Cryotherapy versus Topical Corticosteroid Eye Drop versus Topical Non-Steroidal Anti-Inflammatory Eye Drop in Management of Moderate Cases of Vernal Keratoconjunctivitis Mohamed Yasser Sayed Saif, Khaled Gamal Ibrahim Abueleinen, Abdel Rahman Shaaban Ahmed, Hesham Ali Mohamed Ali Elsherif International Journal of Drug Delivery Technology, 2026 Background: Vernal keratoconjunctivitis (VKC) is a chronic, recurrent allergic ocular illness that might result in corneal complications and vision loss. Various treatment options exist, but the optimal management strategy for moderate cases remains unclear. The purpose of this research is to compare the effectiveness and safety of cryotherapy, topical corticosteroid eye drops, and topical non-steroidal anti-inflammatory eye drops (NSAIDs) in the treatment of moderate VKC. Methods: This prospective randomized research involved sixty cases with moderate VKC, separated equally into 3 groups: Group A (cryotherapy), Group B (fluorometholone 0.1% suspension), and Group C (nepafenac 0.1% eye drops). Cases have been followed for six months, and outcomes assessed included resolution of symptoms and signs, recurrence, and complications. Results: At three months, no significant intergroup differences were observed in symptoms, conjunctival hyperemia, papillae, or keratitis (p > 0.05), except for Trantas dots distribution (p = 0.0375). At six months, all groups demonstrated significant improvement. Group C showed the highest resolution of palpebral papillae (70%) and the lowest relapse rate (35%), compared with Group A (80% relapse) and Group B (50% relapse). No serious treatmentrelated complications occurred in any group. Conclusion: Cryotherapy, corticosteroids, and NSAIDs are all effective in managing moderate VKC. However, cryotherapy remains a safe and useful non-pharmacological option, particularly for refractory cases.
Studying the Effects of High Myopia with Maculopathy in Chronic Smokers Versus Non-Smokers Using Optical Coherence Tomography Angiography E.A. Asmaa, Y.S.S. Mohamed, A.M.A. Safaa Oftalmologija Vostochnaja Evropa, 2025 Purpose. To detect changes in high myopic eyes with maculopathy by optical coherence tomography angiography (OCTA) in non-smokers and smokers and compare these results to high myopic eyes without maculopathy. Materials and methods. This comparative study was applied to 120 eyes of 60 high myopic subjects (40 high myopic eyes without maculopathy, 40 with maculopathy in non-smoker subjects, 40 with maculopathy in chronic smokers). All patients were subjected to OCTA scanning Key measurements included thickness across all macular subfields, macular ganglion cell complex (GCC) thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, foveal avascular zone (FAZ) area, and superficial and deep macular vessel density (VD), as well as optic disc VD and choroidal thickness. Results. The FAZ area was 0.215±0.09 in smokers, 0.210±0.07 in non-smokers, and 0.180±0.04 in the control group (p=0.038). Thickness across all macular subfields, along with choroidal, GCC, and RNFL thicknesses were lower in the smokers compared to the other 2 groups. The whole disc VD was 35.45±7.62% in smokers, 42.49±9.27% in non-smokers, and 48.26±5.2% in the control group (p<0.004). The superficial and deep foveal VD were17.3±7.6%, 26.6±4.2% respectively in smokers, 24.3±9.1%, 37.5±5.1% respectively in non-smokers, and 40.5±4.9%, 43.8±7.3% respectively in control group (p<0.001). The superficial and deep parafoveal VD were recorded at 21.0±6.2% and 27.1±1.6% for smokers, 33.1±7.9% and 37.4±1.3% for non-smokers, and 45.6±5.8% and 47.4±1.4% in controls (p<0.001). Conclusions. High myopia with maculopathy impacted the structure of the macula, optic nerve, and choroid. It enlarged the FAZ area and decreased macular and Optic disc (except inside the disc) VDs. Chronic smoking causes more significant effects. Цель. Выявить изменения в глазах с миопией высокой степени и макулопатией с помощью оптической когерентной томографической ангиографии (ОКТА) у некурящих и курильщиков и сравнить эти результаты с глазами с миопией высокой степени без макулопатии. Материалы и методы. Это сравнительное исследование было применено к 120 глазам 60 пациентов с миопией высокой степени (40 глаз с миопией высокой степени без макулопатии, 40 с макулопатией у некурящих пациентов, 40 с макулопатией у хронических курильщиков). Все пациенты прошли ОКТА-сканирование. Ключевые измерения включали толщину во всех полях макулы, толщину комплекса ганглиозных клеток макулы (GCC), толщину перипапиллярного слоя нервных волокон сетчатки (RNFL), площадь фовеолярной аваскулярной зоны (FAZ), поверхностную и глубокую плотность макулярных сосудов (VD), а также VD диска зрительного нерва и толщину хориоидеи. Результаты. Площадь FAZ составила 0,215±0,09 у курильщиков, 0,210±0,07 у некурящих и 0,180±0,04 в контрольной группе (p=0,038). Толщина во всех полях макулы, а также толщина хориоидеи, GCC и RNFL были ниже у курильщиков по сравнению с двумя другими группами. Общий VD диска составил 