BINA
Year:2016 | Volume:22 | Issue:1 (86)|Papers Count:12

Purpose: To compare changes in anterior segment biometric properties after implantation of conventional posterior chamber phakic intraocular collamer lens (ICL) versus Aquaport posterior chamber phakic ICL.Methods: The records of myopic patients who underwent ICL implantation between March 2012 and April 2015 were reviewed. Patients’ demographic data, manifest and cycloplegic refraction, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were recorded preoperatively. All patients underwent ultrasonic bio microscopy (UBM; STS, Quantel Medical, France) under dim light conditions to determine anterior segment biometric properties including sulcus-to-sulcus distance and iridocorneal angle parameters. Corneal tomography (Galilei dual Scheimpflug analyzer, Ziemer, Switzerland) was used to obtain corneal curvature and elevation data. The same measurements were obtained postoperatively to determine and compare changes in biometric parameters between two types of ICL.Results: Overall, 58 eyes of 30 myopic patients were enrolled in this study. Of which, 28 eyes of 15 patients were implanted with V4b ICL and 30 eyes of 15 patients received V4c ICL. The mean follow up time was 27.7 ± 9.3 and 26.6 ± 8.8 months in the V4b and V4c groups, respectively. There was no significant difference in postoperative refraction results and IOP between groups at 1 and 3 postoperative months. Compared to preoperative values, all anterior segment biometric parameters were changed in both groups postoperatively. Nasal angle parameters (TIA, AOD500) were significantly different between the V4b and V4c groups. The two study groups were comparable in other biometric parameters and lens densitometry postoperatively.Conclusion: The presence of central hole (Aquaport®) in V4c ICL is as effective as performing peripheral iridotomy in V4 ICL lenses in preventing further deterioration of anterior segment biometric parameters and may provide more uniform flow of aqueous humor to the anterior chamber angle.

Purpose: To evaluate corneal biomechanical properties in pseudo exfoliation syndrome (PEX).Methods: This cross-sectional study enrolled 30 patients with PEX and 30 normals. All participants underwent complete ocular examination, including intraocular pressure (IOP) measurement. The ocular response analyzer (ORA) was used to measure corneal biomechanical properties. Corneal hysteresis (CH) and corneal resistance factor (CRF) values were analyzed and compared between the study groups.Results: Both CH and CRF values in the PEX group (7.17±0.75 mmHg and 7.09±0.09 mmHg, respectively) were statistically significantly lower than those in the control group (10.01±1.02 mmHg and 10.02±1.44 mmHg, respectively) (P<0.001). CH also showed a significant negative correlation with the severity of the syndrome.Conclusion: CH and CRF were significantly lower in the PEX group compared to the controls. CH showed a negative correlation with the severity of PEX.

Purpose: To compare refractive outcomes and higher-order aberrations (HOAs) after photorefractive keratectomy (PRK) for correction of astigmatism using customized versus conventional Ablation.Methods: This randomized clinical trial study recruited 40 participants (80 eyes) with astigmatism who were referred to Farabi Eye Hospital for refractive surgery. PRK was performed using Technolas 217p Zyoptix laser (Bausch & Lomb, Rochester, NY). The participants were randomly divided into one of the two groups based on ablation algorithm: customized ablation group (40 eyes of 20 patients) and conventional ablation group (40 eyes of 20 patients). Preoperative and 6 months postoperative refractive outcomes and HOAs were compared between the two groups.Results: The mean age was 28.8 ± 4.7 (range, 20-42) years. Preoperative spherical equivalent was -3.36±1.03 D (range, -1.75 to -5.25 D) in the customized group and -3.49±0.80 D (range, -1.75 to -4.5 D) in the conventional group (P>0.05). Postoperative mean uncorrected distance visual acuity (UDVA) was 0.019±0.032 log MAR and 0.010±0.022 log MAR, respectively (P>0.1). Best-corrected visual acuity (BCVA) was 0.004 ± 0.013 log MAR in the customized group and 0.002±0.010 log MAR in the conventional group 6 months postoperatively (P>0.1). Refractive outcomes were comparable between two groups and no statistically significant differences were seen between the groups in uncorrected and corrected distance visual acuity and spherical equivalent preoperatively and 6 months postoperatively (P>0.05). Correction index (SIA/ TIA) demonstrated that 95% and 90% of astigmatism was corrected in the customized and conventional groups, respectively (P<0.05). Total HOAs and coma increased in both groups postoperatively. However, no statistically significant differences were found between two groups (P>0.05). The conventional group had higher values of total HOAs, coma and spherical aberrations compared with the customized group 6 months postoperatively.Conclusion: Both methods were effective in correcting astigmatism. No significant difference was found between the groups in refractive outcomes and HOAs and both platforms can be used interchangeably. However, it seems that customized ablation treatment may be superior to conventional ablation in terms of total HOAs and coma.

