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   2013| July-September  | Volume 20 | Issue 3  
    Online since July 9, 2013

 
 
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ORIGINAL ARTICLES
Comparison of corneal curvature and anterior chamber depth measurements using the manual keratometer, lenstar LS 900 and the pentacam
Ömür Ö Uçakhan, Veysel Akbel, Zeynep Biyikli, Ayfer Kanpolat
July-September 2013, 20(3):201-206
DOI:10.4103/0974-9233.114791  PMID:24014981
Purpose: The purpose of this study was to compare keratometry and anterior chamber depth (ACD) measurements from the Lenstar LS 900 (Haag-Streit AG, Switzerland) and the Pentacam (Oculus, Weltzar, Germany), and compare the keratometry readings of these two systems to a manual keratometer (MK), (Haag-Streit, Switzerland). Materials and Methods: In this prospective study, keratometry and ACD measurements were obtained in 50 eyes of 50 normal subjects with the Lenstar and the Pentacam. Keratometry was also measured using a MK. Correlation, comparison, and interdevice agreement was evaluated using intraclass correlation analysis, Wilcoxon test, and Bland-Altman plots. Results: The keratometry and ACD measurements obtained from the Lenstar and the Pentacam showed excellent correlation. The mean interdevice differences in mean keratometry (Km) for the Lenstar and the Pentacam, the Lenstar and the MK, and the Pentacam and the MK were 0.39 D, 0.10 D, and 0.30 D respectively; and the 95% limits of agreement (LoA) for Km were 0.04-0.82 D; −1.90-2.10 D; and −2.30-1.70 D, respectively. The mean interdevice difference in ACD for the Lenstar versus the Pentacam was 0.09 mm, with 95% LoA of 0.23-0.05 mm. Conclusions: The ACD measurements obtained using the Lenstar and the Pentacam seem to be interchangeable, whereas, the keratometry measurements obtained using the Lenstar, Pentacam, and MK differ considerably, and are not interchangeable.
  7 1,410 137
CASE REPORTS
Bilateral congenital lacrimal fistula in down syndrome
Manpreet Singh, Usha Singh
July-September 2013, 20(3):263-264
DOI:10.4103/0974-9233.114807  PMID:24014994
Congenital lacrimal fistulae are rare in Down syndrome and bilateral presentation is very unusual. It can be associated with nasolacrimal duct obstruction. We report a 3-year-old female with Down syndrome who presented with watering and discharge from both eyes and bilateral fistulous openings present inferonasal to the medial canthus. Upon examination, the lacrimal sac regurgitation test was positive on both sides. Our case report documents a distinctive case of bilateral congenital lacrimal fistulae in association with Down syndrome. It was managed successfully by primary fistulectomy and nasolacrimal duct probing.
  4 1,880 112
ORIGINAL ARTICLES
Eyelid masses: A 10-year survey from a tertiary eye hospital in Tehran
Abbas Bagheri, Mehdi Tavakoli, Azadeh Kanaani, Reza Beheshti Zavareh, Hamed Esfandiari, Maryam Aletaha, Hossein Salour
July-September 2013, 20(3):187-192
DOI:10.4103/0974-9233.114788  PMID:24014978
Purpose: The purpose of this study was to evaluate the demographics and clinical features of eyelid masses in a tertiary eye hospital over a 10-year period. Materials and Methods: A retrospective chart review was performed for patients admitted with eyelid tumors from 2000 to 2010. Data were collected and analyzed on the demographic features, location of the tumor, types of treatment, and pathologic findings. Results: A total number of 182 patients were evaluated of which, 82 cases were benign and 100 cases were malignant neoplasms. The most common benign tumors included melanocytic nevi (35%), papilloma (19.5%), and cysts (11%). The most frequent malignant tumors included basal cell carcinoma (BCC) (83%), squamous cell carcinoma (8%) and sebaceous gland carcinoma (6%). The most common site for malignancy was the lower lid followed by the upper lid. BCC recurred in 16 cases that were most frequent in the lower lid. Conclusion: Melanocytic nevus, papilloma and cysts are the most common benign lesions and BCC is the most common malignant lesion in the eyelids. Recurrence is a feature of BCC especially in the lower lid.
