) within +/-1.00 D. In 29 eyes with baseline refraction of -6.12 to -12.00 D, postoperative refraction was within +/-1.00 D in 19 (65%). In 19 eyes with baseline refraction of -12.10 to -20.00 D postoperative refraction was +/-1.00 D in 8 (43%). Overall, 64 of 88 eyes (72.8%) had a refraction within +/-1.00 D after surgery. Between three weeks and five months after surgery the change in the mean spherical equivalent refraction was -0.61 D in the myopic direction. Uncorrected visual acuity after surgery was 20/20 or better in 31 eyes (36%) and 20/40 or better in 61 eyes (71%). Three eyes (3.6%) lost two lines or more of spectacle corrected visual acuity, two from progressive myopic maculopathy and one from irregular astigmatism. No eyes had vision threatening complications. CONCLUSION: Excimer laser in-situ keratomileusis (LASIK) under a corneal flap can be an effective method of reducing myopia between -2.00 to -20.00 D, with minimal complications. Current surgical algorithms need modification to improve predictability. Stability of refraction after surgery requires further study.

Adolescent↗
PubMed1993

Reproducibility and validity of laser flare/cell meter measurements of intraocular inflammation.

Preoperative and postoperative anterior chamber reactions in a series of cataract surgery patients were measured with a Kowa FC-1000 laser flare/cell meter by two different technicians, and clinical assessments of inflammation were recorded. The average cell and flare readings by the two technicians were nearly identical at every time point, showing the laser flare/cell measurements to be highly reproducible. The correlations between laser flare/cell measurements and clinical assessments at postoperative time points were highly positive (P < .01), demonstrating the validity of the laser flare/cell measurements.

Anterior Chamber↗
PubMed1993

Effect of incision size on early postoperative visual rehabilitation after cataract surgery and intraocular lens implantation.

One hundred fifty-one unilateral cataract patients were randomly assigned to receive either a one-piece Staar AA-4203 silicone intraocular lens inserted through a 3.5 mm incision, an loptex 5 mm x 6 mm oval optic lens inserted through a 5.5 mm incision, or an AMO three-piece modified C-loop 6.0 round optic poly(methyl methacrylate) lens inserted through a 6.5 mm incision. Follow-up was 97% at two days postoperatively and 84% at one week and two months postoperatively. At one week postoperatively, 62% of 3.5 mm incision cases had uncorrected visual acuity of 20/40 or better compared with 33% of 5.5 mm (P < .01) and 43% of 6.5 mm incision cases. At two months postoperatively, 85% of 3.5 mm incision cases had uncorrected visual acuity of 20/40 or better compared with 64% of 6.5 mm (P < .05) and 71% of 5.5 mm incision cases. The 3.5 mm incision cases had significantly less total keratometric cylinder than other cases at all postoperative examinations (P < or = .001) and less surgically induced cylinder at two days and one week post-operatively (P < or = .02). The 5.5 mm and 6.5 mm incision cases did not differ significantly in visual acuity or astigmatism at any examination.

Adult↗
PubMed1992

Reproducibility and validity of laser flare/cell meter measurements as an objective method of assessing intraocular inflammation.

Preoperative and postoperative anterior chamber reactions in a series of patients who had undergone cataract surgery were measured with a laser flare/cell meter (Kowa FC-1000, Kowa Instrument Corp, Japan) by two different technicians (A.M. and T.M.M.), and clinical assessments of inflammation were recorded. The average cell and flare readings of the two technicians were nearly identical at every time point, showing the laser flare/cell measurements to be highly reproducible. The correlations between laser flare/cell measurements and clinical assessments at postoperative time points were all highly positive (P less than .01), demonstrating the validity of the laser flare/cell measurements.

Anterior Chamber↗
PubMed1992

Multifocal versus monofocal intraocular lenses. Visual and refractive comparisons.

In a unilateral prospective clinical trial, 77 cases were randomized to receive a 3M multifocal IOL or a conventional monofocal implant. Multifocal cases had better uncorrected near vision than monofocal cases at the two to four month visit. Thirty percent of the multifocal cases had near acuity J1, while only 4% of the monofocal cases had that acuity. Eighty-seven percent of multifocal cases and 71% of monofocal cases had near acuities of J1 to J3. With distance correction in place, 54% of multifocal cases had near acuities of J1 to J2, while only 28% of monofocal cases had comparable acuities (P = .04). There have been no serious postoperative complications in either group.

Cataract Extraction↗
PubMed1991

The use of releasable sutures in Molteno glaucoma implant procedures to reduce postoperative hypotony.

We used releasable sutures to minimize immediate postoperative hypotony and flat anterior chamber in 19 cases of refractory glaucoma requiring insertion of a single-plate Molteno implant in a one-stage procedure. A slip knot using 7-0 nylon suture was fashioned around the Molteno tube under a lamellar scleral flap. In 18 of the 19 eyes, anterior chamber depth was normal immediately after surgery.

Glaucoma↗
PubMedDate not supplied

Efficacy and safety of excimer laser photorefractive keratectomy and radial keratotomy for bilateral myopia.

PURPOSE: To compare the safety and efficacy of radial keratotomy (RK) and photorefractive keratectomy (PRK) to correct myopia. METHODS: In this randomized, prospective, parallel-group study, 33 patients with bilateral myopia of 1.00 to 5.00 diopters (D) had PRK in one eye and RK in the other. The order of surgeries and treatment assignments were randomized, and the bilateral surgeries were within 1 week for each patient. Data were collected using standardized procedures. Clinical measurements and satisfaction surveys were taken in masked fashion. RESULTS: Eyes that had PRK had statistically significantly more residual myopia than RK-treated eyes at 3, 6, and 12 months postoperatively. This result was attributed to the use of an older excimer laser PRK algorithm that was used at the initiation of the study. No eye that had PRK was overcorrected by 0.50 D or more at 1 year postoperatively, while seven eyes that had RK were overcorrected by at least 0.50 D and six were overcorrected by 1.00 D. Eyes that had PRK had a statistically significant mean shift in the myopic direction between 6 and 12 months postoperatively; two RK eyes had hyperopic shifts of 1.00 D. Three RK eyes and two PRK eyes failed to achieve an uncorrected visual acuity of 20/40 or better by 12 months postoperatively. No eye lost any best corrected visual acuity. CONCLUSION: The two procedures were comparably safe and effective in treating mild to moderate myopia under this protocol. Eyes that had PRK were somewhat more myopic at 1 year after surgery, attributable to the older PRK ablation algorithm. Adoption of newer (current) laser algorithms has improved the predictability of PRK. There was also evidence of reduced variability of outcome in the PRK group. The PRK eyes did not exhibit hyperopic shifts during the 1 year follow-up.

Adolescent↗
PubMedDate not supplied

Subepithelial reticular cicatrization following radial keratotomy in a patient with inactive trachoma.

BACKGROUND: Opacification of the clear optical zone following radial keratotomy has not been observed before. METHODS AND RESULTS: The authors noted the appearance of subepithelial dense white reticular cicatrization in the central area following radial keratotomy in a patient with inactive trachoma and clear cornea. The corneal changes resulted in regression of the surgical effect and decrease in visual acuity. A good visual result was obtained by performing homoplastic myopic keratomileusis in situ. Clinical and histopathological findings are presented. CONCLUSIONS: Patients undergoing radial keratotomy should be carefully screened for inactive trachoma which may contribute toward postoperative reticulate opacity of the central cornea.

Adult↗