Prevalence of second-eye cataract surgery and time interval after first-eye surgery in Iran: a clinic-based study

To determine the prevalence of second-eye senile cataract surgery [SECS] as a proportion of all senile cataract surgeries and the trend in the interval between first and second cataract operations in a main referral and academic eye hospital. In this cross-sectional study, a list of patients who underwent senile cataract surgery over four consecutive years [2006-2009] was retrieved from hospital computer-based records as the sampling frame. With a systematic random method, 15% of records were selected [1, 585 out of 10, 517 records]. First- and second-eye operations were performed in 1, 139 [71.9%; 95% confidence interval [CI], 69.5-74.1] and 446 eyes [28.1%; 95% CI, 25.9-30.35], respectively. The proportion of SECS procedures increased from 24.3% in 2006 to 33.4% in 2009 [P- 0.017]. The median [interquartile range] interval between the two operations was 9 [4-24] months, which remained stable during the study period. The SECS rate was 10.4% higher [P - 0.0l] and the time interval was 13 months shorter [P- 0.007] in patients who underwent phacoemulsification than extracapsular cataract extraction. The number of cataract operations in this tertiary eye care setting increased 1.5 fold over the study period. The proportion of second-eye operations also rose from 1/4 to 1/3 during the same time

Causes of Visual Impairment among Patients Referred to a Visual Rehabilitation Clinic in Iran

PURPOSE: Epidemiologic evaluation and investigating the causes of visual impairment in any society is a matter of concern and has a direct effect on the country's health care planning. In this study we describe causes of low vision and blindness in Iranian patients referred to rehabilitation clinics for taking vision aids. METHODS: In this cross-sectional study, visual acuity was classified based on best-corrected visual acuity in the better eye according to the World Health Organization definition (blindness, visual acuity [VA] < 20 / 400; severe visual impairment, VA < 20 / 200-20 / 400; mild to moderate visual impairment, VA < 20 / 60-20 / 200). The causes of blindness and low vision were determined using the 10th version of International Classification of Diseases based on the main cause in both eyes. To describe data, we used mean +/- SD and frequency. RESULTS: The study included 432 patients, 65% male, with a mean age of 43.6 +/- 25.5 years (range, 3 to 92 years). Mild to moderate visual impairment, severe visual impairment and blindness were present in 122 (28.8%), 196 (46.4%) and 105 (24.8%) of the patients, respectively. The main causes of visual impairment were retinal and choroidal diseases (74.5%), optic nerve and optic tract diseases (9.8%), vitreous and globe disorders (5.3%), congenital cataract (3.1%), and glaucoma (2.6%). The distribution pattern of the causes was similar in all age subgroups. CONCLUSIONS: Diseases of the retina and choroid are the main cause of visual impairment among patients referred to an academic visual rehabilitation clinic in Iran.

Vision related quality of life in myopia; photorefractive keratectomy versus nonsurgical optical correction

To compare quality of life [QOL] in myopic patients who underwent photorefractive keratectomy [PRK] with that of myopic spectacle or contact lens users. This observational comparative study was performed on 102 low to moderate myopic patients who had undergone PRK at least 6 months ago and 106 myopic spectacle or contact lens wearers. Vision related QOL and its correlation with demographic variables, visual acuity and refractive status were compared between the two groups. QOL was measured using a validated translated version of the Visual Function Questionnaire [VFQ-25] which contains 25 questions in 12 subscales with a total score of zero to 100. Mean total QOL score was 97.0 +/- 4.4 and 86.1 +/- 10.7 in PRK and nonsurgical groups respectively [mean difference [d]=11, P<0.001]. The difference was independent of age, sex, education or marital status [P>0.05]. Overall, 10 out of 12 QOL subscales were significantly higher in the PRK group [P<0.001] especially general vision [d=23.8], general health [d=22.2], driving [d=19.3], role difficulties [d=14.6], distance activities [d=13.8] and mental health [d=13.7]. Only color vision [d=1.6, P>0.9] and ocular pain [d=3.1, P=0.3] were not significantly different between the study groups. Correction of myopia using PRK is associated with higher QOL scores in most subscales as compared to spectacle or contact lens wear.