  4 2,855 273
Efficacy of intacs intrastromal corneal ring segment relative to depth of insertion evaluated with anterior segment optical coherence tomography
Hassan Hashemi, Alireza Yazdani-Abyaneh, Amirhushang Beheshtnejad, Mahmood Jabbarvand, Ahmad Kheirkhah, Seyed Reza Ghaffary
July-September 2013, 20(3):234-238
DOI:10.4103/0974-9233.114800  PMID:24014988
Aim: To evaluate the effect of implantation depth of Intacs microthin prescription inserts (Addition Technology Inc, Fremont, California) on visual and topographic outcomes in patients with post- laser-assisted in situ keratomileusis (LASIK) ectasias. Settings and Design: Retrospective, observational case series. Materials and Methods: In this case series, 16 eyes of 12 patients were evaluated. All cases were post-LASIK ectasia that had undergone intrastromal corneal ring segment (ICRS) implantation. The planned insertion depth was 70% of stromal thickness using a manual dissector. At least 12 months postoperatively, all eyes underwent Visante (Carl Zeiss Meditec) AS-OCT to determine insertion depth. Cases were categorized into 3 groups based on the measured implantation depth: 40-59% thickness; 60-79% thickness; and ≥80% thickness. Visual, refractive and topographic outcomes were evaluated relative to implantation depth. Results: The lowest improvement in the study parameters ocurred when the implantation depth was ≥80%. In this group, uncorrected visual acuity (UCVA) and best spectacle corrected VA (BSCVA) improved less than 0.5 lines. Manifest refractive spherical equivalent (MRSE) and mean keratometry (Km) change was less than 0.5 diopters (D). The greatest improvements were observed with implantation depth of 60-79% where UCVA and BSCVA increased by 4.5 and 2.5 lines respectively, and MRSE and Km changed by approximately 2.00 D. Less improvement was found when ICRS were implanted between 40-59% of stromal thickness. Conclusion: Implantation of ICRS greater than 80% of stromal thickness may have no effect on visual and topographic status.
  3 1,914 160
Loop suture technique for optional adjustment in strabismus surgery
Rishi K Parikh, Christopher T Leffler
July-September 2013, 20(3):225-228
DOI:10.4103/0974-9233.114797  PMID:24014986
Purpose: To describe a loop suture technique that allows intraoperative conjunctival closure and later optional suture adjustment in strabismus surgery in uncooperative patients. Materials and Methods: This retrospective case series comprised 25 patients. After a recessed or resected horizontal muscle was secured to the sclera with a primary suture suspended back 2 mm, a second loop suture was passed through the body of the muscle and under the primary suture knot. The loop suture could be removed later while the patient was awake, or it could be tied to advance the muscle. Success was defined as a residual deviation of 10 prism diopters (PD) or less at 2 months postoperatively. Results: In the study cohort, 20 patients had successful alignment at 2 months (80%). Six patients (24%) underwent postoperative suture tightening by the loop technique, and each muscle affected the alignment an average of 7.7 PD (±3.8 PD). No patients underwent a reoperation within the first 2 months. One patient had a pyogenic granuloma (4%). Conclusions: The loop suture technique permits optional postoperative tightening of muscles and avoids sedation in children or uncooperative patients not requiring adjustment.
  2 5,064 128
Barriers to cataract surgical uptake in central ethiopia
Zelalem Addisu Mehari, Redda Tekle Haimanot Zewedu, Fitsum Bekele Gulilat
July-September 2013, 20(3):229-233
DOI:10.4103/0974-9233.114798  PMID:24014987
Purpose: The aim of this study was to assess the factors that delay surgical intervention in patients suffering from age related mature cataract in Ethiopia. Materials and Methods: A short term descriptive study was performed that evaluated patients with mature cataract presenting to outreach eye care clinics in rural central Ethiopia. Patients were interviewed to determine the reasons for delay in their cataract surgeries. Result: A total of 146 subjects (57 male and 89 females) with operable age related cataract were evaluated at 31 outreach clinics. Over 86% of the respondents were above 55 years of age, (range, 45-78 years). The male to female ratio was 1:1.5 and 30.2% of the subjects were blind bilaterally (best corrected visual acuity <3/60). The majority of the respondents were farmers (53.4%) and 86.3% were illiterate. The major factors that delayed cataract surgery included: Cost of surgery (91.8%), insufficient family income (78.1%), good vision in the fellow (unaffected) eye (39.7%), and the distance to hospital from their village (47.9%). Conclusion: Surgical cost, insufficient family income, and the distance to an eye care centre were the major factors delaying cataract surgery in rural Ethiopia.