35,45±7,62% у курильщиков, 42,49±9,27% у некурящих и 48,26±5,2% в контрольной группе (p<0,004). Поверхностный и глубокий фовеолярный VD составили 17,3±7,6% и 26,6±4,2% у курильщиков, 24,3±9,1% и 37,5±5,1% у некурящих и 40,5±4,9% и 43,8±7,3% в контрольной группе (p<0,001) соответственно. Поверхностный и глубокий парафовеолярный VD зарегистрированы на уровне 21,0±6,2% и 27,1±1,6% у курильщиков, 33,1±7,9% и 37,4±1,3% у некурящих и 45,6±5,8% и 47,4±1,4% в контрольной группе (p<0,001) соответственно. Выводы. Миопия высокой степени с макулопатией повлияла на структуру макулы, зрительного нерва и сосудистой оболочки. Она увеличила площадь FAZ и уменьшила макулярный и зрительный диск (за исключением внутренней части диска) VD. Хроническое курение вызывает более значимые эффекты.
Prevalence of Keratoconus and Characteristics of Refractive Errors in First-Degree Relatives of Patients with Keratoconus among Egyptians Rasha Mohamed Mousa, Mohamed Yaseer Sayed Saif, Mostafa Abd Elnaby Said, Reem Mostafa Mohamed Taher Cornea, 2025 Purpose: This study investigated the occurrence of keratoconus among first-degree relatives of patients with keratoconus and evaluated their refractive characteristics. Method: A cross-sectional observational study was conducted on 248 relatives of 52 patients with keratoconus in whom bilateral eye analysis was conducted. Corneal tomography was performed for all participants with a comprehensive analysis of various parameters, including K1, K2, Kmax, elevation, skewing, and thinnest location. In addition, the following data were also analyzed: uncorrected visual acuity, corrected distance visual acuity, refraction measurements alongside a slit-lamp examination, and fundus examination. Results: Among 248 participants, 19 (7.7%) had keratoconus, 3.2% had forme fruste, and 15.3% had suspected keratoconus. Among all studied cases, 73.8% had normal corneas. Significant differences (P = 0.001) were found in the distribution of keratoconus prevalence among brothers, mothers, sons, and sisters (13.6%, 4.3%, 5.6%, and 12.1%, respectively). The presence of refractive errors also showed significant differences between the relatives (P = 0.03). Conclusions: Increased keratoconus prevalence among relatives of patients with keratoconus indicates the vulnerability of this population to the development of the disease, necessitating early screening of this group for detection of keratoconus as early as possible.
Comparison between surgical outcome of bilateral recession and unilateral recession-resection in intermittent exotropia Sheren M. Aboshanab, Mohamed Y. Saif, Elsayed M. El Toukhi, Ahmed T. Gouda Delta Journal of Ophthalmology, 2024 Purpose The aim of this study was to compare the postoperative drift after bilateral lateral rectus recession (BLR) compared to unilateral lateral rectus recession combined with medial rectus resection (R&R) in children with intermittent exotropia. Patients and methods This is a prospective comparative study that included 52 patients with intermittent exotropia [range=20–50 prism diopters (PD)] who were recruited from the Pediatric Ophthalmology Clinic of the Research Institute of Ophthalmology, Giza, and Beni-Suef University Hospital, Beni-Suef, Egypt between February and September 2020. The patients were randomly divided into two equal groups: BLR group and R&R group, each of 26 patients. The patients were subjected to complete ophthalmic examination including best corrected visual acuity and a full cycloplegic refraction. An alternate prism cover test with accommodative target was used to measure the deviations in the nine positions of gaze, both for distance and near. The cover test was used to examine the control of exodeviation. The ocular dominance was measured by hole in card test. Accommodative convergence/accommodation ratio was measured using the gradient method. The amblyopia cases were not included in this study. According to the postoperative results after 1 year, the patients were assigned to one of the following groups: success [esophoria or esotropia≤5 PD or exophoria or exotropia≤10 PD], overcorrection (esophoria or esotropia >5 PD), and undercorrection or recurrence (exophoria or exotropia >10 PD). Results There was a statistically significant improvement in the angle of deviation after surgery in both groups. In the BLR group, the mean angle of deviation significantly improved from 37.5±5.34 PD preoperatively to 0.58±1.39 PD at 6 months (P<0.00001) and to −2.73±5.95 PD at 12 months (P<0.00001), while in the R&R group, it significantly improved from 39.62±6.15 PD preoperatively to −1.38±2.06 PD at 6 months (P<0.00001) and to −4.42±7.5 PD at 12 months (P<0.00001). At 12 months, the surgical success rate was 92.3% in the BLR group and 84.62% in the R&R group, with no statistically significant difference (P>0.05). There were no serious intraoperative or postoperative complications in either group. Conclusion With long-term follow up, the BLR group appeared to have more stable results on ocular alignment compared to the R&R group.