Purpose: To compare the effect of loteprednol 0.5% versus fluorometholone 1.0% on intraocular pressure (IOP) after photorefractive keratectomy (PRK).Methods: PRK was performed in 124 eyes of 62 participants; one eye of each participant randomly received loteprednol 0.5% and the fellow eye had fluorometholone 1.0% postoperatively. Participants were followed up for three months postoperatively. Ocular discomfort and redness, ocular pain, visual outcomes, corneal haze, and IOP were compared between the two groups after surgery.Results: There was no significant difference between the two groups in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest refraction at the end of follow up. At postoperative 3 month, UDVA>20.25 was achieved in 95% of the loteprednol group and 92% of the fluorometholone group (p>0.05). Neither visually significant corneal haze nor ocular hypertension (IOP rise >10 mmHg or IOP>21 mmHg) was seen in any group. The mean IOP was 13.7±2.2 mmHg in the loteprednol group and 13.7±2.0 mmHg in the fluorometholone group preoperatively (p>0.05). No significant change was observed in IOP in the study groups at postoperative months 1 and 2. However, IOP was similarly decreased (1±2.2 mmHg) in both groups at postoperative month 3. There was a significant association preoperative IOP and reduction in IOP at postoperative month 3 (regression coefficient=-0.56). No significant correlation was found between preoperative spherical equivalent and reduction in central corneal thickness postoperatively. The participants of both groups had ocular pain for 2.0±1.60 days on average (0 to 7 days). No participant reported ocular discomfort or eye redness after they commenced the drugs.Conclusion: No significant difference was observed between loteprednol 0.5% and fluorometholone 1.0% in efficacy and side effects, especially high IOP, after PRK.

Propose: To evaluate the effect of lateral rectus muscle recession with and without intermascular septum dissection on palpebral fissure height.Methods: Twenty-five eyes of 15 patients (10 patients with bilateral and 5 patients with unilateral procedure) and 26 eyes of 19 patients (7 patients with bilateral and 12 patients with unilateral procedure) were assigned to lateral rectus muscle recession ' with' or ' without' intermuscular septum dissection, respectively. The palpebral fissure height was measured preoperatively and three months postoperatively and compared between the study groups.Results: Compared to preoperative values, a significant increase in palpebral fissure height was observed in both groups 3 months postoperatively (Paired T-test; p<0.001). Group analysis revealed that widening of palpebral fissure height was significantly lower when intermuscular septum dissection was performed intraoperatively (ANCOVA test; P<0.001).Conclusion: Intermuscular septum dissection is recommended during lateral rectus muscle recession to decrease undesirable widening of palpebral fissure width.

