Purpose of the Study To compare visual outcome, higher order aberrations (HOAs) of topography guided and Q value adjusted ablation in the fellow eye of patients undergoing photorefractive keratectomy (PRK) for the correction of myopia and myopic astigmatism. Methods Prospective randomized controlled interventional clinical study. The eyes of 52 patients undergoing PRK for myopia and astigmatism were included, that is, 104 eyes in total. In each patient, eyes were randomly allocated to group I: one eye received topography guided PRK using Contoura ablation software, or group II: the other eye received Q value adjusted PRK using Custom Q ablation software. Follow-Up Six months. Results At the end of 6 months, LogMAR UDVA was −0.04 ± 0.12 and −0.05 ± 0.11 (p = 0.688), while LogMAR CDVA was −0.06 ± 0.09 and −0.06 ± 0.1 in group I and group II, respectively (p = 0.972). Both groups showed a progressive oblate shift with time. This oblate shift was insignificantly less in group I by Topolyzer at 6mm, 15° and 30° at 6 months (p = 0.102, p = 0.138, p = 0.245, respectively). Topolyzer identified a significant difference between the change in coma and trefoil in both groups at 6 months (p<0.001 and p = 0.001, respectively). This was caused by the significant worsening of coma in group II (p<0.001) and the significant improvement of trefoil in group I (p = 0.007). No significant difference was found between groups in the change of ISV or ABR (p = 0.955 and 0.982, respectively). Ablation depth is a significant predictor of ΔQ at 6mm, 15° and 30° (p = 0.009, 0.039 and 0, respectively). No significant difference was found in the Strehl ratio or contrast sensitivity, although they were insignificantly better in group I (p = 0.785 and p = 0.745, respectively). Conclusion TG PRK and CQ PRK yielded similar results regarding UDVA, CDVA, MRSE, safety, predictability and contrast sensitivity. Both groups showed a progressive oblate shift, which was less in the TG group but the difference was statistically insignificant. TG PRK showed significantly improved trefoil HOA as compared to CQ PRK.

PURPOSE:Studying the role of ultrasound biomicroscopy (UBM) in detection of anterior segment changes in infants with primary congenital glaucoma (PCG). METHODS:Cross-sectional study that included 25 eyes of 15 patients suffering from PCG and a control group of 15 eyes of ten age- and sex-matched participants. Diagnosis of PCG was based on clinical data (intraocular pressure, corneal diameter, fundus examination and amplitude-modulation scan measurement of axial length). UBM examination was done for all participants for measurement of central corneal thickness, anterior chamber depth, lens thickness, iris thickness (measured 2 mm from the iris root and again at the thickest point near the pupil), zonular length, posterior chamber depth, and angle of anterior chamber. Qualitative evaluation was done for abnormal angle membranes, iris insertion level, and ciliary processes position and configuration. RESULTS:Mean age ± standard deviation was 10.32±3.59 months in the study group and 14.54±5.9 months in the control group. The central corneal thickness, anterior chamber depth, zonular length, and angle of anterior chamber were significantly larger in the study group than in the control group, with mean values 700±190 μm, 3.55±0.32 mm, 1.02±0.15 mm, and 58.47°±5.57°, respectively. The posterior chamber depth had a mean of 0.33±0.06 mm, which was significantly smaller than that of the control group. In the study group, the mean iris thickness 2 mm from the iris root was 0.32±0.04 mm, the mean iris thickness at the thickest point near the pupil was 0.38±0.08 mm, and the mean lens thickness was 3.32±0.18 mm. These three parameters were smaller than the control group but the difference was insignificant. Loss of normal iris configuration was detected in all eyes of the study group. Anterior iris insertion was detected in 56% of the eyes in the study group, and abnormal angle membrane was found in 12%. CONCLUSION:UBM is a useful tool for detection of anterior segment changes in PCG, which is helpful especially in cases with opaque cornea or cases with borderline clinical findings.

Ultrasound biomicroscopy as a diagnostic tool in infants with primary congenital glaucoma Tarek r hussein said M shalaby Molham a elbakary rabab M elseht rania e gad Purpose: Studying the role of ultrasound biomicroscopy (UBM) in detection of anterior segment changes in infants with primary congenital glaucoma (PCG). Methods: Cross-sectional study that included 25 eyes of 15 patients suffering from PCG and a control group of 15 eyes of ten age-and sex-matched participants. Diagnosis of PCG was based on clinical data (intraocular pressure, corneal diameter, fundus examination and amplitude-modulation scan measurement of axial length). UBM examination was done for all participants for measurement of central corneal thickness, anterior chamber depth, lens thickness , iris thickness (measured 2 mm from the iris root and again at the thickest point near the pupil), zonular length, posterior chamber depth, and angle of anterior chamber. Qualitative evaluation was done for abnormal angle membranes, iris insertion level, and ciliary processes position and configuration. Results: Mean age ± standard deviation was 10.32±3.59 months in the study group and 14.54±5.9 months in the control group. The central corneal thickness, anterior chamber depth, zonular length, and angle of anterior chamber were significantly larger in the study group than in the control group, with mean values 700±190 μm, 3.55±0.32 mm, 1.02±0.15 mm, and 58.47°±5.57°, respectively. The posterior chamber depth had a mean of 0.33±0.06 mm, which was significantly smaller than that of the control group. In the study group, the mean iris thickness 2 mm from the iris root was 0.32±0.04 mm, the mean iris thickness at the thickest point near the pupil was 0.38±0.08 mm, and the mean lens thickness was 3.32±0.18 mm. These three parameters were smaller than the control group but the difference was insignificant. Loss of normal iris configuration was detected in all eyes of the study group. Anterior iris insertion was detected in 56% of the eyes in the study group, and abnormal angle membrane was found in 12%. Conclusion: UBM is a useful tool for detection of anterior segment changes in PCG, which is helpful especially in cases with opaque cornea or cases with borderline clinical findings.