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This study determined the clinical effect of subconjunctival administration of bevacizumab in patients with primary and recurrent pterygium. The study was an off-label, single-dosing, interventional case series involving 22 patients with primary and recurrent pterygium. They received subconjunctival bevacizumab [0.2cc]. Pterygium vascularity and thickness was graded. The size of the pterygium [measured by surface area in cm[2]] was recorded from baseline to 12 weeks, after injection. Treatment-related complications and adverse events were reported. The main outcome of measurements was the change in size, vascularity, thickness, color intensity. There were 15 males [68.2%] and 7 females [31.8%] of 22 patients with a mean age of 45.5 years [SD 11.68 years]. One cases didn't cooperate, and excluded. There was a significant difference in the mean surface area of pterygium at different intervals [P < 0.05] and the size of pterygium was reduced. On comparison of the mean pterygium size, there was no significant difference between men and women [P >0.05]. There was a significant reduction in the mean pterygium size of patients younger than 45 years in comparison to those older than 45 years after three month [P =0.037], but after 6 months, this difference was not significant [P = 0.338]. Average changes in pterygium size for both eyes were not different. The reduction of color intensity in both eyes was significant [P =0.031]. Subconjuctival bevacizumab injection is useful in management of patients with primary and recurrent pterygium without significant local or systemic adverse effects
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Humans , Male , Female , Antibodies, Monoclonal, Humanized , ConjunctivaABSTRACT
AIM: To describe the involvement in relatives of kera-toconus (KCN) patients with corneal topography map. METHODS: A total of 300 eyes of 150 siblings of 75 KCN patients referred to corneal clinic were studied and experienced complete slit-lamp, refraction examinations and topographic cornea maps provided by videophoto-keratography. ANOVA, Fisher exact and Chi-square tests were performed to compare the results.RESULTS: From 150 siblings, 56% were female and 44% were male with average age of 21 (range of 15-39) years old. KCN and suspect KCN diagnosed in 12.3% and 6.6% respectively. The central keratometry (CK) was 46.50±4.51 dioptr(D) in KCN and 45.66±1.52 (D) in suspect KCN. Inferior-superior value (I-S) was 3.51±2.50(D) in KCN and 1.56±1.22 (D) in suspect KCN. In KCN condition the oval pattern was 67.6% (n=25) and round pattern detected was 32.4% (n=12). In suspect KCN these patterns detected were 90% and 10% respectively. Refractive errors in KCN were -7.50 to +1.25D(-1.25±1.83), in suspect KCN 0.45 to -4.2D(-0.68±0.76) and in healthy group 2.75 to -7.5D(-0.6±1.12). Astigmatism was mild in 22.7%, moderate astigmatism in 18.3% in KCN and suspect KCN.CONCLUSION: Increase KCN condition in healthy siblings of KCN patients shows require of screening to early diagnose and cautious treatment of contact lens in these individuals.
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AIM: To evaluate Orbscan II corneal topography in hyperopic cases.METHODS: A retrospective, observational, consecutive, clinical case series in two hundred and ninety five eyes of hyperopic patients who undergo a LASIK evaluation. The information that was reviewed included age and sex of the patients and the Orbscan II corneal topographic maps. Refractive powers and the following test indices produced by Orbscan II were analyzed: keratometry, corneal diameter, pupil diameter and anterior chamber depth. RESULTS: The total mean corneal thickness was 546.3±35.5μm.It was found ; 547.3±38.4μm in 17-29 years old, 553.4±38.3μm in 30-44 years old and 546.2±29.3μm in older than 45 years old .The mean corneal thickness was found 551.5±35.9μm in female, and 542.6±34.7μm in male. The total mean depth of anterior chamber was 2.57±0.40mm and in 17-29 years old patients was 2.82±0.39mm. In 30-44 years old patients was 2.49±0.39mm and in patients older than 45 years old was 2.37±0.40mm. The mean depth of anterior chamber was 2.53±0.40mm in female and 2.60±0.40mm in male. A reverse significant relation between corneal thickness and keratometry were found. Refractive error severity had a reverse correlation with depth of anterior chamber and a correlation with keratometry (P=0.061,r=0.108).Corneal thickness had a reverse correlation with keratometry (P=0.005,r=0.160), and correlation with pupil diameter (P=0.013, r=0.144).CONCLUSION: This study provides a description and analysis of Orbscan II findings in hyperopic patients. These show mean corneal thickness 546.3±35.5μm and anterior chamber depth 2.57±0.40mm in hyperopic patients.