Comparative study of transepithelial versus alcohol-assisted photorefractive keratectomy Marwa M. Gaber, Mohamed Y.S. Saif, Hany S.E. Elsaftawy, Ahmad T. Gouda Delta Journal of Ophthalmology, 2024 Aim The aim of this study was to compare the clinical, refractive, and visual outcome of transepithelial photorefractive keratectomy (T-PRK) to the alcohol-assisted photorefractive keratectomy (AA-PRK). Patients and methods This is a prospective randomized controlled trial that included 60 myopic patients (120 eyes). They were randomized into two groups, 60 eyes each: group I (AA-PRK) and group II (T-PRK). The operation was performed in both groups by the same Excimer laser machine (EX 500 Excimer laser WaveLight). In the alcohol-assisted group, the corneal epithelium was removed by 20% ethyl alcohol followed by Excimer laser to correct the amount of ametropia. In the T-PRK group, the Streamlight PRK software (WaveLight EX 500) was used, which incorporated Excimer laser stromal ablation and epithelial removal in a single step. After completion of each procedure in both groups, mitomycin C with a concentration of 0.02% was used for 30 s, followed by copious irrigation with a cold balanced salt solution. A soft bandage contact lens was applied until epithelial healing was complete for 5 days and changed after 48 h. The patients were evaluated postoperatively on the first, third, and fifth day, then after 1 week, 1 month, and 3 months. On the first visit, uncorrected visual acuity (UCVA), epithelial healing, and postoperative pain were evaluated. At 1-week and 1-month follow-up visits, UCVA, best-corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), Schirmer’s I, and tear break-up time (TBUT) tests were evaluated. The corneal haze was evaluated using a slit lamp biomicroscope and subjectively graded. At the 3-month follow-up, UCVA, BCVA, MRSE, Schirmer’s I test, TBUT test, and root mean square (RMS) assessment for total higher-order aberration were evaluated. Results There was an insignificant difference between the studied groups regarding all baseline ophthalmological assessments including UCVA, BCVA, MRSE, central corneal thickness, RMS, TBUT, and Schirmer’s test (P=0.839, 0.057, 0.187, 0.537, 0.219, 0.013, and 0.151, respectively). After 3 months, the median UCVA was the same in both groups (1.0), while the MRSE did not differ significantly between the two groups (P=0.126), with a median (interquartile range) of −0.25 D (−0.75 to 0.25 D) in the AA-PRK group compared to −0.25 D (−0.50 to 0.3125 D) in the T-PRK group. The healing duration was significantly shorter in the T-PRK group (median=3.0 days) than in the AA-PRK group (5.0 days, P<0.001). The median postoperative pain was also significantly higher in the AA-PRK group (4.0) than in the T-PRK group (3.0, P<0.001). The RMS was significantly lower in the T-PRK group (median=0.35) than in the AA-PRK group (median=0.65, P<0.001). The corneal haze did not differ significantly between the two groups after 1 month (P=0.783). After 3 months, the Schirmer’s test was significantly lower in the AA-PRK group (median=18.0 mm) than in the T-PRK group (19.0 mm, P<0.001), while the TBUT test showed no significant difference (P=0.055). Conclusion The T-PRK technique provided a faster visual recovery with a better refractive outcome, faster healing response, less pain score, and less dryness than the AA-PRK.
