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Papers by Osama Al Nahrawy

The Annual ASCRS and ASOA Symposium and Congress, Apr 29, 2014

Journal of the Egyptian Ophthalmological Society, 2014

Purpose The aim of this study was to evaluate our technique of nonincisional (threading) levator ... more Purpose The aim of this study was to evaluate our technique of nonincisional (threading) levator plication operation in cases of mild to moderate blepharoptosis. Setting Ophthalmology Department, Suez Canal University Hospital, Ismailia, Egypt. Design This study was interventional in design. Patients and methods We perform nylon threading 7/0 through the skin using a guiding syringe needle gauge no. 21 and the superior levator palpebral muscle and Mόller's muscle are tucked in by sutures guided to the tarsus surface; then, threads are tightened till the lid margin is elevated to the correct level, and the thread is knotted and inserted under the skin and orbicularis muscle. A total of 21 eyelids of 18 patients were subjected to this procedure. Results A total of 18 patients (12 male and six female, mean age 40 years) were studied. Nineteen eyelids were normally corrected or within 0.5 mm of normal, yielding a success rate of 90.5%. One (4.8%) patient was elevated within 1 mm of normal, and it was accepted. One (4.8%) eyelid was undercorrected and it wasn't accepted. An excellent lid contour was noted in all cases, except one, in whom a slight irregularity of the lid margin was observed, which was corrected spontaneously within 1 month. Conclusion The nonincisional (threading) levator plication technique is a safe and effective surgery for the treatment of mild to moderate blepharoptosis. It has a high success rate and good cosmetic outcome.

Medical Journal Of Cairo University, 2009

Purpose: To compare the outcome of amniotic membrane transplantation (AMT) versus autologus limba... more Purpose: To compare the outcome of amniotic membrane transplantation (AMT) versus autologus limbal stem cell transplantation (LSCT) in the management of recurrent pterygium. Setting: Suez Canal University Hospital, Ophthalmology Department, Ismailia, Egypt. Methods: This is a comparative prospective case series study included forty two eyes with recurrent pterygia. They were equally and randomly assigned to either amniotic membrane transplantation (AMT) or autologus limbal stem cell transplantation (LSCT). Eyes were analyzed preoperatively and followed for 6 months postoperatively. Results: The study included 18 males and 24 females. The mean age was 51.09± 11.3 years in the AMT group and 43.57± 14.9 in the LSCT group. The mean preoperative best corrected visual acuity was 0.41±0.29 in the AMT and 0.52±0.22 in the LSCT groups upon inclusion into the study. The mean postoperative best corrected visual acuity was 0.68 ±0.21 in the AMT and 0.79± 0.18 in the LSCT groups. There was a hig...

Advances in Ophthalmology & Visual System

We prospectively examined 23 eyes of each group of patients who were scheduled to have phacoemuls... more We prospectively examined 23 eyes of each group of patients who were scheduled to have phacoemulsification surgery. Materials were collected from December 2016 till April 2017. Exclusion criteria were a history of previous ocular surgery or inflammation, abnormal findings by slit-lamp biomicroscopic examination, a small pupil diameter after a full dilation of less than 4.0 mm, and a preoperative endothelial cell density of less than 1500 cells/mm2. One surgeon performed all the surgeries. Specular microscopy was used on all eyes preoperatively, one week and one month postoperatively. Three photographs were taken per eye at each examination, and the mean of the measurements were calculated. The CCT (central corneal thickness), ECD (endothelial cell density), and CV (coefficient of variance) will be measured in all cases by automated analysis of the whole image. Complete medical history for type 2 diabetes based on medical history, blood glucose levels and HbA1c levels. Examination of visual acuity, subjective refraction, slit-lamp examination, IOP readings with applanation tonometry was done to all patients. Binocular indirect ophthalmoscopy was conducted for fundus examination. The density of the cataract was clinically graded by the same examiner on a scale of 1 to 6 using the Lens Opacities Classification system lll. IOL power and AC depth were recorded for all patients. A standardized stop and chop phacoemulsification technique was done with the phaco tip of 'white star Signature Pro®' Phaco-machine. Surgical techniques were conducted using retrobulbar anesthesia. Clear corneal incision was used with a 3.2 mm keratome. Sodium hyaluronate was injected to maintain the depth of the anterior chamber. Capsulorhexis completed using fine forceps. Hydro dissection was performed and the lens nucleus emulsified with Phaco machine using the stop and chop technique. The power used was 40-60%, a vacuum of 60-350 mmHg, and an aspiration flow rate of 25-30 ml/min. The bottle height raised to a maximum of 110 cm from a minimum of 90 cm during fragment removal. Figure 1 Nidek CEM5301.

