Purpose:

To assess LASIK associated dry eye after measuring the lower tear meniscus using spectral-domain optical coherence tomography (SD-OCT) in conventional (Microkeratome) and femtosecond (Intralase) assisted laser in situ keratomileusis (LASIK) for myopia.

Setting:

Maghrabi Eye Hospital, Main Branch, Cairo, Egypt.

Methods:

A total of 30 patients were recruited in the study; 15 patients undergoing intralase femtosecond LASIK and 15 patient s having conventional Lasik using the Moria II microkeratome. One eye per patient was chosen randomly prior to surgery and followed-up in the study. The height (LTMH) and area (LTMA) of the lower tear meniscus were obtained using the Optovue SD-OCT (RTvue 100) before surgery, 1 week, 1 month, and 3 months after surgery for each patient. At each visit, Schirmer’s test (type I, without anesthetic), tear break-up time (TBUT), and dry eye symptoms were also evaluated.

Results:

In all patients, the mean LTMH and mean LTMA were significantly decreased from the preoperative values on the first two postoperative visits (P < 0.05), and returned to the mean preoperative values by the 3rd month (P > 0.05). Postoperative mean Schirmer’s and TBUT values were not different from the preoperative values in all visits (P > 0.05). On analysis of the dry eye symptoms, most patients reported improvement on the 3rd visit. On subgroup analysis, no significant difference was detected between the intralase group and Microkeratome group in all of the parameters examined at each visit (P > 0.05).

Conclusions:

The lower tear meniscus parameters measured by anterior segment SD-OCT could be a more sensitive tool to evaluate post-LASIK dry eye than the conventional clinical tests. No significant differences were detected in LTMH or LTMA between the femtosecond LASIK and Microkeratome LASIK groups.

Financial Disclosure:

NONE

{INTRODUCTION: Myelodysplastic syndrome (MDS) is an uncommon disorder accounting for less than 5% of hematopoietic neoplasia in childhood. Although many therapeutic options have been attempted for pediatric MDS including immunosuppressive therapy, epigenetic modifying agents, high-dose chemotherapy, and hematopoietic growth factors, but still hematopoietic stem cell transplant (HSCT) is the only curative therapy for those patients. We described the outcome of pediatric patients with MDS and the factors affecting the overall survival (OS) and event free survival (EFS). METHODS: This is a retrospective descriptive study included newly diagnosed patients with MDS who presented to Children Cancer Hospital Egypt (CCHE-57357), between July 2007 and December 2015, and were followed till June 2017. Patients with congenital (inherited) marrow failure syndromes were excluded. All patients were reviewed for the diagnostic criteria according the WHO classification. Wait and see approach was adopted for patients with Refractory Cytopenia of Childhood (RCC) who had normal karyotype and were transfusion independent. HSCT was offered to patients who had HLA matched family donors after HLA typing. They received myeloablative conditioning therapy followed by stem cell infusion.Systemic chemotherapy (AML-like) was given before transplant for those with RAEB and RAEB-T / MRD-AML. RESULTS: Forty four patients were analyzed with median age at diagnosis of 6.5 years. Primary MDS was encountered in 40 patients (91%), 2 patients were Down syndrome (4.5%), and the remaining 2 patients (4.5%) were secondary MDS (therapy-related). Eighteen patients (40.9%) had RCC, 19 (43.2%) had RAEB, and 7 patients (15.9%) had RAEB-T / MRD-AML. Cytogenetic abnormalities were observed in 23 patients (52.3%), in which monosomy 7 was the commonest abnormality observed (25%), while normal karyotype was found in 19 patients (43.2%). Allogeneic HSCT from HLA matched donors was performed in 9/44 patients. The mean time to transplant since diagnosis was 8.6 months (ranging from 6 months to 15 months). All patients received myeloablative conditioning regimen in the form of Busulfan / Cyclophosphamide followed by stem cell infusion. The Average CD34+ count was 3.57×106 /Kg recipient weight. The bone marrow harvest was the source of the stem cells in 7/9 patients, while peripheral blood was used for the 2 other patients. With median follow up duration of 14.25 months (ranging from 0 - 105 months), the 2-year overall survival (OS) and event-free survival (EFS) for the whole cohort were 43.3% (±15.68) and 33.8% (±14.896), respectively, and for the transplanted patients were 75% (±29.988) and 60% (±35.672), respectively. Univariate analysis showed improved 2 years-OS and EFS in patients who underwent HSCT as compared to those who didn’t; yet it was not statistically significant mostly due to low number of patients (75% versus 35.4% for OS