Intraocular pressure measurements by three different tonometers in children with aphakic glaucoma and a thick Cornea

Background: To evaluate the agreement in intraocular pressure [IOP] measurements by Ocular Response Analyzer [ORA] and Tono-Pen XL [TXL] with the Goldmann Applanation Tonometer [GAT] and to examine corneal biomechanical properties in aphakic glaucoma patients with a central corneal thickness [CCT] >600 micro

Methods: Thirty-six eyes of aphakic glaucoma patients [group 1] and 40 eyes of normal children [group 2] were studied. The mean ORA and TXL IOP values were compared with the GATIOP values. Regression analyses were used to evaluate the associations between IOP and CCT, corneal hysteresis [CH], and corneal resistance factor [CRF]. Bland-Altman plots were used to evaluate the agreement between the tonometers

Results: The mean +/- standard deviations of the age and male/ female ratio were 16.58 +/- 5.44 and 15.75 +/- 5.04 years and 14/22 and 18/22 in group 1 and group 2, respectively. CCT in group 1 was 651.1 +/- 42 and in group 2 was 567.3 +/- 32.4. In group 1, the mean TXL [22.4, P=0.004], IOPcc [corneal compensated] [27.8, P=0.005], and IOPg [Goldmann correlated] values [28.1, P<0.0001] were greater than GAT-IOP [20.6]. In group 2, only IOPg value [16.4] was higher than GAT-IOP [14.8, P=0.04]. IOP reading of all the tonometers were positively and negatively associated with CRF and CH in the multiple regression analysis, respectively

Conclusion: The TXL had a greater agreement with the GAT, and the ORA overestimated IOP in aphakic glaucoma patients. The ORA and TXL seemed to be affected by CH and CRF

Monocular elevation deficiency: a case series of surgical outcome

Background: Inferior rectus recession, Knapp procedure, partial tendon transposition, and combined procedure are different surgical procedures in the management of monocular elevation deficiency [MED]. Only a few studies have been published on the management of this problem. In this study, we report our experience with patients with MED focusing on the indications and types of surgery in the south of Iran

Methods: In this case series, a computerized database review on 4773 patients with strabismus was performed and 18 patients diagnosed as having MED who had undergone strabismus surgery were enrolled

Results: Of the 18 patients, 13 had only hypotropia and 5 had horizontal deviation as well. Preoperative vertical deviation was between 15 and 60 prism diopter [mean +/- SD=25.8 +/- 10.7 PD]. Fourteen patients had positive forced duction test on elevation. Seventeen patients had ptosis twelve of them had true ptosis and the remaining 5 had pseudoptosis]. The mean postoperative follow-up was 24.4 months. Four patients underwent Knapp procedure, 12 patients underwent inferior rectus recession, and for 2 patients a combined procedure was performed. The mean postoperative hypotropia was 6.1 +/- 7.9 PD. Twelve out of the 18 patients were corrected to within five PD of orthophoria and no one was found with overcorrection

Conclusion: Although MED is etiologically multifactorial, satisfactory surgical results can be achieved by judicious selection of the surgical technique based on the results of the forced duction test

Comparison between topical and oral tranexamic acid in management of traumatic hyphema

Background: We sought to determine the efficacy of topical tranexamic acid [5%] in the management of traumatic hyphema

Methods: Thirty eyes with gross traumatic hyphema were enrolled in this study. The patients were treated with tranexamic acid [5%] eye drop every 6 hours for 5 days. The main outcome measures were best corrected visual acuity [BCVA], Intra-ocular pressure [IOP], day of clot absorption, and rate of rebleeding. These parameters were evaluated daily for 4 days and thereafter at the 8[th] and 14[th] days after treatment. The patients were also compared with two historical control groups of patients [80 eyes] with traumatic hyphema; the first control group was treated with oral placebo and the other group was treated with oral tranexamic acid at our department

Result: Prior to treatment, the mean logarithm of the minimum angle of resolution [logMAR] BCVA was 0.59 +/- 0.62. BCVA was increased to 0.08 +/- 0.14 at day 14 [P<0.001] and the mean IOP before treatment was 13.7 +/- 3.9 mm Hg, which was reduced to 11.4 +/- 1.8 mm Hg at day 14 [P=0.004]. Rebleeding occurred in one [3.3%] patient on the 4[th] day post treatment. Comparison between the case group and the other two historical control groups with respect to the rebleeding rate demonstrated statistically significant differences between the case group and the first control group [P=0.008] but no statistically significant differences between the case group and the second control group [P=0.25]

Conclusion: Topical tranexamic acid seems promising in the management of traumatic hyphema. However, the small sample size of the present study precludes the conclusion that topical tranexamic acid can replace the oral tranexamic acid

Retinoblastoma in adolescence: report of an unusual presentation

Herein, we report the clinical, pathologic and photographic findings of a 16 year-old girl who presented with gradual enlargement of a vascularized, hemorrhagic peripapillary mass that eventually led to vitreous hemorrhage and rubeosis iridis. Histopathological findings after enucleation were positive for retinoblastoma. The patient did not have any metastasis during her 20 months of follow up

Limbal-conjunctival autograft transplantation for the management of primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the efficiency of limbal conjunctival autografting technique in patients with primary pterygium.·METHODS: Fifteen eyes of 15 patients with primary pterygium underwent surgery for the removal of pterygium with limbal conjunctival autograft. After the pterygium excision, the limbal portion of the graft was oriented and sutured to the limbus at the recipient bed with the epithelial surface upside. Recurrence was defined as fibrovascular tissue of more than 1 mm over the cornea in the area of previous pterygium excision.·RESULTS: With mean follow-up period of 8 months, neither recurrences nor serious complications were recorded among our patients.·CONCLUSION; Simple excision followed by limbal-conjunctival autograft transplantation is a safe and very effective way of treating primary pterygium.