Purpose: To describe and assess the efficacy of endoscopic dacrocystorhinostomy using microdrill.... more Purpose: To describe and assess the efficacy of endoscopic dacrocystorhinostomy using microdrill. This is a new technique that involves creation of a large rhinostomy and creation of mucosal flaps. The study involved a prospective nonrandomized interventional case series with short post-operative followup. Methods: A prospective series of 30 consecutive endonasal DCRs. Patients included in the study had nasolacrimal duct obstruction and had not had previous lacrimal surgery. The technique involved formation of a large bony ostium and apposition of nasal mucosal and lacrimal sac flaps. Surgery was performed by two surgeons (Ophthalmologist / otorhinolaryngologist). Follow-up assessment included nasoendoscopy as well as symptom evaluation. Success was defined as anatomical patency with fluorescein flow on nasoendoscopy and patency to lacrimal syringing. The average follow-up time was 6 months (range 2-9 months). Results: There were 30 DCRs performed on 30 patients (12 male, 18 female)...

Introduction: Rupture of posterior capsule is a challenging complication especially when the nucl... more Introduction: Rupture of posterior capsule is a challenging complication especially when the nucleus is still present in the eye. Retained nuclear fragments frequently cause sight threatening complications. Objective: To report the outcomes of a technique that implies the use of instruments in the anterior chamber and through pars plana to help delivery of fragments outside the eye together with the known posterior assisted levitation technique. Design: In a retrospective series, the case notes of consecutive 15 surgeries performed by 4 surgeons between 2007 and 2008 were reviewed. Patients and Methods: The study comprised fifteen eyes of 15 patients; 10 were females and 5 were males (age ranged between 50-73 yrs, Mean 65 years, STD 9 years). Subjects had rupture of posterior capsule during phacoemulsification. Dislocation of whole nucleus or nuclear fragments into the anterior or mid vitreous cavity occurred. Immediately after this event, dispersive viscoelastic was used to fill th...

Introduction and Objective: Bilateral bleeding found over healthy eyes, in healthy pubertal femal... more Introduction and Objective: Bilateral bleeding found over healthy eyes, in healthy pubertal females, that is cyclic and concomitant with menses, is a very rare event. Rarer is its association with cyclic epistaxis and cyclic bleeding from ears and skin bleeding. We present a series of such cases and a trial to diagnose and manage them. Those cases remained undiagnosed for years. We also present literature review about different diagnosis and about similar cases. Cases Report: We report a case series of 6 eyes of 3 patients, with history of cyclic bleeding over eyes. It was associated with epistaxis in two patients, with bleeding from ears in one and skin bleeding in one patient. Ages of these girls at presentation to us were as follow: 12, 13 and 20 years old. All of them reported its incidence at 12-13 years age (onset of their puberty). Bleeding was cyclic and took place around the menses time. No systemic or local disorders were found to explain this bleeding. Bilateral dacryocys...

Retina-the Journal of Retinal and Vitreous Diseases, 2001

Purpose: to report a case of Siderosis Bulbi that attained a good postoperative visual outcome de... more Purpose: to report a case of Siderosis Bulbi that attained a good postoperative visual outcome despite of non-recordable Electroretinogram.

Cornea, Jan 26, 2018

To evaluate the effectiveness and safety of combined epithelium-off cross-linking (CXL) with phot... more To evaluate the effectiveness and safety of combined epithelium-off cross-linking (CXL) with photorefractive keratectomy (CXL Plus) for correction of the myopic and astigmatic components of keratoconus. Seventy-nine eyes of 46 patients who underwent CXL Plus were enrolled in this retrospective, multicenter, noncomparative clinical study. Uncorrected distance visual acuity, corrected distance visual acuity, refraction, keratometry, and pachymetry measurements were recorded preoperatively and at 3, 6, 12, and 18 months during follow-up. The mean (±SD) preoperative uncorrected distance visual acuity and corrected distance visual acuity were 1.00 ± 0.22 logarithm of the minimum angle of resolution (logMAR) and 0.62 ± 0.38 logMAR, respectively, and improved to 0.71 ± 0.36 logMAR and 0.32 ± 0.18 logMAR postoperatively. The mean k value, mean corneal thickness at the thinnest location, and mean myopic and astigmatic components decreased from 46.58 ± 0.97 D, 473 ± 29 μm, 3.65 ± 1.72 D, and ...