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AIM: To determine ocular motor nerve palsy in patients with head trauma.METHODS: There were three hundred admitted cases of head trauma in neurosurgery department of Shahid Rahnemon Hospital from March 2006 to September 2006. Data were collected with ophthalmic examinations, filled in questionnaires and analyzed by SPSS software statistically including Chi-square test and Fisher's exact test.RESULTS: A total of 300 patients were reviewed, 242 (81.1%) men and 58 (18.9%) women. Their age ranged from 1 to 87 years (mean of 46 years). Accident and fall were the most common causes of head trauma, occurring in 247 (82.3%) patients and most of patients had Glasgow Coma Scale (GCS) 13-15(82.3%). The most cerebral lesion was subdural and subarachnoid hematoma. Isolated trochlear and abducens nerve palsy (28.6%), isolated oculomotor nerve and combined nerve palsies (combination of 3rd and 4th cranial nerves, 14.3%) were the most affected nerves.CONCLUSION: Although the cranial nerve palsy is rare with minor head trauma, according to their observation in emergency room, neuroophtalmic examination is advised.
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AIM: To evaluate the results and complications of strabismus surgery in Yazd, Iran.METHODS: A total of 200 patients with strabismus disorder who consecutively undertook eye surgery during 10 years were evaluated for outcomes and complications through a historical cohort strategy design. Follow-up period was 6 months. Data were collected and analyzed by appropriate statistical tests.RESULTS: Patients comprised 98 female and 102 male with a mean age of 15.31±11.7 years. Prevalence of exotropia and esotropia was 43.5% and 47.0% respectively. There is significant relationship between result and type of surgery but there isn't significant relationship between result of surgery and reason and date of strabismus beginning.CONCLUSION: Outcomes of surgery were favorable and longer follow-up is needed to evaluate late results and complications. Based on our results and individual experience revision of Rosenbaum Santiago tables, under-and over-correction are needed.
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·AIM:To evaluate and analyze the visual acuity after secondary anterior and posterior chamber intraocular lens (IOL) implantation in aphakic patients.The most common reasons for performing secondary implantation were dissatisfied with aphakic glasses and intolerance or reluctance to use contact lenses,·METHODS:In this prospective,non randomized compara-tive trial study was done at Ophthalmology Department of Sadoughi Hospital,Yazd,Iran from 1995 to 2005.Posterior chamber lens was inserted in 62 eyes (60.78%) and anterior chamber lens in 40 eyes (39.21%) depending upon the type of previous cataract surgery.Demographic and clinical data was analyzed from the patient's medical records during follow up.·RESULTS:102 patients [42 females (41.18%) and 60 males (58.82%)] underwent secondary lens implantation from 1995 to 2005.Their age range was between 48 and 72 years ( mean = 62.6 years),and mean follow up time was 20.2 months (range of 6 -72 months).There were minor intra operative and post operative complications.The state of visual acuity three months after procedure and final suture removal was as follows:visual acuity of 20/20 in 48 cases (47.05%),visual acuity of 20/40 or better in 51 patients (50%),and decrease in visual acuity (3 lines of snellens chart) in 3 cases (2.95%).·CONCLUSION:The short term complications were not more than that of primary cataract surgery with lens insertion and the visual acuity outcome was as good as the preoperative best correction, so secondary lens implantation appears to be safe and effective for aphakic correction.
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·AIM: To review epidemiological features of 200 cases of ocular and adnexal tumors to determine the demographic and location of tumors in Yazd, Iran from 1997 to 2007.·METHODS: Retrospective, observational case series. We reviewed cases of histopathologically verified oculoorbital tumors at our institution from 1997 to 2007, and studied the distribution of patients age, pathology, origin of tumors, and tumor location in 200 consecutive cases.·RESULTS: Among the 200 cases (111 males, 89 females), 110 (55.0%) were benign tumors, 86 (43.0%) were malignant, and 4 (2.0%) were metastatic tumors. 119 tumors (59.5%) were eyelid tumors, 21 (10.5%) were orbital and 60 (30.0%) were in globe. The most frequent malignant tumors were basal cell carcinoma (BCC) (25.5%), squarnous cell carcinoma (SCC) (6.0%) and melanoma (5.5%). All types of nevus (15.0%), dermoid cyst (5.5%) and hemangioma (5.0%) were the most frequent benign tumors respectively. The age distribution of 200 patients was divided into two groups, under 18 years old and over 18 years old. In age group of less than 18 years old patients, the most common tumors were benign (90.1%) malignant and metastatic tumors were 8.4% and 1.5% respectively. While, in patients over 18 years old, the common tumors were malignant (51.1%), benign tumors were 47. 1% and metastatic tumors were 1.8%.·CONCLUSION: The pathologic profiles of orbital tumors were characterized ccording to patient's age and the location of the tumor in the globe and adnexa. The age of onset and tumor location provide us with important information for prognosis prior to biopsy or tumor re-section and to determine the treatment strategy.
