Relation between serum ferritin and liver and heart MRI T2* in beta thalassaemia major patients

There is a need for higly accurate non-invasive methods for assessing organ iron content in thalassaemia patients. This study evaluated the relation between serum ferritin level, liver enzyme levels and hepatitis C antibody and liver and heart iron deposition assessed by MRI T2 Data were obtained from the medical records of 156 thalassemia major patients in Tehran. There was a moderate negative correlation between serum ferritin and liver MRI T2 relaxation time [r= -0.535] and a weak negative correlation between serum ferritin and heart MRI T2 relaxation time [r= -0.361]. Hepatitis C infection and liver enzyme levels did not confound or modify the relation between ferritin and liver or heart MRI T2. Liver and heart MRI T2* readings were poorly correlated [r= 0. 281]. Routine evaluation of liver and heart iron content using MRI T2 is suggested to better evaluate the haemosiderosis status in thalassemia patients

[Randomized trial of intravitreal clindamycin and dexamethasone versus pyrimethamine, sulfadiazine, and prednisolone in treatment of ocular toxoplasmosis]

To compare the efficacy of intravitreal clindamycin and dexamethasone with classic treatment for ocular toxoplasmosis. In this prospective, randomized single-masked clinical trial a total of 68 patients with active ocular toxoplasmosis were assigned randomly to 2 treatment groups: 34 in the intravitreal clindamycin plus dexamethasone [IVCD] group and 34 in the classic treatment [CT] group. The IVCD group received 1 to 3 injection[s] of 1 mg intravitreal clindamycin and 400 microg dexamethasone, and the CT group received 6 weeks of treatment with pyrimethamine and sulfadiazine plus prednisolone. Antitoxoplasmosis antibodies [immunoglobulin [Ig] M and IgG] were measured using an enzyme-linked immunosorbent assay. The mean number of injections in the IVCD group was 1.6. Lesion size reduction was statistically significant after treatment in both IVCD and CT groups [P< 0.001 and P: 0.009, respectiveiy]. The difference in mean percentage of reduction at 6 weeks was not significant: 57 +/- 27.6% in the IVCD group versus 58.4 +/- 29.3% in the CT group. In comparison to baseline, VA increased by 0.44 +/- 0.24 and 0.29 +/- 0.19 logarithm of the minimum angle of resolution units in the IVCD and CT groups, respectively [P< 0.001]; however, the difference in VA improvement between the groups was not significant. The interaction effect of IgM and treatment group on lesion size reduction was significant [P= 0.002]; this indicated that IgM-positive cases responded better to CT and IgM-negative cases responded better to IVCD treatment. Vitreous inflammation reduction was comparable between the groups. Within 2 years, 4 eyes [2 in each group] had 1 episode of recurrence. Adverse drug reactions occurred in 2 patients in the CT group. No major injection-related complication was encountered in the IVCD group. Intravitreal injection of clindamycin and dexamethasone may be an acceptable alternative to classic treatment in ocular toxoplasmosis. It may offer more convenience, a safer systemic profile, greater availability, and fewer follow-up visits and hematologic evaluations

[Comparative study of three phakic intraocular lenses in correction of myopia]

