Purpose: To evaluate the results of pars plana LENSectomy in patients with hereditary LENS SUBLUXATION.Method: Hospital records of patients with hereditary LENS SUBLUXATION who had undergone pars plana LENSectomy at Labbafinejad Medical Center, Tehran-Iran from 1996 to 2003 were reviewed. Patients with more than 6 months of follow up were included. Underlying disorders, best corrected visual acuity (BCVA) before and after surgery, intraocular pressure (IOP), postoperative refraction and complications were evaluated. Results: Overall, records of 87 eyes of 49 patients including 27 male and 22 female subjects were reviewed. Mean follow up duration was 20±18 months. Underlying disorders leading to LENS SUBLUXATION included Marfan syndrome (79.5%), Weill-Marchesani syndrome (8.2%), simple ectopia lentis (8.2%), and homocystinuria (4.1%). The most common indication for surgery was non-correctable refractive error (92.1%). Mean BCVA was 1.13 LogMAR (20/250) preoperatively, which improved to 0.26 LogMAR (20/30-20/40) postoperatively (P<0.001). BCVA ³20/40 was achieved in 82.8% of cases after surgery. Angle-supported anterior chamber intraocular LENS (ACIOL) was implanted in 85.1% of the eyes. Prophylactic band was applied in 63 eyes (72.4%). Retinal detachment developed in four eyes (4.6%) and was successfully treated.Conclusions: LENSectomy/anterior vitrectomy with implantation of an angle-supported ACIOL in patients with hereditary LENS SUBLUXATION improves vision significantly without considerable complications.

Introduction: LENS luxation generally happens secondary to trauma and hereditary disorders into the vitreous body. However, spontaneous dislocation especially into the anterior chamber occurs rarely. We report an unusual case with spontaneous anterior dislocation of a posterior chamber intraocular LENS (IOL) 4 years after cataract surgery.Case Presentation: A 42-year-old woman was referred to ophthalmology department with complaint of sudden onset blurring of vision in the left eye 4 years after cataract surgery. No history of trauma and systemic disorder was reported and no capsular fibrosis was found during eye examination. The patient underwent corneoscleral incision under general anesthesia and the IOL was extracted using a viscoelastic material.Conclusions: To our knowledge, this is the first reported case in the literature. This report may imply that IOL related factors could be considered for spontaneous dislocation of intraocular LENSes.

Introduction: Homocystinuria is a hereditary disease caused by a defect in the enzymes involved in metabolizing methionine. Homocystinuria can influence many systems and may be mistaken for other diseases, includingMoyamoya disease. Here, we report the case of a 10-year-old male patient with a diagnosis of Moyamoya diseasewhohad been monitored for that for an extended period.The patient’s diagnosis was changed to homocystinuria as a result of LENS SUBLUXATION and cataract findings.Case Presentation: A 10-year-old male patient presented with vomiting, headache, lethargy, muscular weakness, and eye redness. The patient was mentally retarded, his right pupil was hyperemic, and he had muscle weakness on his left side. In addition, his blood pressure was high. The patient’s history included a diagnosis of Moyamoya. A neck and cranial computed tomography (CT) angiography showed no flow bilaterally past the bifurcation of the carotid artery. The patient’s bilateral internal carotid arteries were determined to be occluded. It was considered that his eye findings could be compatible with a metabolic disease. Onmetabolic screening, the patient’s homocysteine level was very high. In addition, a heterozygous A1298C mutation was identified in MTHFR.Therefore, the patient was started on a diet free from homocysteine and methionine. In addition, his treatment regimen included vitamins B12 and B6. With these treatments, the patient’s complications regressed.Conclusions: In cases of unusual vascular lesions, metabolic diseases must be considered. In homocystinuria, early diagnosis and treatment are important. Blood homocysteine levels can be returned to normal, and some complications can be prevented.

This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine SUBLUXATION in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications.100 rheumatoid arthritis patients (18 male and 82 female) were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, and physical examination has been done with focus on the cervical spine to determine their demographic data, disease duration, age of disease onset, drug history, swollen and tender joint counts, and ESR, Hb, CRP, RF levels. The disease activity of patients with rheumatoid arthritis was measured using the disease activity score 28. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of the neck and anterioposterior and odontoid projection view. Asymptomatic cervical spine SUBLUXATION was found in 17 of the 100 patients (17%). The prevalence of, anterior atlantoaxial SUBLUXATION, atlantoaxial impaction and subaxial SUBLUXATION was 10 (10%), 5 (5%) and 6 (6%), respectively. Posterior SUBLUXATION was not detected.The only characteristic that showed meaningful relationship with cervical spine SUBLUXATION was CRP (P=O.036). Our results showed that patients with RA, who have cervical spine SUBLUXATION cannot be distinguished on the basis of symptoms. Cervical spine involvement is common and may be asymptomatic, indicating routine cervical spine imaging is needed in patients with RA.

Congenital anterior tibiofemoral SUBLUXATION is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral SUBLUXATION as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

Introduction: Traumatic eye injuries (TEI) involved about 3% of cases referred to the emergency departments of developing countries. LENS dislocation is one of the critical cases of ophthalmic emergencies. The present study was aimed to evaluate the diagnostic accuracy of ultrasonography in detection of traumatic LENS dislocation.Methods: In this cross-sectional study the findings of ultrasonography and orbital computed tomography (OCT) of head and face trauma patients, referred to Imam Reza hospital, Tabriz, Iran, from July 2013 to June 2014, have been compared. The sensitivity, specificity, positive and negative likelihood ratio, positive and negative predictive value, and accuracy of ultrasonography were calculated. Cohen's kappa coefficient was presented to assess the agreement of ultrasonography with OCT findings.Results: One hundred thirty patients with the mean age of 35.4±18.0 were evaluated (75.4% male). Sensitivity and specificity of ultrasonography were 84.6% (95% Cl: 53.7-97.3) and 98.3% (95% Cl: 93.3- 99.7), respectively. Also, positive and negative likelihood ratio were calculated 49.5 (95% Cl: 12.3-199.4) and 0.15 (95% Cl: 0.04- 0.56), respectively. Cohen's kappa coefficient of 0.83 (95% Cl: 0.66-1.0; p<0.0001) was representative of excellent agreement of these two tests.Conclusion: The finding of this project was representative of 84.6% sensitivity, 98.3% specificity, and 96.9% accuracy of ultrasonography in detection of traumatic LENS dislocation. It seems that in cases which OCT is not possible, ultrasonography could be an acceptable option to assess traumatic eye injuries.