[Photorefractive keratectomy for myopia; an 8-year follow up study]

To evaluate the 8-year results of excimer laser photorefractive keratectomy [PRK] for myopia in terms of safety, stability and late complications. Of 203 myopic patients who underwent PRK with single-step method using NIDEK EC-5000 excimer laser with 5-6 mm ablation zones at Basir Eye Center, Tehran-Iran from 1996 to 1998, 179 eyes of 98 patients who completed 8 years of follow up were included in this study. Results of follow up examinations at 1, 3, 6 and 12 months and 2 and 8 years after surgery were analyzed. Treated eyes were divided into three groups according to preoperative refractive error: low [ -10.00 D] myopes. Eight years after PRK, emmetropia [within +/- 1 D] was achieved in 69.1%, 30% and 46.15% of the low, medium and high myopia groups, respectively. Although a small myopic shift occurred up to 8 years after surgery, myopic regression stabilized in all groups within 24 months and was correlated significantly to preoperative spherical equivalent refraction. Corneal haze occurred in 5% especially in medium and high myopic groups but cleared within two years in 89% of cases. Only one eye lost two lines of best spectacle-corrected visual acuity due to corneal haze. According to this study, postoperative refraction remains stable two years after PRK and most cases of corneal haze clear within two years after surgery. Therefore, PRK seems to be a safe and stable surgical procedure in myopic patients

Clinical and laboratory manifestations of meningococcemia in children

Lack of vaccination and modern health care facilities in many countries including Iran let meningococcemia to remain as a serious challenging disorder especially among children and in spite of improved diagnosis and earlier treatment its prognosis is still dismal. This study describes 68 cases [54.4% male] of proved meningococcemia hospitalized since 1992 up to the end of 2002 in Children Medical Center Hospital, Tehran, Iran. Infants of 6 to 12 month old were a major concern in number [14.7%] and severity of disease. 5.9% of the cases have had at least two hospitalization history for meningococcal septicemia and 19.1% of the patients had Systemic Lupus Erythematosus [SLE], nephrotic syndrome or chronic liver disease in their past medical history. Meningeal irritation signs were seen in 55.9% and cerebrospinal fluid [CSF] smear was positive in 71.4% and culture was positive in 48.5% of patients. Meningococcal septicemia ended in shock [38.2%], Disseminated intravascular coagulation [DIC] [7.4%], thrombocytopenia [10.3%], arthritis [4.4%],ocular complications [2.9%], pericarditis [2.9%] and seizure [8.8%] in 51 of the cases, and death occurred in 7 patients. This study shows that the manifestation of the disease is similar to those described elsewhere except for lower pneumonia and no seasonal variations