The Annual ASCRS and ASOA Symposium and Congress, Apr 29, 2014

Journal of the Egyptian Ophthalmological Society, 2014

Purpose The aim of this study was to evaluate our technique of nonincisional (threading) levator ... more Purpose The aim of this study was to evaluate our technique of nonincisional (threading) levator plication operation in cases of mild to moderate blepharoptosis. Setting Ophthalmology Department, Suez Canal University Hospital, Ismailia, Egypt. Design This study was interventional in design. Patients and methods We perform nylon threading 7/0 through the skin using a guiding syringe needle gauge no. 21 and the superior levator palpebral muscle and Mόller's muscle are tucked in by sutures guided to the tarsus surface; then, threads are tightened till the lid margin is elevated to the correct level, and the thread is knotted and inserted under the skin and orbicularis muscle. A total of 21 eyelids of 18 patients were subjected to this procedure. Results A total of 18 patients (12 male and six female, mean age 40 years) were studied. Nineteen eyelids were normally corrected or within 0.5 mm of normal, yielding a success rate of 90.5%. One (4.8%) patient was elevated within 1 mm of normal, and it was accepted. One (4.8%) eyelid was undercorrected and it wasn't accepted. An excellent lid contour was noted in all cases, except one, in whom a slight irregularity of the lid margin was observed, which was corrected spontaneously within 1 month. Conclusion The nonincisional (threading) levator plication technique is a safe and effective surgery for the treatment of mild to moderate blepharoptosis. It has a high success rate and good cosmetic outcome.

Medical Journal Of Cairo University, 2009

Purpose: To compare the outcome of amniotic membrane transplantation (AMT) versus autologus limba... more Purpose: To compare the outcome of amniotic membrane transplantation (AMT) versus autologus limbal stem cell transplantation (LSCT) in the management of recurrent pterygium. Setting: Suez Canal University Hospital, Ophthalmology Department, Ismailia, Egypt. Methods: This is a comparative prospective case series study included forty two eyes with recurrent pterygia. They were equally and randomly assigned to either amniotic membrane transplantation (AMT) or autologus limbal stem cell transplantation (LSCT). Eyes were analyzed preoperatively and followed for 6 months postoperatively. Results: The study included 18 males and 24 females. The mean age was 51.09± 11.3 years in the AMT group and 43.57± 14.9 in the LSCT group. The mean preoperative best corrected visual acuity was 0.41±0.29 in the AMT and 0.52±0.22 in the LSCT groups upon inclusion into the study. The mean postoperative best corrected visual acuity was 0.68 ±0.21 in the AMT and 0.79± 0.18 in the LSCT groups. There was a hig...

Advances in Ophthalmology & Visual System

We prospectively examined 23 eyes of each group of patients who were scheduled to have phacoemuls... more We prospectively examined 23 eyes of each group of patients who were scheduled to have phacoemulsification surgery. Materials were collected from December 2016 till April 2017. Exclusion criteria were a history of previous ocular surgery or inflammation, abnormal findings by slit-lamp biomicroscopic examination, a small pupil diameter after a full dilation of less than 4.0 mm, and a preoperative endothelial cell density of less than 1500 cells/mm2. One surgeon performed all the surgeries. Specular microscopy was used on all eyes preoperatively, one week and one month postoperatively. Three photographs were taken per eye at each examination, and the mean of the measurements were calculated. The CCT (central corneal thickness), ECD (endothelial cell density), and CV (coefficient of variance) will be measured in all cases by automated analysis of the whole image. Complete medical history for type 2 diabetes based on medical history, blood glucose levels and HbA1c levels. Examination of visual acuity, subjective refraction, slit-lamp examination, IOP readings with applanation tonometry was done to all patients. Binocular indirect ophthalmoscopy was conducted for fundus examination. The density of the cataract was clinically graded by the same examiner on a scale of 1 to 6 using the Lens Opacities Classification system lll. IOL power and AC depth were recorded for all patients. A standardized stop and chop phacoemulsification technique was done with the phaco tip of 'white star Signature Pro®' Phaco-machine. Surgical techniques were conducted using retrobulbar anesthesia. Clear corneal incision was used with a 3.2 mm keratome. Sodium hyaluronate was injected to maintain the depth of the anterior chamber. Capsulorhexis completed using fine forceps. Hydro dissection was performed and the lens nucleus emulsified with Phaco machine using the stop and chop technique. The power used was 40-60%, a vacuum of 60-350 mmHg, and an aspiration flow rate of 25-30 ml/min. The bottle height raised to a maximum of 110 cm from a minimum of 90 cm during fragment removal. Figure 1 Nidek CEM5301.