To compare visual outcomes and surgical complications of three phakic intraocular lenses [pIOLs]; Artisan, Artiflex and the Implantable Collamer Lens [ICL] for correction of moderate to high myopia. In this historical cohort study, 112 myopic eyes that were operated between 2005 and 2010 and implanted with one of these three pIOLs were evaluated [Artisan 40 eyes, Artiflex 36 eyes and ICL 36 eyes]. Mean follow up period was 30 +/- 11 months. Intraoperative complications were evaluated. All patients were recalled and a complete ophthalmologic examination including refraction, best corrected visual acuity [BCVA] and intraocular pressure was performed. Pachymetry, endothelial cell count as well as postoprerative higher order aberrations were evaluated and compared with corresponding preoperative values. No significant intraoperative complications were reported. BCVA improvement, more than one line on the Snellen chart occurred in 25%, 19.4% and 38.9% of eyes in Artisan, Artiflex and ICL groups, respectively [P=0.158]. Preoperative spherical equivalent [SE] in Artisan, Artiflex and ICL groups was -11.6 +/- 3.7, -9.59 +/- 1.97 and -12.3 +/- 4.8 diopters, respectively. Reduction changes in SE was not statistically significant among the 3 groups [P=0.237]. Mean reduction of astigmatism was 0.31 +/- 0.72, 0.45 +/- 0.62 and 0.0 +/- 0.57 in Artisan, Artiflex and ICL groups, respectively [P=0.07]. Postoperatively, 60% of Artisan, 91.7% of Artiflex and 77.8% of ICL eyes were within one diopter of emmetropia, but the change was statistically significant between Artisan and Artiflex groups [P=0.017]. Percentage of endothelial cell loss was 10 +/- 9%, 9 +/- 6% and 9 +/- 10% in Artisan, Artiflex and ICL groups, respectively [P=0.694]. Pachymetry changes was minimal and the difference among groups was not statistically significant [P=0.754]. Higher order aberrations [P=0.039], vertical trefoil [P=0.032] and spherical aberration [P=0.001] were higher in Artisan than ICL. Total aberrations [P=0.028] and spherical aberration [P=0.001] was higher in Artisan than Artiflex. Visual outcomes such as BCVA improvement, reduction in SE and astigmatism were comparable among Artisan, Artiflex and ICL groups. There was no significant intra and postoperative complications in the 3 groups. Due to the increased higher order aberrations and problems in quality of vision in myopic eyes after implantation of Artisan lens, ICL and Artiflex may be better choices

[Randomized trial of intravitreal bevacizumab alone or combined with triamcinolone versus macular photocoagulation in diabetic macular edema]

To compare the results of intravitreal bevacizumb [IVB] injection alone or in combination with intravitreal triamcinolone acetonide [IVT] versus macular laser photocoagulation [MPC] as primary treatment of diabetic macular edema [DME]. In this randomized clinical trial, 150 eyes of 129 patients with clinical DME and no previous treatment were enrolled. The eyes were randomly assigned to one of the three study arms: the IVB group received 1.25 mg IVB [50 eyes]; the IVB/IVT group received 1.25mg of IVB and 2 mg of IVT [50 eyes]; and the MPC group underwent focal or modified grid laser [50 eyes]. Retreatment was performed at 12-week intervals whenever indicated. Visual acuity [VA] changes among the groups were statistically significant at 6 [P<0.001] and 24 [p=0.012] weeks. VA change was significant only in the IVB group at 12 weeks. VA changes +/- standard deviation at 36 weeks were -0.28 +/- 0.25, -0.04 +/- 0.33, and +0.01 +/- 0.27 LogMAR in the IVB, IVB/IVT, and MPC groups, respectively [P=0.053]. Significant reduction in central macular thickness [CMT] was observed in all groups only up to 6 weeks; however, CMT changes were not significantly different among the groups in all visits. Overall, retreatment was required for 27 eyes up to 36 weeks [14 in the IVB group, 10 in the IVB/IVT group, and 3 in the MPC group]. In the IVB group, in which greater VA improvement was observed, only one injection was required in 72% of the cases. VA improvement more than 2 Snellen lines at 36 weeks occurred in 37%, 25%, and 14.8% of patients in the IVB, IVB/IVT and MPC groups, respectively. Intravitreal bevacizumab injection in patients with DME yielded a better visual outcome at 24 weeks compared with macular photocoagulation. After 6 weeks changes in CMT and VA were not compatible. No adjunctive effect of IVT was demonstrated

[New criteria to assess the risk of acute angle closure]

