[Intraocular pressure assessment before and after photorefractive keratectomy using static, dynamic and noncontact pneumotonometry [air puff]]

To compare the preoperative and postoperative measurement of intraocular pressure [IOP] using goldman applanation tonometry [GAT], the air puff and pascal dynamic contour tonometers [PDCT] in eyes undergoing myopic and myopic astigmatic photorefractive keratectomy [PRK]. In a descriptional -analytic and prospective study, a complete examination was performed at the slit lamp, followed by pachymetry and pentacam imaging in patients scheduled for PRK.IOP was measured in myopic and myopic astigmatic eyes before and 2 months after PRK by GAT, PDCT and the air puff tonometer in a randomized sequence at similar times. 1] Before PRK the difference among the 3 tonometers in IOP measurement was compared 2] After PRK the difference among the 3 tonometers was compared in the same manner 3] The difference between pre-operative and post-operative measurements for each instrument was measured 4] Finally dissimilarity of changes from preoperative to postoperative among the 3 instruments was compared. The study included 402 eyes [201 patients, 162 females, 39 males] with mean age of 28.7 +/- 7.03 [18-48]. Mean tonometry before PRK with GAT, PDCT and air puff was: [15.44 +/- 2.79], and [16.81 +/- 3.39], [16.31 +/- 3.36] respectively. Mean IOP after PRK with GAT, PDCT and Air puff was: [12.04 +/- 2.63], [13.57 +/- 2.91] and [11.01 +/- 3.29] respectively. The difference between 3 tonometer in IOP measurement was statistically significant [P<0.001]. In the same manner the difference between 3 tonometer was statistically significant post operatively [P<0.001]. There was statistically significant difference between mean pre-operative and post operative measurement taken by the three instruments [P<0.001]. There was no statistically significant difference between mean changes preoperative with postoperative measurement taken by PDCT and GAT [P= 0.778]. Briefly PDCT and GAT underestimate IOP approximately equally. There was a significant difference between mean changes preoperative with postoperative measurement taken by Air puff compared with GAT, and air puff compared with PDCT [P<0.001]. Measurements of IOP may be underestimated after PRK, by GAT, PDCT and Air puff. This underestimation probably relate to biomechanical changes of the cornea after surface ablation

[Limbal autograft after excision of primary and recurrent pterygium]

To report the result of limbal autografting in primary and recurrent pterygium. In this case series, all patients who were referred to our clinic at Farabi hospital, Isfahan, Iran for treatment of pterygium were included. Indications of surgery included chronic ocular irritation, impaired or threatened vision, ocular motility problem and cosmetic reasons. Under subconjunctional anesthesia, pterygium was removed from the cornea and conjunctiva and a crescent shape limbal tissue from supratemporal region of the same or the sound eye was then prepared and sutured in the area of pterygium removal. In cases with conjunctival problem due to previous surgery or severity of the disease, some amount of conjunctival tissue was also included in the transplanted limbal tissue. Postoperatively, topical betamethasone for 4 weeks and antibiotic for 2 weeks were prescribed. Two-hundred and three eyes were studied of which, 125 eyes [61.6%] had primary and 78 eyes [38.4%] had recurrent pterygium. After at least one year of follow-up, only 9 eyes [4.5%] had recurrence larger than 1 mm. Visual acuity and refraction improved in 60% of the eyes. No significant complication occurred except appearance of a fibrous tissue in the donor site which was not progressive and was covered by the upper lid in all cases. Surgical removal together with limbal autograft is a safe and effective method for treatment of primary and recurrent pterygium

Ferrara intrastromal corneal ring segments in keratoconus

To evaluate the efficacy and safety of Ferrara intra-stromal corneal ring [FISCR] segments for keratoconus. The study was performed on 57 eyes of 44 patients with keratoconus and clear cornea who were contact lens intolerant. Subjects underwent complete ophthalmic examination before surgery. Objective and subjective refraction achieving the best visual acuity was used to determine the refractive error and Orbscan II corneal topography system provided the corneal data on pre- and post-operative visits. FISCR segments were implanted according to the manufacturers monograms and standard surgical method. Mean patients age was 26.7 +/- 6.8 years. Patients were followed for 2-14 months [mean, 9 months]. At last follow-up visit, mean +/- standard deviation improvement in main outcome measures were as follows: 5.4 +/- 3.65 D for spherical equivalent [P<0.001]. 1.89 +/- 2.25 D for magnitude of cylindrical error [P<0.001], 0.61 +/- 0.46 LogMAR for best corrected visual acuity [P<0.001], and 0.18 +/- 0.36 LogMAR for uncorrected visual acuity [P=0.002]. The rings were removed and reimplanted in 3 cases due to inadequate depth and in one case because of suspected infectious keratitis. Implantation of FISCR segments is a safe and reversible procedure, particularly in contact-lens-intolerant patients with keratoconus whose only option is corneal transplantation