RESUMO
BACKGROUND: Phlebotomus sergenti s.l. is considered the most likely vector of Leishmania tropica in Iran. Although two morphotypes- P. sergenti sergenti (A) and P. sergenti similis (B)-have been formally described, further morphological and a molecular analysis of mitochondrial cytochrome oxidase I (mtDNA-COI) gene revealed inconsistencies and suggests that the variation between the morphotypes is intraspecific and the morphotypes might be identical species. METHODS: We examined the sequence of the ITS2-rDNA of Iranian specimens of P. sergenti s.l., comprising P. cf sergenti, P. cf similis, and intermediate morphotypes, together with available data in Genbank. RESULTS: Sequence analysis showed 5.2% variation among P. sergenti s.l. morphotypes. Almost half of the variation was due to the number of an AT microsatellite repeats in the center of the spacer. Nine haplotypes were found in the species constructing three main lineages corresponding to the origin of the colonies located in southwest (SW), northeast (NE), and northwest-center-southeast (NCS). Lineages NCS and NE included both typical P. cf sergenti and P. cf similis and intermediate morphotypes. CONCLUSION: Phylogenetic sequence analysis revealed that, except for one Iranian sample, which was close to the European samples, other Iranian haplotypes were associated with the northeastern Mediterranean populations including Turkey, Cyprus, Syria, and Pakistan. Similar to the sequences of mtDNA COI gene, ITS2 sequences could not resolve P. sergenti from P. similis and did not support the possible existence of sibling species or subspecies within P. sergenti s.l..
RESUMO
PURPOSE: To report the clinical features and surgical outcomes of two patients with heavy eye syndrome who underwent partial Jensen's procedure. CASE REPORT: A 21-year-old man and a 24-year-old woman with high myopia (-18 and -8 diopters, respectively), high axial length (27.5 and 24.6 mm), progressive esotropia (40 and 50 prism diopters), hypotropia (5 and 2 prism diopters), abduction limitation, and inferior displacement of the lateral rectus on computed tomography were diagnosed with heavy eye syndrome and underwent partial Jensen's procedure. The technique consisted of splitting the lateral and superior recti from their insertion up to the equator and uniting their superior and temporal halves respectively, with non-absorbable sutures without scleral fixation. Two months postoperatively, esotropia was reduced to 10 prism diopters in case #1 and to 25 prism diopters in case #2; limitation of abduction was also considerably diminished. CONCLUSION: Patients with heavy eye syndrome, large angle esotropia and limitation of abduction, may benefit from partial Jensen's procedure which is a simple and safe surgical option.
