[Aspergillus fumigatus keratitis after laser in situ keratomileusis]

To report a case of unilateral Aspergillus fumigatus interface keratitis after laser in situ keratomileusis [LASIK]. A 22-year-old woman developed corneal infiltrates located at the flap- stroma interface in her left eye 48 hours after myopic LASIK. The infiltration progressed despite administration of topical fortified antibiotics therefore, the flap was lifted and irrigated with antibiotic solution. Six days after LASIK, visual acuity was counting fingers at 30 cm and a large full-thickness corneal infiltrate was located at the flap-stroma interface. On scanning confocal microscopy, fungal hyphae were observed as high-contrast filaments. The LASIK flap was amputated. Corneal scraping revealed fungal filaments in smears and culture. The fungus was identified as Aspergillus fumigatus. Fortified antibiotic drops were discontinued and intensive topical natamycin and systemic ketoconazole were initiated which controlled the keratitis. Two months after surgery the eye was quiet and vision improved to 20/200. Interface fungal infection after LASIK is a potentially vision-threatening complication. Early lifting of the flap, fungal culture and aggressive antifungal treatment are required to treat this complication. Confocal microscopy may be a fast and safe diagnostic tool in determining the presence of fungal hyphae in vivo within the human cornea

Prevalence of pseudoexfoliation syndrome in diabetic patients

Pseudoexfoliation syndrome [PEX] is the most common identifiable cause of secondary glaucoma, the prevalence of which varies considerably among different ethnicities. The aim of this study was to assess the prevalence of PEX in diabetic patients older than 50 years. In this descriptive, cross-sectional study 400 diabetic patients older than 50 years referred to the Yazd Diabetes Research Center were selected consecutively. After completing a questionnaire, ophthalmologic examination was performed with slit-lamp, 3-mirror lens and Direct Ophthalmoscopy. Of the total of 400 patients, 24 patients [6%] had PEX. PEX was significantly higher in older diabetic patients [P = .007]. No significant association was observed with the other variables, including sex, duration of diabetes and retinopathy [p = 0.7]. Also, prevalence of glaucoma in patients with PEX was 14.8%. In our study the prevalence of PEX was 6%. On comparison of results with similar studies on non diabetic patients of the same age group in our region, the prevalence of PEX in diabetic patients is less than non diabetic patients in Yazd

[Prevalence and causes of low vision and blindness in the blind population supported by the Yazd Welfare Organization]

In 1995, the World Health Organization [WHO] estimated that there were 37.1 million blind people worldwide. It has subsequently been reported that 110 million people have severely impaired vision, hence are at great risk of becoming blind. Watkins predicted an annual increase of about two million blind worldwide. This study was designed to investigate the causes of blindness and low vision in the blind population supported by the welfare organization of Yazd, Iran. This clinical descriptive cross-sectional study was done from January to September, 2003. In total, 109 blind patients supported by the welfare organization were included in this study. All data was collected by standard methods using questionnaire, interview and specific examination. The data included; demographic characteristics, clinical states, ophthalmic examination, family history and the available prenatal information. The data were analyzed by SPSS software and chi square test. of total patients, 73 cases were male [67%] and 36 were female [33%]. The median age was 24.6 years [range one month to 60 years]. More than half of the cases [53.2%] could be diagnosed in children less than one year of age. In total, 79 patients [88.1%] were legally blind of which 23 cases [29.1%] had no light perception [NLP]. The most common causes of blindness were retinitis pigmentosa [32.1%] followed by ocular dysgenesis [16.5%]. Our data showed that more than half of the blindness cases occur during the first year of life. The most common cause of blindness was retinitis pigmentosa followed by ocular dysgenesis, cataract and glaucoma, respectively

Early results and short term complications of lasik surgery

Today, Lasik surgery is one of the most common and effective procedures for correction of refractive errors. Less than 1% of patients undergoing Lasik operation suffer from serious and 3-5% suffers from mild complications. Also, results of lasik in most centers are promising. With the recent inauguration of the Lasik center of Yazd, it was decided to evaluate the results and complications of this surgery. In this descriptive outcome study, cases were selected randomly and data from files of 230 operated eyes was filled in a specially formatted questionnaire. Data of patients who had been operated upon between March 2003 and March 2004 was gathered and evaluated using SPSS software program with 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 treatment and more than +/- 0.5 considered as relative. 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%] myopic-astigmatism, 5 cases [2.2%] hyperopic and 13 cases [5.6%] hyperopic-astigmatism. 204 eyes were in the age group of less than 40 years and 26 eyes were in the age group of more than 40 years. Based on visual acuity well-being, 225 eyes [97.8%] were treated completely and 5 eyes [2.2%] were treated relatively. Complete eradication of refractive error, 3 months after surgery in myopias was 96%, myopic astigmatisms 88%, hyperopias 60% and hyperopic astigmatisms 62%. At 3 months of follow up, 224 cases [97.4%] were without any complications and the rest had few minor side effects. Lasik operation is a safe and effective procedure for correcting refractive errors with limited complications. Results are comparable with similar studies