Purpose: To describe and assess the efficacy of endoscopic dacrocystorhinostomy using microdrill.... more Purpose: To describe and assess the efficacy of endoscopic dacrocystorhinostomy using microdrill. This is a new technique that involves creation of a large rhinostomy and creation of mucosal flaps. The study involved a prospective nonrandomized interventional case series with short post-operative followup. Methods: A prospective series of 30 consecutive endonasal DCRs. Patients included in the study had nasolacrimal duct obstruction and had not had previous lacrimal surgery. The technique involved formation of a large bony ostium and apposition of nasal mucosal and lacrimal sac flaps. Surgery was performed by two surgeons (Ophthalmologist / otorhinolaryngologist). Follow-up assessment included nasoendoscopy as well as symptom evaluation. Success was defined as anatomical patency with fluorescein flow on nasoendoscopy and patency to lacrimal syringing. The average follow-up time was 6 months (range 2-9 months). Results: There were 30 DCRs performed on 30 patients (12 male, 18 female)...

Introduction: Rupture of posterior capsule is a challenging complication especially when the nucl... more Introduction: Rupture of posterior capsule is a challenging complication especially when the nucleus is still present in the eye. Retained nuclear fragments frequently cause sight threatening complications. Objective: To report the outcomes of a technique that implies the use of instruments in the anterior chamber and through pars plana to help delivery of fragments outside the eye together with the known posterior assisted levitation technique. Design: In a retrospective series, the case notes of consecutive 15 surgeries performed by 4 surgeons between 2007 and 2008 were reviewed. Patients and Methods: The study comprised fifteen eyes of 15 patients; 10 were females and 5 were males (age ranged between 50-73 yrs, Mean 65 years, STD 9 years). Subjects had rupture of posterior capsule during phacoemulsification. Dislocation of whole nucleus or nuclear fragments into the anterior or mid vitreous cavity occurred. Immediately after this event, dispersive viscoelastic was used to fill th...

Introduction and Objective: Bilateral bleeding found over healthy eyes, in healthy pubertal femal... more Introduction and Objective: Bilateral bleeding found over healthy eyes, in healthy pubertal females, that is cyclic and concomitant with menses, is a very rare event. Rarer is its association with cyclic epistaxis and cyclic bleeding from ears and skin bleeding. We present a series of such cases and a trial to diagnose and manage them. Those cases remained undiagnosed for years. We also present literature review about different diagnosis and about similar cases. Cases Report: We report a case series of 6 eyes of 3 patients, with history of cyclic bleeding over eyes. It was associated with epistaxis in two patients, with bleeding from ears in one and skin bleeding in one patient. Ages of these girls at presentation to us were as follow: 12, 13 and 20 years old. All of them reported its incidence at 12-13 years age (onset of their puberty). Bleeding was cyclic and took place around the menses time. No systemic or local disorders were found to explain this bleeding. Bilateral dacryocys...

Retina-the Journal of Retinal and Vitreous Diseases, 2001

Purpose: to report a case of Siderosis Bulbi that attained a good postoperative visual outcome de... more Purpose: to report a case of Siderosis Bulbi that attained a good postoperative visual outcome despite of non-recordable Electroretinogram.

Cornea, Jan 26, 2018

To evaluate the effectiveness and safety of combined epithelium-off cross-linking (CXL) with phot... more To evaluate the effectiveness and safety of combined epithelium-off cross-linking (CXL) with photorefractive keratectomy (CXL Plus) for correction of the myopic and astigmatic components of keratoconus. Seventy-nine eyes of 46 patients who underwent CXL Plus were enrolled in this retrospective, multicenter, noncomparative clinical study. Uncorrected distance visual acuity, corrected distance visual acuity, refraction, keratometry, and pachymetry measurements were recorded preoperatively and at 3, 6, 12, and 18 months during follow-up. The mean (±SD) preoperative uncorrected distance visual acuity and corrected distance visual acuity were 1.00 ± 0.22 logarithm of the minimum angle of resolution (logMAR) and 0.62 ± 0.38 logMAR, respectively, and improved to 0.71 ± 0.36 logMAR and 0.32 ± 0.18 logMAR postoperatively. The mean k value, mean corneal thickness at the thinnest location, and mean myopic and astigmatic components decreased from 46.58 ± 0.97 D, 473 ± 29 μm, 3.65 ± 1.72 D, and ...