Purpose: This study was designed to detect occult hepatitis B virus (HBV) infection among cornea donors to the Central Eye Bank of Iran using polymerase chain reaction (PCR).Methods: Cornea donors with negative screening serologic results for HBS Ag, HBS Ab, HCV Ab, HIV Ab, HTLV Ab, and syphilis, and positive serology for HB Core Ab, underwent real-time PCR to detect HBV DNA with a detection level of 400 IU/mL.Results: Over a 2-year period, 8372 sera from 8372 cornea donors were enrolled; 76 (0.9%) out of which were serology negative for abovementioned antibodies except for HB Core Ab. Real-time PCR performed in these 76 cases detected HBV DNA in 6 (7.9%) cases. The sera were inadequate for PCR test in 4 cases (5.3%). HBV DNA was not detectable in 66 cases (86.8%), and hence the corresponding corneas were released for transplantation.Conclusion: Nucleic acid amplification test for HBV is necessitated for detection of occult HBV in cornea donors in order to minimize the risk of HBV transmission via corneal transplantation. In the present study, HBV DNA was undetectable in the majority of cases who were suspicious of occult HBV infection, leading to release of the corresponding corneas for transplantation. These tissues used to be discarded because of inability to evaluate HBA DNA.

Purpose: Cognitive models emphasize on the role of primary maladaptive schemas to explain psychological disorders. It is important in the context of body defects in a clinical setting. This study was performed to determine early maladaptive schemas in patients with severe visual deficits.Methods: In this cross-sectional study, 300 patients from oculoplastic and cornea clinics of Labbafinejad Medical Center, Tehran, Iran with severe visual deficits were sequentially selected. Severe visual deficit was defined as having one enucleated eye or corrected distant visual acuity less than 20/200 in at least one eye. Informed consent was obtained from all patients. Data were gathered using demographic, Mental Health, and Young Maladaptive Schema questionnaires. Also structured clinical interview was performed. Chisquare and regression tests were used to analyze the data.Results: A significant correlation was found between the majority of early maladaptive schemas and mental health in these patients. There was a strong negative correlation between psychological well-being and four schemas of vulnerability to harm or illness, dependency, insufficient self-control/self-discipline, and defectiveness/shame (p<0.01). Also, there was a strong positive correlation between psychological distress and four schemas of vulnerability to harm or illness, dependency, mistrust/abuse, and insufficient selfcontrol/ self-discipline (P<0.01).Conclusion: Early maladaptive schemas destroy psychological well-being and increase psychological distress. Considering these psychological variables may help prevention, diagnosis, and treatment of patients with severe visual deficits.

 The time frame was until the end of 2016. Then, the results were refined to the countries. Therefore, the total number of documents related to the category of Ophthalmology, Iran, and other countries were recovered. The data analyses were performed using Excel software.Results: The results showed that a total of 1558 records in the field of Ophthalmology were indexed in the Web of Science Database by Iranian researchers until the end of 2016. The “Tehran University of Medical Sciences” and “Shahid Beheshti University of Medical Sciences” were identified as the most productive centers in Ophthalmology with a contribution rate of 43.13% and 38.48%, respectively. The results also showed that the most international collaboration of Iranian researchers was with the United States scientific centers. Most articles in the field of Ophthalmology (176 articles) were published in the “Iranian Journal of Ophthalmology”. Most scientific productions in this field, were related to the “surgery” (10.65%), “psychology” (4.42%) and “children” (3.53%). Most scientific productions of Ophthalmology were published in the form of “article” and in “English” language.Conclusion: Results showed that Iranian scientific productivities in the field of Ophthalmology have reached its peak by 2010; but they has been descending in the recent years. Therefore, we should pay more attention to this issue and find out the obstacles of research productivity. Conditions and possibilities must provide to researchers pay more attention to this field. We should try to develop research capacity and lead to prompting in productivity of Iranian ophthalmologists and vision researchers.

Macrolides are a group of antibiotics which are effective against Gram-positive and Gram-negative microorganisms, as well as some sensitive species of Mycobacteria (such as Kansasii and Scrofulaceum), Legionella pneumophila, mycoplasma, Rickettsia, chlamydia and Campylobacter. Azithromycin is a relatively new drug from macrolides family that has extended half-life, broad spectrum, easy application and few side effects. Because of these advantages, this drug is now more frequently used by ophthalmologist. This review article deals with applications, pharmacokinetics and side effects of azithromycin.