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AIM: To evaluate the results and complications of LASIK surgery in Yazd, Iran.METHODS: In this descriptive study, cases were selected randomly and data from files of 230 operated eyes were filled in a questionnaire with special format. Data of patients who had been operated upon between March 2003 and March 2004 were gathered and evaluated by SPSS software program, in particular, Chi-square and Fisher statistical tests. Patients were followed up for 3 months. Residual refractive error in the range of±0.5 was considered as complete correction and more than±0.5 considered as relative correction.RESULTS: From the total of 230 eyes, 122 eyes were of women and 108 eyes belonged to men. 24 cases (10.4%)were myopic; 188 cases (81.8%) were myopic-astigmatism; 5 cases (2.2%) were hyperopic and 13 cases (5.6%) were hyperopic-astigmatism 204 eyes were in the age group of younger than 40 years and 26 eyes were in the age group of older than 40 years. Based on visual acuity recovering condition, 225 eyes (97.8%) were treated completely and 5 eyes (2.2%) were relatively corrected. Patients were followed up for 3 months after surgery. The rate for complete correction of refractive errors in myopia was 96.0%, myopic astigmatism 88.0%, hyperopia 60.0% and hyperopic astigmatism 62.0%. At 3 months after operation, 224 cases (97.4%) did not have any complications and the others had minor side effects.CONCLUSION: LASIK operation is a safe and effective procedure for correcting refractive errors with limited complications. Results are comparable with similar studies.
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AIM: To investigate clinical presentation, classification,diagnosis, pathogenesis, complication and treatment of blepharitis.METHODS: In this study, 300 patients referred to general eye clinic have been chosen with diagnosis of blepharitis by Haag-streit slit-lamp examination. A questionnaire was filled in for patient with blepharitis. Then, the treatment of out-patient cases based on the causes of the condition was started.Patients were followed up and evaluated with respect to the results and complications of the treatment.RESULTS: The most common form of lesion in seborrheic dermatitis was squamous (62.5%) but ulcerative lesions was the most common in infectious and mixed types (P ＜0.001).Also, Seborrheic blepharitis mostly had chronic clinical course but infectious type commonly was acute (P ＜0.001). A significant difference was found between the cause of blepharitis and incidence of complications including hordeolum, chalazia, epithelial keratitis, conjunctivitis, dry eye (P ＜0.05). Moreover, There was a significant difference between clinical course of disease and complications such as dry eye and epithelial keratitis (P ＜0.05). There was a close relationship between the underlying diseases including seborrheic dermatitis, atopic dermatitis, diabetes mellitus,allergy, acne rosacea and the cause of blepharitis(P ＜0.05).CONCLUSION: The blepharitis is one of the most common problems in general ophthalmology and needs attention to prevent the complications.
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· AIM: This study was conducted to compare the outcomes of amniotic membrane transplantation (AMT) with conjunctival autograft transplantation (CAT) in primary and recurrent pterygium. The main outcome measurement was the recurrence rate after surgery.· METHODS: This study was designed as a prospective study on consecutive cases of pterygium from April 2004 to Feb2006. The cases were randomly divided into two groups of AMT (26 cases) and CAT (24 cases). All subjects were operated with an extensive excision of the fibro vascular tissues with AMT or CAT approach. Patients were followed for recurrence and complications for 24 months. The surgical procedures were performed by a single surgeon.The associations between demographic variables, surgical techniques (AMT, CAT), recurrences and postoperative complications were analyzed.· RESULTS: The patients' male to female ratio was 4:1. Involvement of right to left eye ratio was 3:2. Pterygium in70% of cases was primary and in 30% was recurrent. The most common clinical signs were red eye and reduced visual acuity while the most common complications were recurrence and corneal scar. In the first month of follow up, the recurrence rates in AMT and CAT approaches were 3.8% vs 8.3%respectively and these rates increased to 46.2% vs 25% respectively after 24 months of follow up.· CONCLUSION: The success rate of 2 years follow up was better in CAT technique. The AMT technique for pterygium surgery has an unacceptably high recurrence rate.