To compare anterior segment and ocular biometric parameters of unaffected fellow eyes of patients with a previous attack of acute angle closure [AAC], primary angle closure suspect [PACS] eyes, and normal eyes; and to assess the risk of developing AAC in PACS. In this prospective comparative observational case series, 16 unaffected fellow eyes of patients with a previous attack of AAC [group I], 40 PACS eyes [group II] and 32 normal eyes [group III] were evaluated. Pentacam and A-scan echography were performed in all cases. Anterior chamber angle [ACA], anterior chamber volume [ACV], anterior chamber depth [ACD], central corneal thickness [CCT], keratometry [KR], lens thickness [LT] and axial length [AL] were measured in all eyes as main outcome measures. Age, CCT and LT were comparable among the study groups [all P values>0.05]. Mean ACA was 24.8, 22.9 and 35.4 in groups I, II, and III respectively [P<0.001]. Corresponding values for ACV were 72, 76 and 172 microl, respectively [P<0.001]. Central ACD measured from the endothelium was 1.80, 1.91, and 3.09 mm in groups I, II, and III respectively [P<0.001]. Using receiver operating characteristic [ROC] curves, ACV

[Inferior oblique muscle recession versus myectomy for inferior oblique overaction]

To determine the effect of recession and myectomy on inferior oblique overaction [IOOA]. This study was performed on 50 patients [82 eyes] scheduled for IOOA surgery who were randomly divided into two groups: recession [R] versus myectomy [M]. A complete eye examination was performed before the operation. IO was cut off at its inferior temporal region when using M procedure. In the other group [R] after disinsertion, the IO muscle was sutured to 2mm lateral and 3.5 to 4mm posterior to the insertion of the inferior rectus. After at least 3 months, the same examinations were repeated. Successful surgery was defined as IOOA<+1. Twenty-five men [50%] and 25 women with the mean age of 12.3 +/- 5.9 [range 3-32] years entered the study. The surgery was performed in 18 patients unilaterally and in 32 patients bilaterally. Both myectomy and recession methods were successful in reducing IOOA [PM<0.001, PR<0.001]. The amount of IOOA reduction was 2.37 in the M group and 1.92 in the R group which was not significantly different [P=0.097, using Mann-Whitney test]; however, ordinal logistic regression showed a difference [P=0.016]. We found primary IOOA without superior oblique underaction [SOUA] in 28 eyes in the M group and in 32 eyes in the R group. Secondary IOOA with superior oblique underaction [SOUA] was found in 14 eyes in the M and in 8 eyes in the R group, respectively. In patients with more initial IOOA, the outcomes of both methods were better compared to patients with less initial overaction. There was no statistically significant difference in postoperative function of IO between these two methods of surgery [P=0.051]. Both methods resulted in equal improvements in SOUA and V-pattern. Complications included new hypertropia [2%], new DVD [dissociated vertical deviation] [8%] and asymmetry [2%]. Both recession and myectomy have significant weakening effect on IOOA. Myectomy results in more normal function of IOOA but IOUA is also higher with this method. Both methods are more effective if the initial overaction is higher

[Corneal endothelial cell density and morphology after photorefractive keratectomy with mitomycin C]

To assess the short-term effect of Mitomycin-C [MMC] 0.02% on endothelial cell density and morphology after photorefractive keratectomy [PRK] in patients with moderate myopia. Forty-two eyes of 21 participants with moderate myopia [range, -4.0 to -8.0 D] underwent PRK with MMC 0.02% for 40 seconds. Specular microscopy was performed preoperatively and repeated 6 months after surgery to determine any change in central endothelial cell density [ECD], mean cell area [MCA], and coefficient of variation in cell size [CV]. Mean patient age was 26.2 +/- 6.3. Mean preoperative spherical equivalent refractive error was -5.2 +/- 1.2 D which was reduced to -0.4 +/- 0.5 D postoperatively [P < 0.001]. Mean ECD was reduced insignificantly from 2920 +/- 363 cells/mm2 preoperatively to 2802 +/- 339 cells/mm2 postoperatively [P = 0.59]. Similarly, there was no significant change in MCA [P= 0.76] or CV [P= 0.52] at six months. Intraoperative MMC 0.02% applied for 40 seconds during PRK for moderate myopia did not significantly change central corneal endothelial cell density and morphology after 6 months

[Mitomycin-C drops versus subconjunctival 5-fluorouracil for management of early bleb failure]

