Review Articles


Intracameral Antibiotics as Prophylaxis in Cataract Surgery; a Mini-Review of Literature

Razieh Khazaii, Soheila Sobhani, Sara Shabani

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 1-4
https://doi.org/10.22037/joos.v1i3.19288

Purpose: To conduct a mini-review of intracameral antibiotics usage as prophylaxis for post cataract surgery endophthalmitis.

Materials and Methods: We conducted a brief search of English literature regarding the recent developments in use of various intracameral antibiotics as anaphylaxis for post cataract surgery endophthalmitis.

Results: The effect of prophylactic intracameral antibiotics in reducing post cataract surgery endophthalmitis is still a controversial subject.  Randomized clinical trials (RCTs) are great sources to confirm benefits from prophylactic intracameral antibiotics. Several recent surveys have reported higher rates of endophthalmitis among cataract patients not receiving prophylactic intracameral antibiotics compared with those receiving antibiotics.

Conclusion: Based on the latest findings it seems that more surgeons should set aside their doubts and use intracameral antibiotics as routine prophylaxis to reduce the rate of post cataract surgery endophthalmitis.

Original Articles


Biometric Indices and Their Relation with Age, Sex and Ethnicity

Ahmad Shojaei, Ali Moradi, Mohsen Gohari

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 5-12
https://doi.org/10.22037/joos.v1i3.20659

Objective: The aim of the present study was to evaluate the association of biometric indices with age, gender and ethnicity.

Patients and Methods:  Three hundred and seventy patients entered the study from Basir Eye Clinic refractive assessment clinic. Sociodemographic data was gathered. Ocular parameters for both eyes and corneal curvature were measured by immersion technique and manual keratometry, respectively.

Results: Axial length was significantly higher among male patients (P = 0.01) and vitreous chamber depth was significantly higher in females (P = 0.02). Axial length and vitreous chamber depth parameters were significantly higher among Arab patients (P = 0.01) compared to Persian patients and there was no other significant differences between these two groups. A significant increase in lens thickness and mean K (P < 0.001, coefficient = 0.15 and 0.023 respectively) and a significant reduction with axial length, anterior chamber depth and vitreous chamber depth (P < 0.001, coefficient = - 0.31, - 0.10 and - 0.37 respectively) were observed in correlation with the age of participants.

Conclusion: There was correlation between axial length, depth of the anterior chamber, vitreous chamber depth, lens thickness and mean k with age of the participants. Male subjects and specific ethnicities such as Arab patients tend to have higher axial length values.

Keywords: Axial length, anterior chamber depth, vitreous chamber depth, sex, age, Iran.

Clinical Outcomes After Continuous Intracorneal Ring implantation in Post-LASIK Ectasia: (Long-Term Follow-up)

Farhad Nejat, Mostafa Naderi, Leila Janani, Hossein Aghamollaei, Seyed Aliasghar Mosavi, Khosrow Jadidi

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 13-20
https://doi.org/10.22037/joos.v1i3.20266

Purpose: The aim of the present study was to evaluate the clinical outcomes after implantation of MyoRing in patients with ectasia secondary to LASIK.
Patients and Methods: This study was a retrospective, consecutive, nonrandomized interventional case series. The MyoRing was implanted after creation of a stromal pocket using a PocketMaker microkeratome (Dioptex, GmBH, Linz, Austria) in 6 eyes of 6 patients with ectasia secondary to LASIK. Uncorrected distance visual acuity, corrected distance visual acuity, sphere, cylinder and keratometric changes were reported after a 3 year follow-up period.
Results: Uncorrected distance visual acuity and corrected distance visual acuity were improved in 5 and 3 patients respectively. One patient showed decreased UDVA after 3 years and in 3 patients the corrected distance visual acuity decreased at the last visit compared to the preoperative reading. Maximum keratometry, sphere and cylinder were improved from preoperative values in 4, 2 and 5 patients respectively.
Conclusion: Because of the mixed results in our small group of patients, it seems that MyoRing implantation using mechanical dissection is not a very effective method for treatment of patients with post LASIK ectasia. However, large comparative multicenter studies are recommended to further verify these results.

Keywords: Ectasia, Cornea, LASIK, Corneal ring, Iran.

Visual Outcomes and Patient Satisfaction after Unilateral Implantation of a Diffractive Trifocal Intraocular Lens to Treat Cataract

Rama Pourmatin, Abbas Abolhassani, Ahmad Shojaei, Ali Moradi, Mohsen Gohari

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 21-27
https://doi.org/10.22037/joos.v1i3.21462

Abstract

Purpose: To assess clinical outcomes and patient satisfaction after unilateral implantation of a diffractive trifocal intraocular lens (IOL) following phacoemulsification in unilateral cataract.

Patients and Methods: This retrospective case series study included six males and five females. Patients underwent phacoemulsification and unilateral implantation of a trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec, Jena, Germany). Visual acuity was evaluated at 1 month, 3 months, 1 year, and 2 years postoperatively. Monocular and binocular contrast sensitivity and patient satisfaction were evaluated at 2 years of follow-up using 25 item National Eye Institute visual functioning questionnaire (NEI VFQ-25).

Results: At 2 years, the mean uncorrected distance visual acuity was from 0.549 ± 0.32 to 0.021 ± 0.037 logMAR, uncorrected intermediate visual acuity was from 0.544 ± 0.31 to 0.018 ± 0.045 LogMAR, and uncorrected near visual acuity was from 0.52 ± 0.30 to 0.022 ± 0.045 LOGMAR showing a significant improvement in the operated eye. The VFQ-25 evaluation indicated that patients were satisfied with their outcomes. Also, Binocular contrast sensitivity measured by CSV1000 was similar to monocular contrast sensitivity.