  2 2,198 239
CASE REPORTS
Acute hydrops in the donor cornea graft in non-keratoconus patients
John B Cason, Samuel C Yiu
July-September 2013, 20(3):265-267
DOI:10.4103/0974-9233.114808  PMID:24014995
A 44-year-old Hispanic male and 91-year-old Caucasian male presented to the clinic with acute vision loss and pain years after penetrating keratoplasty (PKP). Neither patient had a history of keratoconus. Both patients had a history of eye rubbing and intraocular device present in the anterior chamber. The first patient had a history of a glaucoma drainage tube and the second patient had an anterior chamber intraocular lens implanted. Anterior segment ocular coherence tomography showed deep stromal cystic cavities. Both patients exhibited breaks in the endothelium by ultrasound biomicroscopy and the histopathologic examination after repeat PKP. Those findings were most consistent with acute corneal hydrops in the donor graft.
  1 1,556 83
Oculocardiac reflex in a medial orbital wall fracture without clinically evident entrapment
Lakshman Swamy, Laura T Phan, Zakeya M Sadah, Timothy J McCulley, Ronald E Warwar
July-September 2013, 20(3):268-270
DOI:10.4103/0974-9233.114810  PMID:24014996
In this report, we describe a patient with a medial wall orbital fracture, who presented with vasovagal-like symptoms secondary to an oculocardiac reflex. This case is unusual because the patient had no other clinical evidence of muscle entrapment. A 15-year-old male presented with daily 5-10 min episodes of dizziness, light headedness, and nausea consistent with a vasovagal reaction. On examination, the patient had full extra ocular motility and was orthotropic in all fields of gaze. On computed tomography a comminuted medial orbital wall fracture was identified. The adjacent medial rectus muscle was in normal position, but was "rounded" relative to the contralateral side. The patient underwent fracture repair with immediate resolution of all symptoms. Symptoms related to a vasovagal response may occur with orbital fractures despite normal extra ocular motility. Presumably this relates to tension or pulling on an extra ocular muscle, which is not to a degree that alteration in function is appreciable clinically.
  1 1,790 107
EDITORIAL COMMENTARY
Beyond a typical thyroid eye disease
Mohsen Bahmani Kashkouli
July-September 2013, 20(3):185-186
DOI:10.4103/0974-9233.114787  PMID:24014977
  1 1,365 148
ORIGINAL ARTICLES
A single drop of 0.5% proparacaine hydrochloride for uncomplicated clear corneal phacoemulsification
Rajesh Subhash Joshi
July-September 2013, 20(3):221-224
DOI:10.4103/0974-9233.114795  PMID:24014985
Purpose: The purpose of this study was to compare the efficacy of a single drop of 0.5% proparacaine hydrochloride in uncomplicated cataract surgery with phacoemulsification. Materials and Methods: Two hundred and ninety five patients scheduled for the phacoemulsification were divided into 2 groups based on the anesthetic agents they were to receive: 146 patients who received a single drop of 0.5% proparacaine 2 min before the start of the surgery (proparacaine group) and; 149 patients who received supplementation of 0.5% intracameral preservative free xylocaine (xylocaine group). A single surgeon performed all surgeries. Intraoperative and post-operative pain scores were evaluated on a visual analog scale. The surgeon noted his subjective impression of corneal clarity, discomfort while performing the surgery any supplemental anesthesia required and intraoperative complications. An anesthetist noted vital parameters and the need for intravenous sedation. Total surgical time was noted. Comparison of parameters was performed with the Chi-square test, and A P value less than 0.05 was considered as statistically significant. Results: No statistically significant difference was seen in the intraoperative (P = 0.24) and post-operative (P = 0.164) pain scores between groups. There was no pain (0 score) in 41.8% of patients in the proparacaine group and 46.3% of patients in the xylocaine group. The average surgical time (P = 0.279) and surgeon discomfort (P = 0.07) were not statistically significantly different between groups. No patients required supplemental anesthesia. There were no surgical complications that could compromise the visual outcome. An equal number of patients in both groups preferred same type of anesthetic technique for the fellow eye cataract surgery (89.11% for the proparacaine group and 90.18% for the xylocaine group). No patients in either group had changes in vital parameters or required intravenous sedation. Conclusion: A single drop pre-operatively, of proparacaine hydrochloride was comparable to the intracameral supplementation of preservative free xylocaine for phacoemulsification in uncomplicated cataract surgery without compromising the visual outcome. However, we recommend individualizing the anesthetic technique according to the requirements of the surgeon.
