Résumé
To determine the outcomes of visual correction with femto-LASIK following PK. In this prospective study, 34 eyes of 31 patient who had undergone thin - flap lasik due to high efractive error after corneal grafting were evaluated .After complete ocular examination and assessment of uncorrected and corrected distant visual acuity [UCVA and BCVA], the patients underwent femto-lasik using the Ziemer femto-LDV with 100 micron flap thickness. After 3 to 19 [10.14 +/- 4.81] months of follow-up, mean UCVA increased from 1.5 Log MAR preoperatively [5/100] to 0.3 LogMAR [5/10] postoperatively [P<0.05]. Mean BCVA also increased from 0.3 LogMAR [5/10] to 0.1 LogMAR [8/10] [P<0.05]. Mean spherical equivalent changed from -6.98 +/- 3.87 to -2.18 +/- 2.69 and mean of defocus equivalent also decreased from 10.32 +/- 3.74 preoperatively to 4.13 +/- 2.93 postoperatively [P<0.05 for both]. No significant intraoperative and postoperative complications occurred. Femto-LASIK surgery after penetrating keratoplasty is a successful procedure for correction of moderate to high refractive errors. It seems to be clinically safe, effective and predictable
Résumé
To report the results of photorefractive keratectomy [PRK] with mitomycin-C [MMC] to correct myopia and astigmatism in patients who had previously undergone penetrating keratoplasty [PKP]. Thirty-eight eyes of 32 patients underwent PRK with MMC to correct astigmatism and myopia following PKP. Mean spherical equivalent [SE] was -5.2 +/- 4.7 D [diopter] and mean astigmatism was -2.4 +/- 3 D preoperatively which reached -3.1 +/- 3.1 D and -1.2 +/- 2.8 D 3 months after the operation respectively. The cornea was clear in 55.3%, had trace haze in 21.1%, moderate haze in 15.8% and severe haze in 7.9% of cases. PRK with MMC after PKP is a relatively safe and effective procedure. It reduces both the spherical error and the cylindrical component of the ametropia. Corneal haze is the major complication
Résumé
To compare the effects of standard tissue saving method and personalized techniques of photorefractive keratectomy [PRK] on aberration changes in fellow eyes. This randomized controlled trial was performed on patients who were referred to Isfahan Parsian Clinic during 2007. After a comprehensive ophthalmologic examination, PRK was randomly performed using tissue saving [TS] technique in one eye and personalized [P] technique in the fellow eye. Aberrometry was performed pre- and 6 months postoperatively. This study included 296 eyes of 148 [67 male and 81 female] patients with mean age of 29.1 +/- 7.0 years. The two groups had no significant difference in terms of laterality, pupil size and level of myopia preoperatively [P=0.65]. Uncorrected visual acuity was 20/25 or more in 88.9% of the TS group and 92.6% of the P group [P=0.83]. Mean refractive error 6 months postoperatively was -0.50 +/- 0.36 diopter [D] in the TS group and 0.31 +/- 0.43 D in the P group [P=0.95]. Mean root-mean-square [RMS] value was -0.41 +/- 0.17 preoperatively and 0.86 +/- 0.43 postoperatively in the group TS [P<0.01]. Corresponding figures were 0.47 +/- 0.39 and 0.77 +/- 0.43 in the P group [P<0.01]. The two groups did not differ regarding pre- and postoperative RMS. Postoperative aberrations may be increased with both tissues saving and personalized techniques of PRK with no significant difference between them in this regard
Résumé
To report the result of limbal autografting in primary and recurrent pterygium. In this case series, all patients who were referred to our clinic at Farabi hospital, Isfahan, Iran for treatment of pterygium were included. Indications of surgery included chronic ocular irritation, impaired or threatened vision, ocular motility problem and cosmetic reasons. Under subconjunctional anesthesia, pterygium was removed from the cornea and conjunctiva and a crescent shape limbal tissue from supratemporal region of the same or the sound eye was then prepared and sutured in the area of pterygium removal. In cases with conjunctival problem due to previous surgery or severity of the disease, some amount of conjunctival tissue was also included in the transplanted limbal tissue. Postoperatively, topical betamethasone for 4 weeks and antibiotic for 2 weeks were prescribed. Two-hundred and three eyes were studied of which, 125 eyes [61.6%] had primary and 78 eyes [38.4%] had recurrent pterygium. After at least one year of follow-up, only 9 eyes [4.5%] had recurrence larger than 1 mm. Visual acuity and refraction improved in 60% of the eyes. No significant complication occurred except appearance of a fibrous tissue in the donor site which was not progressive and was covered by the upper lid in all cases. Surgical removal together with limbal autograft is a safe and effective method for treatment of primary and recurrent pterygium
Résumé
Age- related cataract is the main cause of blindness and visual impairment worldwide. Surgery is the only treatment currently available for lens opacity. It is the most frequently performed procedure in ophthalmology. There are many different advantage and disadvantages. Today, ultrasound phaco-emulsification is the most performed method for surgery. One of alternative energy forms is laser photolysis. The aim of this study was to evaluate the mean energy delivery to eye using Dodick laser photolysis for phaco-emulsification. 76 eyes from 76 patients at Aban Eye Clinic in Esfahan were introduced to study. Cataract density was rated preoperatively using lens opacity classification system III [LOCS III] on 0 to +4 density scale. Lenses with +4 nuclear density scales were excluded. Finally 67 eyes were operated with ARC Dodick laser photolysis system throw 2.8 mm clear corneal incision. Delivered energy was recorded. Of 67 patients, 39 [58.2%] were male and 28 [41.8%] were female, and had a mean age of 58.3+12.8 [14-84 years]. There was no statistically significant difference between age of male patients [56.5+12.8] and female patients [60.7+11.9] [p=0.18]. Mean delivered energy to eyes was 4.5+2.6 joules for nucleuses with density of +1, +2 and +3 mean delivered energy was calculated as 3.32+2.60, 3.7+2.59 and 5.7+2.23 joules respectively. Finally it was reverted that there was a direct relationship between delivered energy and nuclear density [p=0.00001, r=0.57]. In spite of the lower amount of energy used, as the preoperative hardness of lens nucleus or lengthening of operation cannot be predicted before surgery, this technique is not well- accepted; hopefully with resolving of technical problems in the future, it can be used more properly