effects of riboflavin/ultraviolet: a corneal cross-linking on the signs and symptoms of bullous keratopathy

To evaluate the effectiveness of corneal cross-linking in improving the signs and symptoms of bullous keratopathy. This prospective non-randomized case series evaluated 20 eyes with bullous ketratopathy that underwent corneal cross-linking [C3R] with riboflavin and ultraviolet-A [UVA, 370 nm, 3 mW/cm 2]. C3R was performed for 30 min in a routine procedure after removal of epithelium. Central corneal thickness [CCT], corneal haze, visual acuity [VA], and the presence of irritating symptoms were recorded before the procedure, and at 1 week, 1 month, 3 months, and 6 months after the procedure. The mean CCT was 872 +/- 162 micro m [range: 665-1180 micro m] before the procedure. Following the procedure, CCT was 855 +/- 175 micro m after 1 week, 839 +/- 210 micro m after 1 month, 866 +/- 185 micro m after 3 months, and 863 +/- 177 micro m after 6 months [P>0.05, all visits]. There was no significant improvement in VA or corneal clarity after 6 months. Improvement of the following symptoms: burning, pain, and foreign body sensation were reported after 6 months by 83.3%, 75.0%, and 66.7% of patients, respectively. Persistent epithelial defect occurred in five patients [25%] resolved with frequent lubrication and bandage contact lenses. The outcomes of this study indicate corneal cross-linking is not an effective treatment for bullous keratopathy with respect to VA and CCT, although it can improve irritation and discomfort

study of the complaint of patients coming to the emergency ward of Khatam-Ol-Anbia eye hospital Mashhad. [Center Research Ophthalmology of Mashhad University of Medical sciences]

Ocular emergency is one of the most common problems in the Emergency Department [ED], but a general survey of ocular emergencies has rarely been reported in the literature. This study reviews cases of ocular emergencies presented to the ED of Khatam Hospital [Mashhad] over a 6-months period. A retrospective analysis was done on patients who presented with eye complaints to the ED of Khatam Hospital-Mashhad between March 2007 and August 2007. Ocular diagnoses and hospitalizations due to ocular emergencies in addition to their associated variables were collected and assessed separately. 28,312 patients presented to the ED during the period with eye complaints. The most frequent diagnoses in newly presented patients were grouped as trauma [61%] and inflammatory disorders [22%]. A male to female ratio of about 2.5:1 was assessed. Both genders had the peak age in the third decade. There was a trend toward increased numbers in late spring and early summer. There were a total of 431 cases of hospitalization [1.5% of all presented patients] most of them due to traumatic consequences notably globe rupture [38% of all hospitalizations]. Ocular occupational casualties estimated to be responsible for 43% of all traumatic injuries occurred between 20-59 years of age. Young males were found to run a higher risk of ocular accidents, especially at work. Individuals under 10 years of age estimated to be particularly at risk for severe ocular traumas e.g. eye penetration. Taking more care of these two specially at risk groups and directing protectional educations and preprations towards their work and play could be suggested

Alteration of tear film after vitrectomy and its influencing factors

To detect the prevalence of dry eye after vitrectomy and its influencing factors. Schirmer I, Tear Basic Secretion Test and Tear Breakup Time was done preoperatively and 3 months postoperatively on consecutive patients undergoing vitrectomy in Khatam Hospital from 2005 to 2006. Eyes with previous peritomies of more than 120° and symptoms of dry eye or tear tests compatible with a diagnosis of dry eye were excluded. Intraoperative factors including the extent of peritomy, extent of inadvertent conjunctival lacerations, extent of scleral depression and the instrument used for scleral depression were recorded. Scleral depression was graded extensive if it was done for more than 180° of globe circumference. Seventy five eyes of 75 patients were studied. Forty six [61.3%] of patients were male. The mean age of the patients was 47.13 +/- 18.85 years. Peritomy size was on average 179.33 +/- 124.75 and the mean size of conjunctival ruptures was 2.18 +/- 4.33 mm. Based on the type of instrument used for scleral depression, patients were divided into 4 groups: 1] metallic instrument, 6 cases [8%] 2] cotton applicator 32 cases [42.7%] 3] both, 14 cases [18.8%] 4] none [no scieral depression], 23 cases [30.7%]. Of 52 cases with scleral depression, the depression was extensive in 35 cases [46.7% of all eyes]. Thirteen eyes [17.3%] developed tear film parameters or symptoms consistent with dry eye. All of these eyes had undergone extensive scleral depression. Cotton applicator had been used significantly more in cases which developed dry eye. There was a direct relation between extent of peritomy and inadvertent conjunctival laceration and development of dry eye. Due to damage to the conjunctiva during operation, vitrectomy is apt to cause dry eye. To lower the risk of this complication, scleral depression, peritomy and possibility of inadvertent conjunctival lacerations should be minimized. It is also better to use metallic instruments for scleral depression rather than cotton applicator