  1 1,859 123
Anterior orbit and adnexal amyloidosis
Hailah Al Hussain, Deepak P Edward
July-September 2013, 20(3):193-197
DOI:10.4103/0974-9233.114789  PMID:24014979
Purpose: To describe six cases of anterior orbital and adnexal amyloidosis and to report on proteomic analysis to characterize the nature of amyloid in archived biopsies in two cases. Materials and Methods: The clinical features, radiological findings, pathology, and outcome of six patients with anterior orbit and adnexal amyloidosis were retrieved from the medical records. The biochemical nature of the amyloid was determined using liquid chromatography/mass spectroscopy archived paraffin-embedded tissue in two cases. Results: Of the six cases, three had unilateral localized anterior orbit and lacrimal gland involvement. Four of the six patients were female with an average duration of 12.8 years from the time of onset to presentation eyelid infiltration by amyloid caused ptosis in five cases. CT scan in patients with lacrimal gland involvement (n = 3) demonstrated calcified deformable anterior orbital masses and on pathological exmaintionamyloid and calcific deposits replaced the lacrimal gland acini. Ptosis repair was performed in three patients with good outcomes. One patient required repeated debulking of the mass and one patient had recurrenct disease. Proteomic analysis revealed polyclonal IgG-associated amyloid deposition in one patient and AL kappa amyloid in the second patient. Conclusion: Amyloidosis of the anterior orbit and lacrimal gland can present with a wide spectrum of findings with good outcomes after surgical excision. The nature of amyloid material can be precisely determined in archival pathology blocks using diagnostic proteomic analysis.
  1 2,064 150
Etiology of tearing in patients seen in an oculoplastic clinic in Saudi Arabia
Amal Bukhari
July-September 2013, 20(3):198-200
DOI:10.4103/0974-9233.114790  PMID:24014980
Aim: To determine the prevalence of various causes of tearing among patients referred to an oculoplastic clinic. Materials and Methods: A prospective study on all patients seen in an oculoplastic clinic with a chief complaint of tearing. The cause of tearing was determined on the basis of the anatomical location of the primary etiology. Results: This study included 357 patients with a mean age 53.9 years. Punctal stenosis was the most common etiology, affecting 37.8% of the patients. Among patients with punctual stenosis, 63.4% were women over 50-year-old (P = 0.001); 55.6% had tearing for less than 6 months (P = 0.038), and all of them had associated chronic blepharitis. The remaining study participants had dry eye with reflex tearing (27.7%), nasolacrimal duct obstruction (10.1%), canalicular obstruction (4.2%), entropion or ectropion (3.4%), pterygium (1.7%), megalo-caruncle (1.7%), and functional tearing (1.7%). Conclusion: The outcomes of this study indicate the most common cause of tearing is punctal pathology. Therefore, slit lamp evaluation with careful attention to the punctum is warranted in all patients with tearing.
