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Purpose: To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TSDLC) in advanced glaucoma patients with hest-corrected visual acuity (BCVA) of 0.3 Snellen unit or better. Materials and Methods: Patients with BCVA of 0.3 Snellen unit or better who underwent TSDLC for uncontrolled intraocular pressure (IOP) and followed up regularly for at least 12 months were evaluated retrospectively. The primary end-point was the decrease of one or more Snellen lines in BCVA, secondary end-point was the IOP control with or without medications. Results: Thirty-six eyes of 36 patients were included and followed for a mean of24.1+26.4 months. The mean IOP was reduced from 28.3±6.0 mmHg at baseline to 14.4±5.0 mmHg (p<0.001). The average number of antiglaucoma medications was significantly reduced from 3.7±0.5 at baseline to 3.0±0.87 (p<0.05) at last follow-up. BCVAremained constant in 24 (66.7%) eyes, improved in 4 (11.1%), and deteriorated by one line or more in 8 (22.2%). The vision loss was attributed to TSDLC in only 3 patients who had cystoid macular edema, central retinal vein occlusion and post-laser hypotony. Conclusion: TSDLC is an effective, safe, and technically easy procedure for controlling the IOP in advanced glaucoma cases with good visual acuity. TSDLC may be considered both as primary treatment and as an alternative treatment after failed filtration procedures instead of invasive glaucoma surgeries. [ABSTRACT FROM AUTHOR]

Purpose: evaluate the reasons for intraocular lens (IOL) reposition and exchange in our clinic. Materials and Methods: 75 eyes of 73 patients with a history of cataract extraction having either IOL reposition or IOL exchange in our clinic was evaluated retrospectively from the patient charts. Visual acuity, the place of IOL implantation (either anterior or posterior chamber), the structure of GIL and indication of IOL exchange or reposition was noted. Results: In the study 39 eyes underwent IOL exchange and 36 eyes IOL reposition. Of 39 eyes having IOL exchange 12 eyes had bullous keratopathy, 10 eyes incorrect IOL power, 7 eyes (one eye due to capsular phymosis and 6 eyes due to psoudoexfoliation) IOL subluxation, 5 eyes cataract progression secondary to fakic IOL, 4 eyes IOL opacification and one eye with fakic IOL experienced chronic inflammation. Of 36 eyes having IOL reposition 13 had zonular damage (12 eyes due to pseudoexfoliation and one eye due to ocular travma), 4 eyes capsular phymosis and 19 eyes IOL dislocation due to either one or both of the haptics remaining outside the capsular bag. Conclusion: A significant number of eyes requiring IOL exchange or reposition may be prevented by the experience and cautiousness (vigilance) of the surgeon. [ABSTRACT FROM AUTHOR]

Purpose: Retrospective analysis of complications and outcomes of phacoemulsification (phaco) surgery in hypermature, brunescent, and nigra (grade 5 and 6 according to LOCS classification) cataracts. Materials and Methods: In our series 74 eyes of 74 patients with hypermature, brunescent, and nigra cataracts in Khartoum, Sudan, were included. All the operations were performed by experienced surgeons. Trypan blue was used in all of the cases in order to obtain a regular image of anterior capsulorhexis. Preoperative and postoperative visual acuity, surgical techniques, biomicroscopic findings, intraocular pressure, and complications were investigated. Results: Peribulbar anesthesia was applied in 65 of the patients and topical anesthesia in 9. Band keratopathy was observed in 25 cases and corneal scarring in 10. Irregular anterior capsulorhexis was not found in any of the cases. Posterior capsule rupture occurred in 5 cases. Intravitreal nucleus drop did not occur in any of the cases. Corneal edema in different levels occurred in 49 patients. IOP increased in 12 cases and a fibrin reaction occurred in 11 cases. Phaco burn developed in 19 eyes. Visual acuity improved in 63 (85%) eyes but did not change in 11 (15%) eyes. Conclusion: Extracapsular cataract surgery is the usual and preferred method for hypermature, brunescent, and nigra cataracts. With experienced surgeons, and appropriate phacoemulsification parameters and methods, satisfactory results can be achieved. [ABSTRACT FROM AUTHOR]