comparison of the effect of donor-recipient trephine size disparity on refractive error in keratoconus

To compare the effect of donor-recipient trephine-size disparity on spherical equivalent, and visual outcomes in penetrating keratoplasty for keratoconus. A prospective randomized clinical study conducted between April 2000 and April 2004 in the Ophthalmology Department, Shaheed Sadoughi Hospital, Yazd, Iran. Forty patients with keratoconus were randomly assigned to 2 groups. In group I [n=20] the patients were operated on with under-sized blade [0.25 mm disparity[D]], and in group II [n=20] with over-sized [0.50 mm D] trephine. The spherical equivalent in group I was -2.61 +/- 2.81 D, and -3.92 +/- 3.2ID in group II. We found a better final visual acuity in group I compared with group II. More myopic shift was observed in group II, with greater disparity. Best-corrected visual acuity [BCVA] was better at the final follow-up in group I, compared with group II. Fourteen patients [70%] achieved BCVA 20/40 or better in group I, whereas in group II only 10 pane/its [5.0%] achieved this vision. Mean keratometry was 44.35D in group I, and 45.05D in group II. We conclude that using donor-recipient under-sized trephine [0.25mm D] can be considered a reliable and effective method in reducing postoperative myopia

Prevalence of retinopathy in hypertensive patients

To determine the prevalence of retinopathy in hypertensive patients referred to a teaching hospital in Yazd, Iran. This cross-sectional study included 213 hypertensive patients referring to a teaching hospital in Yazd, Iran between November 2004 and June 2005. Data were collected using a questionnaire after an interview and ocular examination. Demographic variables, hypertensive retinopathy, familial history of hypertension, duration of diagnosis, and other hypertension side effects such as cardiac, renal, cerebro-vascular complications were analyzed. The Scheie's staging system was used for retinopathy grading. A total of 213 patients [95 men, 118 women] with high blood pressure aged between 25 and 85 years [mean age of 64.47 +/- 10.66 years] were enrolled in this study, wherein 39.9% of patients suffered from retinopathy. This rate was higher in women [45.6%] than in men [33%]. The positive familial history of hypertension was reported in 47.8% of patients. The prevalence rate of retinopathy in patients suffering from mild hypertension was 25.3%, moderate hypertension was 34.5% and severe hypertension 84.6%. Of the patients with retinopathy, 42.36% had grade I, 20% had grade II and 2.35% had grade III retinopathy. The most common ophthalmoscopic findings were arteriolar narrowing [35.13%], arterio-venous nicking [17.12%] and cotton wool patches [9%]. Positive family history of hypertension and target organs involvement are important risk factors for retinopathy. Early diagnosis and treatment of hypertension to prevent complications is essential

Results and complications of external dacryocystorhinostomy surgery at a teaching hospital in Iran

To conduct a survey of outcomes, failure frequency rates, and other complications of dacryocystorhinostomy [DCR] at a teaching hospital in Iran. In this outcome study, we survey the results of DCR in 187 consecutive chronic dacryocystitis patients operated at the Eye Department of Yazd Medical University, Iran from March 2001 to April 2003. We investigated the results and probable complications of this surgical procedure. Our data shows that the success rate of the operation was 90.4% with a confidence interval of 95% [86.3-94.5]. The success rate was 91% in female and 89.3% in males [p=0.543]. The failure rate was 9.6%. According to the methods used in this study, the success rate of the external method with silastic intubation was 96.3% and 88% without. These differences, however, were not statistically significant [p=0.08]. The most frequent and important complication of DCR was failure and recurrence of epiphora or purulent discharge [9.6%]. The less frequent complications included scar formation [8.6%], wound infection [5.3%] and granuloma formation [3.2%]. There were no complications during the operation. External DCR is an easy technique with a success rate of more than 90%, with few complications