BINA
Year:2000 | Volume:5 | Issue:4|Papers Count:14

Purpose: To study the effect of vitrectomy on gentamicin induced retinal toxicity.Methods: Gentamicin (0.4mg) was injected intravitreally in the left eye of nine rabbits. After performing pars plana vitrectomy, the right eyes of same rabbits were each injected intravitreally with same dose of gentamicin, after aspirating 0.1ml of aqueous humor from anterior chamber. Electroretinogram (ERG) was recorded before injection, 24 and 72 hours after injections. The 24dB single flash scotopic wave amplitudes were analyzed.Results: On the first post-treatment day, there was a decrease of the b-wave amplitude of ERG in both groups and values were significantly reduced in vitrectomized group (P=0.00).On the third post-treatment day, there was a more prominent decrease of b-wave amplitude in both groups, and there was no significant difference between the two groups.Conclusion: After vitrectomy, even partial, intravitreally injected gentamicin can induce more rapid and severe toxic effects on retinal physiologic function.

The normally existing bacterial flora is the most common cause of intraocular infection. This study was done to evaluate the normal existing bacterial flora in 207 patients at Matini Hospital, Kashan. It shows that there was positive culture in 50% of the cases and was more pronounced as age increased.

Purpose: To evaluate anterior chamber contamination after extra capsular cataract extraction with IOL implantation (ECCE + PCIOL) in comparison with normal flora of conjunctiva.Methods: This prospective study was performed on 50 eyes (50 patients) scheduled for ECCE + PCIOL surgery. The conjunctival culture was done prior to irrigation. At the end of the surgery 0.1 cc of aqueous humor was aspirated. The specimens were inoculated in liquid culture media (nutrient broth, thioglycolate).Results: Of 50 patients (28 males and 22 females) with the mean age of 63.88 yrs, the 20 positive conjunctivae cultures included staph. aureus, staph saprophyticus, E-coli and Beta hemolytic streptococcus. The cultures from aqueous revealed staph saprophyticus in 5 patients. Endophthalmitis did not occur in follow up time (mean 4 months).Conclusion: Aqueous culture was positive in 10% of the cases.

Purpose: To evaluate the therapeutic effect of the injection of 98% ethyl alcohol in the treatment of iris cyst.Method: 102 patients with secondary iris cyst participated in this study between 1982-1999. Clinical trial quasi-experimental study. 98% ethyl alcohol was injected in the iris cyst.Results: 102 patients 37 female (36.2%) and 65 male (63.7%), 4 to 71 years old with secondary iris cyst were treated. Causes of iris cycst included: 11 post ICCE, 30 post ICCE + vitreous loss, 3 post ECCE, 5 post ECCE+ P/C IOL, 50 after penetrating trauma, 2 after trabeculectomy and 1 congenital. Of 102 cases, 98% ethyl alcohol was injected in 99 cases. 90 were treated with a single injection, 3 responded to treatment after the second injection, 98% alcohol was injected for the third time and of this 3 cases did not respond to the treatment. Of all our cases 3 were omitted as they had connection to the anterior-chamber.Conclusion: Injection of 98% alcohol in the treatment of iris cyst is a safe, cheap and easy procedure.

Purpose: Management of hypotonia maculopathy remains controversial. This study evaluates the management of patients with hypotonia maculopahty and their results.Material and Methods: Data of 7 patients with hypotonia maculopathy including age, sex, type of surgery, visual acuity, intraocular pressure and refraction were recorded.Results: 7 eyes from 6 patients were evaluated, bleb revision was done on 5 eyes, bleb revision with ECCE + PCIOL on one patient, and ECCE + PCIOL alone were done on the last one. After one week IOP increased in all cases and visual acuity improved in all but one.Conclusion: Bleb revision is a relatively safe and effective way in management of these patients and cataract surgery if indicated is an alternative way. More experimental studies is proposed.