Use of inhaled corticosteroids and risk of cataracts: a case-control study

Exposure to systemic corticosteroids is known to be associated with a risk of cataract. This study was undertaken to determine the risk of cataract associated with the use of inhaled corticosteroids in old age. A case-control study consisting of 160 people with cataract [case] and 160 controls matched for age and sex was conducted at Shaheed Sadoughi and Shaheed Rahnemoon hospitals of Yazd. Data gathered via a questionnaire and interview and analyzed by SPSS, Chi Square and ANOVA tests. There was no difference in age and sex between the two groups of case and control. In case group, 22 [13.8%] and in control group 11 [6.9%] persons [total of 33 patients] used inhaled corticosteroids that was statistically significant [P-Value=0.042]. The odds ratio for the association between inhaled corticosteroids and cataract was 2.16 [95% CI 1.01 to 4.61]. After adjustment for systemic corticosteroid exposure, the Odds ratio rose to 4.73 [95% CI 1.51 to 14.82]. The association was stronger with increase in duration of use. This case-control study showed an association between use of inhaled corticosteroids and increased risk of cataract, especially the posterior sub capsular type. But, in order to confirm these findings, other studies including experimental ones and similar groups in respect to other risk factors of cataract are needed

Vitamin C concentration of Aqueous humor in senile cataract

Oxidative agents like ultraviolet are one of the important cause of cataract and vitamin C is an important water soluble antioxidant agent in the aqueous humor. This study aimed to evaluate the concentration of vitamin C in the aqueous and plasma of patients with senile cataract. In a descriptive cross- sectional study on 85 patients [41 men and 44 women] admitted for cataract surgery, aqueous [0.2 ml] and blood [5ml] were sampled just before operation under general anesthesia from anterior chamber and vein, respectively. Spectrophotometer measured the concentration of vitamin C in both samples. The mean age was 64.3 +/- 11.1 years. Aqueous and plasma concentration of vitamin C was 4.29 +/- 1.11 mg/dl and 0.77 +/- 0.0332 mg/dl, respectively. The differences were statistical significant [P almost equal to 0]. Vitamin C of aqueous were equal in both sexes, but vitamin C of plasma in women were higher than men [P= 0.043]. The concentration of vitamin C showed no relation to the type of cataract. Vitamin C of aqueous and plasma in senile cataract are lower than normal. More study is recommended for evaluating preventive effect of high vitamin C diets or supplements

Evaluation of vitamin C concentration of aqueous humor in senile cataract

Senile cataract is one of the most important preventable causes of blindness. Oxidative agents like ultraviolet [UV] are one of the most important causes of cataract. Vitamin C is an important water soluble antioxidant agent in the aqueous humor. In a cross-sectional study, 85 patients admitted to Rah-Ahan Eye Hospital for cataract surgery were evaluated. The mean age of the patients was 64.3 +/- 1.2 yr of the 85 patients, 41 were men and 44 were women. Under general anesthesia 0.2 cc of aqueous humor from anterior chamber and 5 cc of peripheral blood were taken just before operation. Concentration of vitamin C was measured in these samples and the data was analyzed by SPSS statistical program. Mean concentration of vitamin C was 4.29 +/- 0.12 mg/dl [mean +/- SE] in the aqueous and 0.77 +/- 0.036 mg/dL in the plasma. The differences were statistically significant when compared with normal values. P 0.000 in both conditions. Vitamin C concentrations of aqueous humor were equal in both sexes, but vitamin C concentrations of plasma in women were higher than men [p=0.043]. The concentration of vitamin C was not related to the type of cataract or job of patients. Since vitamin C concentration of aqueous humor and plasma in senile cataract are lower than normal, it is better to advise fresh vegetables and fruits or other supplements to patients who are at risk of senile cataract