To compare the efficacy and safety of topical Mitomycin-C [MMC] drops versus subconjunctival 5-Fluourouracil [5-FU] injections for management of early bleb failure after trabeculectomy or combined phacoemulsification and trabeculectomy with posterior chamber intraocular lens implantation [PT+PCIOL]. In a comparative study, 37 eyes of 37 patients with impending early bleb failure were randomly allocated to MMC 0.02% eye drops [19 eyes] or subconjunctival 5-FU injections [5mg each dose] [18 eyes] for 2 to 4 weeks or. Main outcome measures included intraocular pressure [IOP], and bleb morphology according to the Indiana Bleb Appearance Grading Scale. Other outcome measures included success rate, number of glaucoma medications, best corrected visual acuity [BCVA] and complications. Complete success was defined as 5

[Success rates of scleral buckling with and without retinopexy]

To compare the anatomical results of scleral buckling surgery with and without retinopexy in the management of phakic rhegmatogenous retinal detachment [RD]. In this retrospective, nonrandomized, interventional, comparative case series, data of 71 phakic eyes of 71 patients with rhegmatogenous RD that had undergone scleral buckling were evaluated. The procedure in 41 consecutive eyes was accompanied by retinopexy using intraoperative transscleral cryotherapy [6 cases] or postoperative laser photocoagulation [35 cases].The next 30 eyes did not receive retinopexy.The primary outcome measure was retinal redetachment rate.The secondary outcomes measures were final visual acuity and the occurrence of cystoid macular edema and macular pucker. The two groups were matched regarding age, sex, history of trauma or high myopia, and duration of RD before the surgery as well as the characteristics of the breaks and RD except for RD externt which was more in the non-retinopexy group. Retinal redetachment occurred in 4 patients [13.3%] in the nonretinopexy group and in 6 patients [14.6%] in the retinopexy group.The difference was not statistically significant [P>0.999].Neither was the difference between the groups significant in terms of final visual acuity and the occurrence of cystoid macular edema and macular pucker. Retinopexy does not seem to offer additional benefit to scleral buckling surgery for phakic rhegmatogenous RD in terms of anatomical and functional success. However, thses findings have to be confirmed in a randomized clinical trial

[Agreement among galilei, orbscan II, and placido disk-based topography]

To evaluate agreement between Galilei, Orbscan II, and placido disk-based topography in terms of keratometry readings, and anterior and posterior elevation. In this prospective comparative study, 184 eyes of 92 keratorefractive surgery candidates were evaluated with Galilei, Orbscan II, and placido disk-based topography. Keratometry readings and anterior and posterior elevation maps were compared using ANOVA and paired t-test. Mean keratometry reading by Galilei, orbscan II and corneal topography was 44.30 +/- 1.49 D, 44.11 +/- 1.47 D, and 44.60 +/- 1.56 D, respectively. The maximum difference in SimK and astigmatism obtained three devices was less than 0.5 D with respect to the anterior and posterior best fitted sphere, the agreement between the Galilei and orbscan II was 0.96 and 0.95, respectively. Maximum elevation of the anterior central cornea was 9.17 +/- 5.1 m by orbscan II and 3.2 +/- 1.78 m by Galilei. Maximum depression of the posterior central cornea was 33.84 +/- 9.33 mm and 6.81 +/- 3.78 m, respectively. Despite a significant difference in mean keratometry readings, the three devices can be used as the difference in measurements was not clinically significant. However a large amount difference was found between Galilei and orbscan II interms of anterior and posterior maximum elevation values

[Quality of life [QOL] in myopia corrected with photorefractive keratectomy, contact lenses and spectacles]

The Impact of Photo Refractive Keratectomy Compared with Using Glasses or Contact Lens on Patient's Quality of Life [QOL] in Myopia. In this retrospective cohort study, 102 myopic patient who had undergone PRK [at least 6 months ago] and 106 myopic patients using glasses or contact lens were included. Changes in vision related QOL, uncorrected and best corrected visual acuity [UCVA, BCVA] and refraction were compared between the two groups. QOL was assessed using the VFQ-25 questionnaire which contains 25 questions in 12 subscales [score: 0-100]. Total QOL score in patients using glasses or contact lens, and patients who had undergone PRK was 86.1 +/- 10.7 and 97 +/- 4.4 respectively [P