  1 1,520 127
Autologous cryoprecipitate for attaching conjunctival autografts after pterygium excision
Anas A Anbari
July-September 2013, 20(3):239-243
DOI:10.4103/0974-9233.114801  PMID:24014989
Purpose: To report the efficacy, safety, and reliability of autologous cryoprecipitate in pterygium excision surgery and to compare it with the traditional method of using absorbable sutures, in regard to surgical time and the patient comfort. Materials and Methods: A prospective interventional clinical study was carried out in a specialized eye clinic. A total of 54 patients (90 eyes) underwent surgical excision of the nasal pterygium (whether primary or recurrent) with conjunctival autograft obtained from the same eye. Patients were divided into two groups. Autologous cryoprecipitate was used in 47 eyes (glue group), and absorbable sutures (8/0 vicryl) were used in 43 eyes (suture group) to attach the free conjunctival graft. There were 42 primary and 48 recurrent nasal pterygia that were included in the study. The surgical time was noted, and post-operative pain was graded. Follow-up period ranged from 6 months to 18 months (mean 12 months). P< 0.05 was statistically significant. Results: The medians of the visual analogue scale values were significantly lower in the glue group (P< 0.05). The median surgical time was statistically significantly lower at 11 min (range 9 min to 15 min) in the glue group, compared to 21 min (range 12 min to 28 min) for the suture group (P< 0.05). No significant intraoperative or post-operative complications were noted. Recurrence rate was 12%, and all recurrence cases occurred in the sutures group. Conclusions: Application of autologous cryoprecipitate glue instead of sutures for attaching the free conjunctival graft in pterygium surgery resulted in less post-operative pain and shorter surgical time. Additionally, there were no cases of recurrence during the follow-up in patients who received autologous cryoprecipitate glue during pterygium surgery.
  1 2,574 177
Vitrectomy for posterior segment intraocular foreign bodies, visual and anatomical outcomes
Khalil Ghasemi Falavarjani, Masih Hashemi, Mehdi Modarres, Mohammad Mehdi Parvaresh, Masood Naseripour, Hossein Nazari, Ali Jalili Fazel
July-September 2013, 20(3):244-247
DOI:10.4103/0974-9233.114803  PMID:24014990
Purpose: To evaluate the visual and anatomic results and determine the prognostic factors after pars plana vitrectomy and posterior segment intraocular foreign body (IOFB) removal. Materials and Methods: This retrospective study reviews the patients' charts of 48 consecutive patients with posterior segment IOFB who underwent pars plana vitrectomy and IOFB removal over a 4-year period, recently. Association between visual outcome and various preoperative, operative, and postoperative variables was statistically analyzed. Data were analyzed with the paired t-test and the chi square test. Statistical significance was indicated by P < 0.05. Results: The mean interval between the time of injury and IOFB removal was 24 ± 43.1 days and 27 (53%) eyes underwent IOFB removal within 7 days of the injury. Nine (19.1%) patients achieved a visual acuity of 20/40 or better. An improvement of visual acuity of at least three lines occurred in 21 (44.6%) eyes and the vision remained unchanged in 15 (31.9%) eyes. Postoperative retinal detachment occurred in five (10.6%) eyes. Visual improvement was more likely to occur in eyes with lower levels of presenting visual acuity (P = 0.2). Visual improvement was not associated with an entry site and IOFB location, lens injury, time to surgery, and pre- and post-operative retinal detachment. At the end of follow up, anatomical success was achieved in 97.9% of eyes. Conclusions: High anatomical success could be achieved after the removal of posterior segment IOFBs by vitrectomy, despite a delay in surgery. Poor visual outcome may be mainly due to the initial ocular injury.
  1 1,788 197
REVIEW ARTICLE
Albinism: Particular attention to the ocular motor system
Richard W Hertle
July-September 2013, 20(3):248-255
DOI:10.4103/0974-9233.114804  PMID:24014991
The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a) periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has "typical" types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function.