Effect of smoking on the macula and optic nerve integrity using optical coherence tomography angiography Safaa Awad-Allah Aboud, Layla Mohamed Hammouda, Mohamed Yasser Said Saif, Samar Said Ahmed European Journal of Ophthalmology, 2022 Objective: To investigate the effect of chronic smoking on the macula and optic nerve integrity using optical coherence tomography angiography (OCTA). Methods: This prospective, comparative study involved the right eyes of 160 healthy subjects (80 smokers group, and 80 control group). OCTA scanning was performed for all subjects. All macular subfields thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, superficial and deep macular vessel density, foveal avascular zone (FAZ) area, and the macular outer retina flow area, were measured and analyzed. Results: The thickness of some macular subfields, inferior GCC, and RNFL was statistically significantly lower in the smokers’ group ( p < 0.05). The FAZ area was 0.409 ± 0.048 mm2 in the smokers' group and 0.327 ± 0.055 mm2 in the control group ( p < 0.001). The superficial foveal VD was 31.35 ± 5.79% in the smokers’ group and 33.63 ± 4.78% in the control group ( p = 0.06). The deep foveal VD was 39.38 ± 4.56% in the smokers’ group and 34.15 ± 6.57% in the control group ( p ≤ 0.001). The superficial and deep parafoveal VD was 52.09 ± 4.56% and 59.99 ± 2.25% respectively in the smokers’ group, and 54.75 ± 2.30% and 55.58 ± 4.69% respectively in the control group ( p < 0.05). The macular outer retina flow area was 1.29 ± 0.12 mm2 in the smokers’ group and 1.16 ± 0.11 mm2 in the control group ( p < 0.001). Conclusion: Chronic smoking affected the integrity of the macula and optic nerve. It decreased the macular VD, enlarged the FAZ, and increased outer retinal flow area.
Physical therapy interventions for reduction of ocular deviation after strabismus surgery Amany R. Abdel Wahid, Adel Abdel H. Nossier, Mohamed Y.S. Saif, Sameh G. Taher, Walid A. Abouelnaga Physiotherapy Quarterly, 2022 IntroductionThe study aim was to examine the effect of physiotherapy exercises on correcting the remaining ocular deviation after strabismus surgery.MethodsA randomized interventional clinical trial was performed in the Faculty of Physical Therapy, Cairo University, among 40 patients with ocular deviation after strabismus surgery. The participants were randomly divided into an experimental group (<i>n</i> = 20) and a control group (<i>n</i> = 20). All subjects received usual medical care, while the experimental group performed different types of physiotherapy exercises for 2 sessions a week for 12 weeks. The near and far angles of ocular deviation were measured before and after the 12 weeks of treatment.ResultsA significant improvement was observed in the experimental group compared with the control group after 12 weeks of training. There was a reduction in the near angle (19.85 ± 4.09 to 15.4 ± 3.87; 22.41%) and far angle (19.65 ± 4.78 to 16.75 ± 3.9; 14.75%) in the experimental group, with no significant change of the near angle (20.5 ± 3.64 to 20.75 ± 3.19; 1.21%) or far angle (19.7 ± 2.97 to 19.95 ± 3.41; 1.26%) in the control group.ConclusionsThe application of different types of physiotherapy exercises can reduce ocular deviation, restore binocular function, and improve the cosmetic appearance in patients with remaining ocular deviation after strabismus surgery.
Effect of omega-3 fatty acids on dry eye following phacoemulsification Mahmoud M. Kesba, Mohamed Y.S. Saif, Moustafa A. Saeed Delta Journal of Ophthalmology, 2021 Purpose The aim of this study was to evaluate the efficacy of omega-3 fatty acids on dry eye after phacoemulsification. Patients and methods This is a randomized controlled clinical trial which included 50 patients who developed dry eye symptoms following phacoemulsification. They were randomly allocated into two groups, with 25 patients each. The first group received an omega-3 dietary supplementation of 1000 mg in addition to the conventional treatment (artificial tears and anti-inflammatory eye drops) for 3 months. The second group received only artificial tears and anti-inflammatory eye drops. Both groups received treatment from September 2019 to March 2020, and they were followed up for 3 months. All patients had the same diagnostic tests (Schirmer test, ocular surface disease index, and tear break-up time), postoperatively. Results There was no statistically significant difference between the two groups in the demographic data. However, a significant difference was noted in the tear break-up time test scores (11.08±3.29 and 9.20±1.87 s) in the treatment and control groups, respectively. In addition, the ocular surface disease index showed a statistically significant difference between the treatment and control groups (19.41±9.69 and 31.23±11.66, respectively) after 3 months. No significant difference (P=0.186) was noted in the Schirmer test between the treatment and the control groups (9.16±2.72 and 8.12±2.76 mm, respectively). Conclusions The study showed that the addition of omega-3 fatty acid supplements after phacoemulsification can reduce the incidence of dry eye and improve both the objective and subjective measurements of dry eye.