[Intravitreal bevacizumab [avastin] injection alone or combined with triamcinolone versus macular photocoagulation as primary treatment for diabetic macular edema; an interim analysis]

To report the efficacy of a single intravitreal injection of bevacizumab [IVB] alone or in combination with intravitreal triamcinolone acetonide [IVT] versus macular laser photocoagulation [MPC] as primary treatment for diabetic macular edema [DME]. This randomized three-arm clinical trial included 103 eyes of 97 patients with clinically significant DME and no previous treatment. The eyes were randomly assigned to one of the three study arms: the IVB group received 1.25 mg IVB [37 eyes], the IVB/IVT group received 1.25 mg IVB together with 2 mg IVT [33 eyes], and the MPC group underwent focal or modified grid laser photocoagulation [33 eyes]. Primary outcome measure was change in best-corrected visual acuity [BCVA]. Changes in BCVA [logMAR] at 12 weeks were -0.22 +/- 0.23, -0.13 +/- 0.31 and +0.08 +/- 0.31 in the IVB, IVB/IVT and MPC groups, respectively. The marginal regression model based on generalized estimating equation analysis demonstrated that changes in visual acuity was statistically significant in the IVB group at both 6 [P<0.001] and 12 [P=0.024] weeks but only at 6 weeks in the IVB/IVT group. Significant decrease in central macular thickness [CMT] was observed in the IVB and IVB/IVT groups at 6 weeks. Up to 12 weeks, IVB treatment in eyes with DME yielded better visual outcome than laser photocoagulation, although it was not associated with a significant decrease in CMT. IVT seemed to have no further beneficial effect in combination with IVB

[Superior versus inferior Ahmed glaucoma valve implantation]

To compare the efficacy and safety of Ahmed Glaucoma Valve [AGV] implantation in the superior versus inferior quadrants. This prospective parallel cohort study was performed on 106 eyes of 106 patients with refractory glaucoma. Main outcome measures included intraocular pressure [IOP] and rate of complications. Other outcome measures included best-corrected visual acuity [BCVA], number of glaucoma medications and success rate [defined as at least 30% IOP reduction and 5

[Association between acute corneal hydrops in patients with keratoconus and mitral valve prolapse]

To investigate the association between acute corneal hydrops in patients with keratoconus [KCN] and mitral valve prolapse [MVP]. This case-control study included KCN patients with corneal hydrops who were referred to Labbafinejad Medical Center or a collaborating private clinic from March 2006 to March 2008 as the case group. The control group included age- and sex-matched individuals who were selected from patients without any ophthalmic diseases among clients of the same medical centers. Patients with history of eye trauma, corneal degenerative diseases, rheumatic fever, Marfan syndrome, rheumatoid arthritis, and systemic lupus erythematous were excluded. The size of the control group was four times that of the case group to increase the power of the study. All subjects were referred for cardiac examination and underwent two-dimensional M-mode and color Doppler echocardiography. Proloff's criteria were used for diagnosis of MVP. Fisher exact test and logistic regression were used to compare these two groups. Overall, 160 patients [32 cases and 128 controls] with mean age of 31.0 +/- 13.2 were studied. Prevalence of MVP was 65.6% in the case group and 9% in controls [P<0.001]. Patients with hydrops had an odds ratio of 26.7 for having MVP [95% confidence interval, 9.5-75.2]. Age- and sex-adjusted analysis revealed a higher correlation between the two conditions in the case group. There seems to be a correlation between corneal hydrops secondary to KCN and MVP suggesting the need for cardiovascular evaluation in these patients to assess mitral valve status

[Intravitreal injection of bevacizumab versus triamcinolone acetonide in patients with refractory CME]

