[Risk of sleep apnea in patients with atrial fibrillation]

Sleep apnea is defined as more than 10 seconds to stop the air flow in the adult airway, which may occur due to upper airway obstruction during sleep. Sleep apnea is highly prevalent among patients with cardiovascular disease, so that 50% of patients with atrial fibrillation suffer from sleep apnea. Therefore, this current study discussed the risk of sleep apnea in patients with atrial fibrillation. This comparative-descriptive study with convenience sampling was performed on 150 patients with atrial fibrillation and 150 patients without atrial fibrillation admitted to CCU of Imam Khomeini's hospital, Saghez, Iran. Patients were matched for age and sex. Data was collected using demographic and Berlin questionnaire. Data analysis was performed by SPSS16 statistical software and descriptive and inferential statistical tests. Blood pressure in patients with atrial fibrillation was significantly higher than patients without atrial fibrillation [p=0.001]. In the groups with and without atrial fibrillation, 60% and 36% had a high risk of sleep apnea, respectively. Patients with sleep apnea were prone 2.98 times to atrial fibrillation more than those without this disorder. According to high incidence of sleep apnea and atrial fibrillation in the CCU, using the screening methods for patient's identification to reduce the risk factors among these patients seems to be necessary

Central corneal thickness in Iranian congenital glaucoma patients

To compare central corneal thickness [CCT] in subjects with controlled primary congenital glaucoma [PCG] and nonglaucomatous subjects and to investigate the correlation between CCT and intraocular pressure [IOP] in the study population. Twenty-three consecutive PCG cases with controlled IOP and no clinical evidence of corneal edema comprised the Study Group. There was an interval of at least 2 months between last intraocular surgery and inclusion in the study. Twenty-one subjects with strabismus or lacrimal drainage insufficiency who did not have glaucoma or any history of intraocular surgery or ocular trauma comprised the control group. The Control Group was age and sex-matched. Data from ultrasonic pachymetry and applanation tonometry were analyzed for differences between groups. Correlation of the study parameters was investigated. A P-value less than 0.05 was statistically significant. Data from both eyes of subjects in the Study Group and Control Group were included in the original analysis. Mean CCT was statistically significantly higher in the Study Group compared to the Control Group [589.42 +/- 53.44 æm vs. 556.14 +/- 30.51 æm, respectively; P=0.001]. There was a significant correlation between CCT and IOP [r=0.63; P<0.0001]. Similar statistically significant outcomes were observed when only one eye per subject was used in a reanalysis of the data for the Study and Control Groups. Patients with PCG who had controlled IOP have statistically significantly thicker corneas than nonglaucomatous age and sex-matched subjects The thicker cornea could significantly alter IOP measurement with applanation tonometry. Pachymetry should be considered an essential part of the evaluation for PCG

Office-based slit-lamp needle revision with adjunctive Mitomycin-C for late failed or encapsulated filtering blebs

The purpose of this study was to assess the results of bleb needling in glaucomatous patients with late failed filtering blebs. A retrospective case series of 27 eyes of 27 patients was considered. All patients underwent needle bleb revision with adjuvant mitomycin-C performed at the slit lamp, during an office visit. Complete success was defined as postneedling intraocular pressure [IOP]=21 mmHg without any antiglaucoma medications and qualified success was IOP=21 mmHg with topical antiglaucoma medications. There were 12 eyes with encapsulated blebs and 15 eyes with flat blebs. The mean interval between index filtering surgery and bleb revision was 32.74 +/- 15.36 months. Mean IOP was 25.07 +/- 4.80 mmHg before surgery and 19.66 +/- 4.97 mmHg at last postoperative follow-up. The mean follow-up was 20.31 +/- 15.63 months. Complete and qualified successes were 7.4% and 51.9%, respectively. Cumulative rates of success at 1, 2, 3, and 4 years were 76%, 65%, 49%, and 37%, respectively. The mean number of antiglaucoma medications was reduced from 3.15 +/- 0.36 preoperatively to 2.33 +/- 1.21 postoperatively [P<0.001]. Slit-lamp needle revision in office is a simple and effective method for treating late encapsulated or flat filtering blebs without significant complications even for late bleb failure

Early-onset pseudoexfoliation syndrome following multiple intraocular procedures

To present early-onset ocular manifestations of pseudoexfoliation syndrome in young patients who had undergone multiple intraocular procedures. This is an observational case series, introducing four cases with histories of multiple intraocular procedures for glaucoma. All reported cases demonstrated typical manifestations of pseudoexfoliation unilaterally in the eye that had undergone multiple surgeries. The diagnosis of pseudoexfoliation was made prior to the age of 50 in all subjects and the earliest manifestation was at the age of 18 in a case with primary congenital glaucoma. The role of multiple surgical procedures, in addition to genetic predisposition, should be further investigated as a possible inciting factor predisposing to pseudoexfoliation in younger individuals.