  1 5,087 201
CASE REPORTS
Successful use of intravitreal bevacizumab and pascal laser photocoagulation in the management of adult Coats' disease
Naz Raoof, Fahd Quhill
July-September 2013, 20(3):256-258
DOI:10.4103/0974-9233.114805  PMID:24014992
Traditional methods of managing exudative retinal detachment secondary to Coats' disease have been associated with varying degrees of success. We describe a case of a 34 year-old male who presented with a sub-total exudative retinal detachment of the right eye that encroached upon the macula, associated with a vasoproliferative tumor secondary to Coats' disease. The patient under-went successful treatment with two intravitreal injections of bevacizumab (Avastin, Genetech Inc., San Francisco, CA, USA) combined with targeted laser photocoagulation with a 532 nm Pascal laser (Topcon Corp., Tokyo, Japan). The visual acuity improved 5 days after the second intravitreal injection from 6/18 to 6/5, with no residual macular edema and complete regression of the vasoproliferative tumor. The improvement in visual acuity was maintained at 12 months post-treatment. We believe this is the first case report describing the successful use of Pascal laser photocoagulation with intravitreal bevacizumab in the treatment of Coats' disease. Our aim was to defer laser treatment until 'near total' retinal reattachment and regression of the vasoproliferative tumor was achieved. There are, however, reports of vitreous fibrosis in patients with Coats' disease treated with intravitreal bevacizumab. This suggests further long-term follow-up studies are required in patients treated with this approach.
  - 1,594 124
Eyelid angiosarcoma: A case report and review of the literature
Hakan Demirci, Murray D Christanson
July-September 2013, 20(3):259-262
DOI:10.4103/0974-9233.114806  PMID:24014993
A 77-year-old woman presented with a 3-month history of a lesion on her left lower eyelid. External examination showed a tan-colored nodule with an overlying crust-covered ulcer on the left lower eyelid, nasally. The ulcer measured 12 mm × 7 mm. Complete surgical excision with a frozen section margin control was performed. Histopathological examination showed islands and sheets of spindle and epithelioid cells with little intervening stroma. The cells had copious amounts of either rounded or tapered eosinophilic cytoplasm with occasional intracytoplasmic lumina and large vesicular nuclei with prominent nucleoli. There was intense immunoreactivity for CD34, CD31, factor VIII, and Ki-67. The diagnosis was eyelid angiosarcoma. The patient refused any further therapy. At 1-year follow-up, there was no recurrence or development of metastasis. In conclusion, tan-colored eyelid nodules with overlying ulcer are usually a basal cell carcinoma; however, rarely it can be an eyelid angiosarcoma.
  - 1,515 86
ORIGINAL ARTICLES
Diffractive multifocal intraocular lens compared to pseudo-accommodative intraocular lens implant for unilateral cataracts in pre-presbyopic patients
Rajesh Subhash Joshi
July-September 2013, 20(3):207-211
DOI:10.4103/0974-9233.114792  PMID:24014982
Purpose: To evaluate the efficacy of diffractive multifocal and pseudo-accommodative IOLs in pre-presbyopes with cataract. Materials and Methods: A prospective randomized control study was performed on patients with cataract in the pre-presbyopic age group. Patients were randomly allocated to 2 groups: Group 1 comprised 12 patients who underwent implantation of a diffractive multifocal IOL and Group 2 comprised 13 patients who underwent implantation of a pseudo-accommodative IOL after standard phacoemulsification. Efficacy was measured by postoperative distance and near uncorrected visual acuity, contrast sensitivity, spectacle independence, and glare and halo. Between-group comparison was performed with the unpaired t test. Fisher's exact test was used for categorical variables. All the tests were two-sided with confidence interval set at 95%. Results: The study patients were aged 22-35 years and included 14 females and 11 males. All examinations were performed 6 months postoperatively by a second observer unaware of the study objectives. Mean uncorrected distance visual acuity was 0.125 ± 0.1 LogMAR in Group 1 and 0.1385 ± 0.1 in Group 2 (P = 0.7993). Near visual acuity was 0.0917 ± 0.1 in Group 1 and 0.386 ± 0.2 in Group 2 (P < 0.0001). Contrast sensitivity was good in both groups based on the Pelli-Robson chart (P = 0.3919). Night-time glare was present in 3 (25%) patients in Group 1 and in 2 (15.4%) patients in Group 2. No patients in either group had difficulty driving during the day or night. Ten patients in Group 1 (83.3%) and 7 patients in Group 2 (53.85%) had spectacle independence (P = 0.1249). Conclusion: Greater proportions of patients who underwent diffractive multifocal implantation achieved functional distance and near vision as compared to those in the pseudo-accommodative IOL group. There was greater variability in near vision in patients who received the pseudo-accommodative IOL as compared to those in the multifocal IOLs. Contrast sensitivity remained adequate in both the groups. There were more glare and halos in the multifocal group as compared to those in the pseudo-accommodative group. More patients achieved spectacle independence with multifocal IOLs.