To compare intravitreal bevacizumab [IVB] with intravitreal triamcinolone acetonide [IVT] for treatment of refractory uveitic cystoid macular edema [CME]. In this randomized clinical trial, 31 eyes with uveitic CME were allocated into 2 groups: the IVB group, received one to three injections of 1.25 mg bevacizumab [15 eyes]; the IVT group received one to three injections of 2mg triamcinolone [16 eyes]. The primary outcome measure was change in best-corrected visual acuity [BCVA] at 36 weeks. Visual acuity improvement as compared to baseline values was meaningful in the IVB group at 12, 24, and 36 weeks and in the IVT group at 24 and 36 weeks. A significant reduction in central macular thickness [CMT] was observed only in the IVT group at week 36 [74.6?108.0 microm [P=0.049]]. Intergroup analysis however, disclosed no significant difference in any of the outcome measures. By removing the effect of cataracts, IVT had a better improving effect on VA [P=0.007]. No significant systemic side effect was observed during the study period. IVB was as effective as IVT in refractory uveitic CME regarding VA improvement. Irrespective of triamcinolone-induced cataract, the effect of IVT may be superior to IVB

[Outcomes of amniotic membrane grafting in surgery for severe upper lid cicatricial entropion]

To evaluate the efficacy of amniotic membrane [AM] grafting in surgery for severe upper lid cicatricial entropion. This randomized clinical trial was performed on both upper eyelids of 22 patients with severe cicatricial entropion. On one side the anterior and posterior lamellae were split and the anterior lamella was recessed. On the other side, the same procedure was done but bare tarsus was covered with AM. Patients were evaluated one day, one and two weeks, and one and three months after surgery. The mean follow-up period was 9.89 +/- 6.17 [range 4-21] months. Overall, 22 patients [13 women and 9 men] aged 55 to 84 years [mean age, 71.54 +/- 8.58] entered the study. The cause of cicatricial entropion was old trachoma in 18 [81.8%] and idiopathic in 4 [18.2%] subjects. In second week, eyelids with AM stained less with fluorescein than the control group [P= 0.016]. At the end of the first month, all lids were epithelialized. There was no significant difference between the two groups in the number of lids with recurrent trichiasis but the number of lashes in contact with the globe in the AM group was significantly lower than the controls [P= 0.042]. There was no significant difference in tarsal shrinkage and normalization of bare tarsus between the study groups. Subgraft hemorrhage occurred in 3 cases in the first week which completely resolved by one month. AM is a useful tissue which can enhance reepithelialization of bare tarsus and may be considered as an adjunct in lid split entropion surgery

[Assessing Iranian ophthalmologists' perception of english language presentations in scientific congresses]

To assess the English language competence of Iranian ophthalmologists and their points of view regarding the need for and importance of holding ophthalmologic congresses in English. A descriptive-analytic, cross sectional study was conducted during the 17th Iranian Ophthalmology Congress, Tehran. Data collection was performed via a standard self administered questionnaire. Five-hundred question forms were distributed among ophthalmologists and answers were graded using an ordinal five-level score. The response rate of this study was 94.6%. The English competence of 200 [42.3%] of the responders was good or perfect. Overall, about 90% of the responders agreed on holding ophthalmologic congresses in English; 72 [15.2%] individuals proposed holding speeches in English at all sessions, 189 [40.0%] preferred holding the main hall speeches in English and 162 [34.2%] said that the best way is to have only foreign guests' speeches in English. Most ophthalmologists implied that holding ophthalmic congresses in English and inviting foreign lecturers is of great importance and the best form of performance is holding all lectures in the main hall in English. It seems that improving the English abilities of ophthalmologist together with holding English congresses and inviting foreign lecturers may help improve international communications and update their knowledge

[Keratocyte density in keratoconus and post-LASIK corneas with and without keratectasia; a confocal scan study]