Purpose: Evaluation of post operative corneal thickness in normal and pseudoexfoliative eyes. Methods: One hundred and one patients (PXS = 50 and normal = 51) were randomly selected and preoperative and postoperative corneal thickness was measured ultrasonic pachymeter. Other related factors such as age, sex, preoperative and postoperative IOP, inflammation and type of IOL were also registered and finally two groups were compared with statistical tests (chi-square, student t test).Results: A total of 101 patients 55 men and 46 women examined, 50 with PXS and 51 without PXS. The main results were: The preop IOP is higher in patients with PXS (student t test, P<0.03). The postop IOP in both groups were higher than preop IOP (mean=2 ±2.86mmHg) which was statistically significant (student t test, P<0.001). Surgical edema index (difference of postoperative and preoperative cornea) thickness in men with PXS is higher that men without it (chi-square, P<0.05).Conclusion: In male patients with pseudoexfoliation and in those who had rise of 1-4mmHg in postop IOP had a statistically significant increase in corneal thickness (postop compared with preop). Further research of these findings in a larger population is recommended.

Purpose: Due to different surgical results of Duanes retraction syndrome (DRS) type I, a comparison between two surgical procedures (vertical transposition and medial rectus recession) was done on patients who were referred to Farabi Hospital.Material and Methods: This research was done by clinical trial method on 28 patients who had esotropia, face turn or both. Fourteen Patients with transposition procedure (group I) and 14 patients with recession of medial rectus (group II). Four variables of deviation in distance and near, face turn, abduction motion and binocular visual fields were studied.Results: The mean age of the patients was 11.82 years old. They were 68% female and 32% male. Age, sex, involved eye (unilateral or bilateral), hyperopia and other characters were identical in two groups. After operation the mean increase of abduction in group I was 2.21mm more than group II which was zero (P<0.001). The mean reduction of distance deviation was 15.92 PD in group I and 18.89 PD in group II (N.S). The mean reduction of near deviation was 15.71 PD in group I and 19.57 in group II (N.S). The mean reduction of face turn was 9.14 degree in group I and 10.96 degree in group II (N.S). We found 28.57% vertical deviation in group I, but we did not find this complication in group II. The need for second surgery was 71.42% in group I and 35.71% in group II which was statistically significant (P<0.5).Conclusion: We conclude that vertical recti transposition to the insertion of lateral rectus like medical rectus recession can be effective in correction of distance and near deviation, face turn in DRS type I and also it can increase the abduction and binocular field, but because of serious complications like vertical deviation and increasing the need for second surgery, we do not recommend this technique as a primary line of treatment.

Purpose: To Find The Prevalence of Hereditary Color Blindness in Primary School Children of Kermanshah (1998-1999).Materials and Methods: This descriptive study was done on primary school children of Kermanshah. Ishihara test was used to evaluate the severity of color blindness. Results: Two thousands and twenty eight students were examined. Fifty were color blind 47 boys and 3 girls. Thirty three deuteranopia, nine protanopia and eight were totally color blind. Conclusion: Color blindness in primary school children of Kermanshah is lower in prevalence in comparison to literature. Further study is recommended.

Introduction: Keratoconus (KCN) is a bilateral non-inflammatory corneal disease, leading to corneal ectasia with severe decrease of visual acuity. Diagnosis, etiology and its management is discussed.Material and methods: All articles in MedLine up to 2000 were reviewed and those available in Iran, 39 in English and 2 in Persian were included.Findings: Incidence of KCN is about 1/2000 in general population. Its etiology is not completely clear but genetic factors and degenerative enzymes seem to play a key role. Proteinase inhibitors are decreased in affected corneas and there may be a possible role for interleukin 1 in its pathogenesis. Early cases can be diagnosed by videokeratography and managed with rigid gas permeable contact lenses. Advanced cases should be treated by penetrating keratoplasty (PKP). Lamellar keratoplasty (LK) can be done in selected cases like those with Down syndrome and vernal keratoconjunctivitis (VKC). Photorefractive keratectomy, Lasik and epikeratophakia are investigational procedures and results are not promising.Conclusion: In any patient with myopic astigmatism whose visual acuity cannot be improved to 20/20 keratoconus should be suspected.

Retinal toxicity after intraocular antibiotics has been repeatedly reported. Amicacin was reported to have a lower risk. Here we report a case of Amicacin retinal toxicity who had received intraocular Amicacin injection after penetrating trauma as prophylaxis for endophthalmitis.