Efficacy of intacs intrastromal corneal ring segment relative to depth of insertion evaluated with anterior segment optical coherence tomography

To evaluate the effect of implantation depth of Intacs microthin prescription inserts [Addition Technology Inc, Fremont, California] on visual and topographic outcomes in patients with post- laser-assisted in situ keratomileusis [LASIK] ectasias. Retrospective, observational case series. In this case series, 16 eyes of 12 patients were evaluated. All cases were post-LASIK ectasia that had undergone intrastromal corneal ring segment [ICRS] implantation. The planned insertion depth was 70% of stromal thickness using a manual dissector. At least 12 months postoperatively, all eyes underwent Visante [Carl Zeiss Meditec] AS-OCT to determine insertion depth. Cases were categorized into 3 groups based on the measured implantation depth: 40-59% thickness; 60-79% thickness; and >/= 80% thickness. Visual, refractive and topographic outcomes were evaluated relative to implantation depth. The lowest improvement in the study parameters ocurred when the implantation depth was >/= 80%. In this group, uncorrected visual acuity [UCVA] and best spectacle corrected VA [BSCVA] improved less than 0.5 lines. Manifest refractive spherical equivalent [MRSE] and mean keratometry [Km] change was less than 0.5 diopters [D]. The greatest improvements were observed with implantation depth of 60-79% where UCVA and BSCVA increased by 4.5 and 2.5 lines respectively, and MRSE and Km changed by approximately 2.00 D. Less improvement was found when ICRS were implanted between 40-59% of stromal thickness. Implantation of ICRS greater than 80% of stromal thickness may have no effect on visual and topographic status

Effect of amniotic membrane combined with ciprofloxacin in curing the primary stages of pseudomonal keratitis

Keratitis caused by Pseudomonas aeruginosa is often resulted in severe corneal ulcers and perforation, which leads to losses of vision. Human amniotic membrane [HAM] forms the inner wall of the membranous sac which surrounds and protects the embryo during gestation. The purpose of this study was to evaluate the effectiveness of the amniotic membrane's healing in rabbits with pseudomonas keratitis. In total 14 rabbits divided in 2 groups of: 1 as Control and 2 as experimental amniotic membrane combined with ciprofloxacin. A 0.05 ml suspension of Pseudomonas aeruginosa ATCC 27853 was injected into rabbit's corneal stroma, with no interference in control group. In the second group, the amniotic membrane in pieces of 1.5 x 1.5 cm transplanted to the entire corneal surface by eight interrupted 10.0 nylon sutures. In the first day ciprofloxacin drop was injected to the second group every 30 minutes and through second to seventh days every 2 hours. The results of perforation in cornea and the amount of infiltration were registered. The results showed that amniotic membrane transplantation [AMT] + ciprofloxacin group had 0% perforation and the control group 85.6%. Average infiltrations were 5 mm in AMT + ciprofloxacin groups and 23.75 mm in control. The use of amniotic membrane with ciprofloxacin was effective in prevention of cornea perforation and controlling the process of pseudomonal keratitis remission. The improvement of inflammation rapidly happened in ciprofloxacin + AMT group.

prevalence and determinants of pterygium and pinguecula in an urban population in Shahroud, Iran

While pterygium is considered a common eye disorder, the etiology and pathogenesis is still not known. The aim of this study was to describe the prevalence of pterygium and pinguecula in the over 40 population of Shahroud and assess associated factors. The present study is part of the phase one of the Shahroud Eye Cohort Study conducted in 2009, in which the target population was people between 40 and 64 years of age. Ophthalmic examinations were performed by two ophthalmologists who made the diagnosis of pterygium and pinguecula. We used Chi-square tests, analysis of variance, and multiple logistic regression tests to examine associations. Of the 6311 invitees, 5190 people participated in the study [response rate: 82.2%]. The prevalence of pterygium in at least one eye was 9.4% [95% CI, 8.6-10.3], while 2.9% [95%CI, 2.4-3.3] had bilateral pterygium. The prevalence was significantly higher in men [11.4% vs. 8.0%], and remained relatively constant with age, while the prevalence in women significantly increased with age. The prevalence of pinguecula was 61.0% [95%CI, 59.1-62.9] in at least one eye, and 49.0% [95%CI, 47.1-50.9] in both eyes. The age difference between those with and without pinguecula was significant and the prevalence was significantly higher among men than women [70.6% vs. 53.8%]. The prevalence of pterygium in our study was lower than reported rates in the world but higher than Tehran and was significantly associated with age, gender, working outdoors, and the level of education. The prevalence of unilateral and bilateral pinguecula falls in the mid range and was significantly associated with age, male gender, smoking, working outdoors, and level of education