[Outcomes of lensectomy, posterior capsulotomy, anterior vitrectomy and posterior chamber intraocular lens implantation in pediatric cataracts]

To evaluate the visual outcomes and complications of lensectomy, posterior capsulotomy, anterior vitrectomy and Acrylic hydrophobic posterior chamber intraocular lens [PCIOL] implantation for congenital or developmental cataract in children 6-9 years of age. In a prospective interventional case series, 13 eyes of 10 children with congenital or developmental cataract underwent the above-mentioned surgery. Patients were followed for at least six months postoperatively. Pre- and postoperative visual acuity as well as intra- and postoperative complications were evaluated. Mean age was 7.8 +/- 1.2 [range 6-9] years. Patients were followed for a mean period of 13.3 +/- 7 months after surgery. Mean preoperative visual acuity was 1 +/- 0.1 LogMAR which reached 0.1 +/- 0.1 LogMAR at final follow up [P<0.0001]. No intraoperative complication occurred. All cases had clear visual axis at the last visit. Lensectomy, posterior capsulotomy, anterior vitrectomy and PCIOL implantation in 6-9 years old children with congenital or developmental cataract is a safe procedure and effective in terms of visual improvement

[Deep lamellar endothelial keratoplasty [DLEK] for management of corneal endothelial disorders]

To evaluate the visual outcomes and complications of deep lamellar endothelial keratoplasty [DLEK] for management of corneal endothelial disorders. From 2003 to 2005, nine eyes of nine patients with severe bullous keratopathy due to endothelial dysfunction underwent DLEK. Uncorrected [UCVA] and best-corrected [BCVA] visual acuity were evaluated pre- and one week, 1, 3 and 6 months postoperatively. The sutures were removed 3-4 months postoperatively in all eyes. Five female and four male subjects with mean age of 66.3 +/- 10.9 years underwent DLEK. Preoperative diagnoses included aphakic bullous keratopathy [ABK, 2 cases], pseudophakic bullous keratopathy [PBK, 4 cases] and Fuchs' endothelial dystrophy [FED, 3 cases]. Mean BCVA was 1.7 +/- 0.5 LogMAR [20/1000] preoperatively which improved to 1.4 +/- 0.1 LogMAR one month [P=0.02], 1.4 +/- 0.2 LogMAR three months [P=0.04] and 1.2 +/- 0.4 LogMAR six months [P=0.01] postoperatively. Mean corneal astigmatism was 7.43 +/- 5.02 diopters one month after DLEK which decreased to 4.06 +/- 3.58 at final follow up. All eyes had clear graft and cornea after 6 months. Postoperative complications included transient leakage [two eyes], lenticule displacement, graft wrinkling, double chamber formation, mild interface hemorrhage and filamentary keratitis [each in one case]. Cystoid macular edema was present in four eyes. DLEK has acceptable results for replacement of the endothelium in patients with ABK, PBK and FED. The most important drawback of this technique is the complexity of the equipment and the procedure. DSAEK [Descemet stripping automated endothelial keratoplasty] seems to be replacing DLEK due to less dependence on instruments and being a more simple procedure

[Effect of religious fasting on basal tear secretion, tear break up time and intraocular pressure]

To compare the effect of religious fasting on basal tear secretion [BTS], tear break up time [TBT] and intraocular pressure [IOP] in Ramadan 2005. One-hundred fifty-six healthy male volunteers less than 40 years of age from Tehran, Zahedan, Ahvaz, Mashhad and Tabriz with no ocular and systemic disease participated in this study. Weight, urine specific gravity, BTS, TBT and IOP were measured at 8:00 AM one week before as well as at 8:00 AM and 5.00 PM in the third week of Ramadan. Mean age of participants was 30 +/- 5.9 years. Duration of fasting was 12-13 hours. Mean TBT, BTS and IOP decreased by 1.8 second [P<0.0001], 2.1 mm [P<0.0001] and 0.5 mmHg [P<0.0001], respectively at 5:00 PM in the third week of Ramadan compared to 8:00 AM one week before Ramadan. IOP reduction was not clinically significant. Significant decrease in BTS and TBT was seen after three weeks of religions fasting

Clinical aspects and results of lensectomy in hereditary lens subluxation

To evaluate the clinical manifestations and results of lensectomy in patients with hereditary lens subluxation at Labbafinejad Medical Center, Tehran-Iran from 1996 to 2003. In an interventional case series, records of patients with hereditary lens subluxation who had undergone lensectomy were reviewed. Patients with at least 6 months of follow up were included. Background disease, best corrected visual acuity [BCVA] before and after surgery, intraocular pressure [IOP], and post-operative refraction and complications were evaluated. The study was performed on 87 eyes of 49 patients including 27 male and 22 female subjects. Mean follow up was 20 +/- 18 months. 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 preoperatively which improved to 0.26 Log MAR post-operatively [P< 0.001]. BCVA better than 20/40 was achieved in 82.8% of cases after surgery. Angle-supported anterior chamber intraocular lens [AC IOL] was implanted in 85.1% of the eyes. Prophylactic band was applied in 63 eyes [72.4%]. Retinal detachment developed in four eyes, which was successfully treated. Lensectomy with implantation of angle-supported AC IOL in patients with hereditary subluxated lens will improve vision significantly without significant complications

[Indications for penetrating keratoplasty in Iran; 1994-2004]

To determine the indications for penetrating keratoplasty [PK] in Iran over an 11-year period. All eye bank records of patients who underwent PK from 1994 to 2004 at ophthalmologic centers throughout Iran were reviewed. During this 11-year period, a total of 19,668 cases were operated. The most common indication for penetrating keratoplasty was keratoconus [34.5%], followed by corneal opacity and scar [18.7%], pseudophakic bullous keratopathy [9.2%], corneal dystrophies [6.5%], aphakic bullous keratopahty [6.1%], and regraft [5.3%]. There was an increasing trend in rates of keratoconus and pseudophakic bullous keratopathy and a decreasing trend in aphakic bullous keratopathy during this period. [P<0.001] No significant change of trend was noted in the corneal opacity and scar, regraft, and corneal dystrophy groups. Keratoconus is the most common indication for penetrating keratoplasty in Iran