  - 2,203 145
Anterior segment study with the pentacam scheimpflug camera in refractive surgery candidates
Masih Hashemi, Khalil Ghasemi Falavarjani, Gholam Hosseyn Aghai, Kaveh Abri Aghdam, Arzhang Gordiz
July-September 2013, 20(3):212-216
DOI:10.4103/0974-9233.114793  PMID:24014983
Purpose: The purpose of this study was to evaluate the anterior segment measurements according to refractive status in a sample of the Iranian population. Setting: Rassoul Akram Hospital, Tehran University of Medical Sciences. Material and Methods: In this study, refractive surgery candidates were assigned according to the refractive error to one of three groups : emmetropia, myopia, and hyperopia. Myopic eyes were further divided to four subgroups : simple myopic group, simple myopic astigmatism group, high myopic group, and high myopia with astigmatism group. Anterior segment measurements with the Pentacam Scheimpflug system were performed in the right eye of all subjects. Results: The study sample was comprised of 283 subjects with a mean age of 29.1 ± 7.5 (standard deviation) years. Mean keratometry reading, Anterior chamber depth (ACD) and volume measurements were significantly higher in the myopic group and mean keratometry reading and anterior chamber angle measurements were significantly lower in the hyperopic group (P < 0.05, all comparisons). Maximum anterior elevation (AE max ) and maximum posterior elevation (PE max ), Q value, progression index, minimum corneal thickness, and corneal volume measurements were similar for all groups (P > 0.05, all comparisons). In the myopic subgroups, AE max and PE max and maximum keratometry (K max ) were significantly higher, and ACD was lower in the astigmatic groups (P < 0.05, all comparisons). The Q value was less negative in low myopia (P < 0.05). Conclusions: Myopic eyes had steeper corneas than hyperopic eyes and anterior chamber measurements were significantly higher in the myopic eyes. In myopic eyes, AE max and PE max and K max measurements were higher, and ACD measurements were lower in the astigmatic groups.
  - 3,615 174
Results of cataract surgery and plasma ablation posterior capsulotomy in anterior persistent hyperplastic primary vitreous
Rajesh Sinha, Shveta Jindal Bali, Chandrashekhar Kumar, Himanshu Shekhar, Namrata Sharma, Jeewan S Titiyal, Rasik B Vajpayee
July-September 2013, 20(3):217-220
DOI:10.4103/0974-9233.114794  PMID:24014984
Purpose: To report the feasibility and outcome of lens aspiration, and Fugo blade-assisted capsulotomy and anterior vitrectomy in eyes with anterior persistent hyperplastic primary vitreous (PHPV). Materials and Methods: In this case series, 10 eyes of 10 patients with anterior PHPV underwent lens aspiration. The vascularized posterior capsule was cut with a Fugo blade (plasma knife) and removed with a vitrector. A foldable posterior chamber intraocular lens (IOL) was implanted in eight eyes and the outcomes were evaluated. Results: The mean age of patients was 16.8 ± 6.37 months (range: 5 to 28 months). The surgery was completed successfully in all eyes. There were no cases of intraocular hemorrhage intraoperatively. Foldable acrylic IOL was implanted in the bag in 3 eyes and in the sulcus in 5 eyes. Two eyes were microphthalmic and did no undergo IOL implantation (aphakic). None of the eyes had a significant reaction or elevated intraocular pressure postoperatively. The follow-up ranged from 4 to 21 months. All the pseudophakic eyes achieved a best corrected visual acuity of ≥20/200 with 50% (4/8) of these eyes with ≥20/60 vision. Conclusion: Lens aspiration followed by posterior capsulotomy with Fugo blade-assisted plasma ablation is a feasible technique for performing successful lens surgery in cases with florid anterior PHPV.
  - 2,046 113
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