Conclusion: Unilateral implantation of trifocal intraocular lens can be considered as a safe and viable option in presbyopic patients with unilateral cataract.

 

Keywords: Cataract; Surgery; Trifocal; Intraocular lens; Visual acuity.

Comparison of Propofol and Isoflurane Effects on Intraocular Pressure among Patients Undergoing Lumbar Disc Surgery

Alireza Mirkheshti, Seyed Puzhia Shojaei, Hossein Mohammad Rabei, Mehdi Yaseri, Marzieh Mirzaei, Morteza Jabbary Moghaddam, Afsaneh Barabadi, Kourosh Sheibani, Mohammad Reza Aryani

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 28-33
https://doi.org/10.22037/joos.v1i3.21745

Purpose: Blindness is a catastrophic complication of surgeries performed in prone position which occurs mainly due to hemodynamic alterations and the relevant effects on optic nerve perfusion. In this study, we compared the effects of Propofol and Isoflurane on intraocular pressure among patients undergoing lumbar disk surgery.

Patients and Methods: In this randomized clinical trial, 60 patients who were candidates for lumbar disk surgery were randomly assigned into two groups: Propofol and Isoflurane groups. Intraocular Pressure was measured before and after induction of anesthesia in supine position, immediately after prone positioning of the patient and at the end of operation in prone position and also after turning the patients back to supine position. Mean arterial pressure, systolic and diastolic blood pressure and heart rates were also assessed.

Result: The baseline Mean Intraocular Pressure among awake patients in supine position in Isoflurane and Propofol groups were 15.8 ± 3.1 and 18.2 ± 5.4 mmHg respectively. At the end of operation intraocular pressure in prone position in these two groups of patients changed to 18 ± 5.8 and 17.2 ± 4.9 mmHg respectively (P = 0.024) indicating a statistically significant difference in change. According to mixed analysis, mean arterial pressure, systolic blood pressure, diastolic blood pressure, end tidal Co2 and heart rate did not show statistically significant difference between the two groups (P < 0.05).

Conclusion: Propofol better controls the intraocular pressure compared to Isoflurane in prone position among patients undergoing lumbar disk surgery with no significant difference in hemodynamic responses.

 

Keywords: Intraocular pressure; prone; position; surgery; Propofol; Isoflurane.

Electroretinographic Changes in Multiple Sclerosis Patients with Abnormal Visual Evoked Potentials

Seyed Mohammad Masoud Shushtarian, Farhad Adhami-Moghadam, Maryam Naser

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 34-38
https://doi.org/10.22037/joos.v1i3.22729

Purpose: Multiple Sclerosis (MS) is a disease of nervous system which is accompanied by degeneration of visual pathway in certain cases. Magnetic Resonance Imaging (MRI) and Visual Evoked Potentials (VEP) are among the diagnostic techniques in detecting this disease. The aim of the present study was to evaluate the possible electroretinography (ERG) changes among these patients.
Patients and Methods: Thirty eyes of the patients with definite diagnosis of multiple sclerosis and delay in latency of visual evoked potential P100 peak entered the present prospective case control study as the case group. Latency and amplitude of ERG b-wave peak were measured in each eye. The result was compared with normal eyes thirty from age and sex marched individuals to evaluate the possible differences between the two groups.
Results: There was no statistically significant difference regarding the demographic data (age, UCVA) between the case and control groups. The b-wave latency did show a statistically significant difference between patients with MS and normal controls (P < 0.001). The ERG b-wave amplitude did not show statistically significant difference between patients with MS and the control group.
Conclusion: From the result of the present study it seems that the latency of b-wave in flash ERG might be used as an indicator to evaluate the retinal dysfunction in MS patients with abnormal VEP pattern.

Keywords:  Multiple sclerosis; retinal changes; flash electroretinography

Case Reports


Visual Disturbance in a Patient with Amiodarone Treatment Following Refractive Surgery

Maryam Naser, Seyed Mohammad Masoud Shushtarian, Ahmad Shojaei, Farhad Adlami-Moghdam

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 39-42
https://doi.org/10.22037/joos.v1i3.23351

Amiodarone is an antiarrhythmic medication used to treat a number of irregular heartbeats. Known ocular side effects of amiodarone include visual loss, swelling of the optic disc without visual deterioration and abnormal blue color vision. After discontinuation of amiodarone either a visual improvement or a permeant deterioration may result. Here we report a rare case of visual disturbance in a patient with a history of amiodarone treatment complaining from seeing colored rings around the lights after refractive surgery. After the discontinuation of amiodarone treatment the patient complains subsided.

 

Keywords: Amiodarone; Visual side effect; Treatment; Refractive surgery.

A Rare Case of Thalassemia and Angioid Streaks

Sasan Vojoodi

Journal of Ophthalmic and Optometric Sciences, Vol. 1 No. 3 (2017), , Page 43-46
https://doi.org/10.22037/joos.v1i3.23350

Here we describe a rare case of thalassemia and angioid streaks. Our patient was a woman who had been referred to our center due to reduction in vision over the past few years. She had a history of thalassemia major and related therapeutic interventions. The right eye sight was - 2/10 and the left eye sight was - 1/10. In her fundus view diffuse lesions were observed in both eyes. The patient was diagnosed as a case of angioid streak.

Keywords: Angioid Streak; Thalassemia; Iran.