To compare keratocyte density in stromal layers of the cornea in keratoconus, post-LASIK keratectasia, LASIK without keratectasia, and normal corneas by confocal scan. Thirty-one unscarred corneas from 22 patients with keratoconus, 24 clear corneas from 17 cases with post-LASIK keratectasia, 12 corneas from 7 LASIK cases without keratectasia, and 26 corneas from 13 normal subjects were evaluated using confocal scanning. None of the patients were contact lens wearers. Keratocyte density was determined in three stromal layers and compared with densities in the corresponding layers in control corneas. Cell densities in different corneal layers were also compared among the study groups. Overall, 93 eyes from 59 patients with mean age of 30 +/- 7.3 years were evaluated. There was no difference in mean keratocyte density at 3 stromal layers between the keratoconus and control groups. In the post-LASIK keratectasia group, keratocyte density was significantly lower than controls in the anterior and posterior stromal layers; whereas in LASIK cases without keratectasia it was lower than controls in all 3 stromal layers. No difference in keratocyte density was found between cases with post-LASIK keratectasia and LASIK without keratectasia. In the post-LASIK keratectasia group, there was a significant difference in keratocyte density between the anterior and posterior, and between the middle and posterior stromal layers; such a difference was not observed in the LASIK cases without keratectasia. Mean keratocyte density seems to be lower in post-LASIK keratectasia and LASIK cases without keratectasia as compared to normal corneas. The distribution of keratocytes among different stromal layers was different in the two LASIK groups: there was a non-homogenous distribution of keratocytes in stromal layers in the post-LASIK keratectasia. Whereas the distribution of keratocytes in the post-LASIK cases without keratectasia was homogenous, this latter observation may be a protective factor against corneal ectasia

[Amplitude and facility of accommodation in myopic eyes after photorefractive keratectomy]

To determine the amplitude and facility of accommodation after photorefractive keratectomy [PRK] in myopic subjects. The study was performed on 160 eyes of 80 patients aged 19 to 72 years. Amplitude and facility of accommodation was evaluated before and 2 weeks and one and three months after PRK. Amplitude of accommodation was evaluated by "Minus Lens" method and facility of accommodation was determined using alternate plus and minus lens technique. Overall 67.5% of cases were female and mean age was 26.1 +/- 5.4 years. Mean amplitude of accommodation was 3.8 +/- 1.4 diopters [D] preoperatively which reached 4.5 +/- 1.6 D [P=0.02] two weeks and 4.9 +/- 1.4 D [P=0.03] one month postoperatively but remained stable up to three months. Mean binocular facility of accommodation was 5.8 +/- 3.4 cycles/minute [c/m] preoperatively which reached 7.4 +/- 3.6 c/m two weeks [P<0.001], 9.2 +/- 3.4 c/m [P<0.001] one month and 10.0 +/- 3.2 c/m [P<0.001] three months postoperatively. The amplitude and facility of accommodation in young myopic patients gradually increases after PRK. Near work and accommodative vision will improve over time

[Correlation of otolaryngological disorders and congenital nasolacrimal duct obstruction]

To determine the frequency of otolaryngological disorders in patients with congenital nasolacrimal duct obstruction [CNLDO] as compared to controls. In this case-control study, 80 children with CNLDO [cases] and 80 children without CNLDO [controls] were examined for ophthalmological and otolaryngological dosirders. Data analysis was performed using Pearson Chi-square and Fisher exact tests for frequency values and t-test for mean values. Mean age was 22.7 +/- 14.3 [range 5-72] months in the case group and 23.4 +/- 13.7 [range 9-72] months in controls [P=0.76]. CNLDO was bilateral in 7 [8.75%], left-sided in 23 [28.75%] and right-sided in 50 [62.5%] cases .There were no significant differences between cases and controls in nasal, oral and external ear examinations, however otitis media with effusion [OME] was found in 26.3% of cases vs 10% in controls [P=0.01]. Odds ratio for OME in the CNLDO group was 3.2 [95% confidence interval, 1.32-7.75]. Tympanometry was type A in 71.3%, type B in 22.5%, type C in 5% and unrecordable in 1.3% of cases compared to type A in 88.8% and type B in 11.2% of controls [P=0.01]. The incidence of asymptomatic OME in patients with CNLDO is higher than controls therefore, children with CNLDO may need screening for OME for timely diagnosis and treatment