Original Articles

The Long Term Outcome of Ahmed Glaucoma Valve Insertion in Neovascular Glaucoma

Maryam Yadgari, Kiana Hassanpour

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 1 (2019), 1 January 2019, Page 1-5

Purpose: To evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation for neovascular glaucoma (NVG), in short, intermediate, and long term follow ups.

Patients and Methods: The present study was a retrospective review of 23 eyes of 23 patients with NGV who underwent AGV implantation at Imam Hussein Medical Center, Tehran, Iran, between January 2008 and March 2017. Pre and post operative intraocular pressure (IOP), visual acuity, surgical success rate, number of medications, and complications were recorded. The primary outcome was surgical success  defined  in  terms  of  5 ≤ IOP ≤ 21 mmHg and at least 20 %  reduction  in  IOP without glaucoma medication (complete success), or with medications (qualified success). The sum of complete success and qualified success was reported as cumulative success.

Results: The mean follow up period was 4.69 years (range, 2-10 years). The mean IOP was significantly lower compared to preoperative mean at each postoperative visit up to three years (P < 0.001). The cumulative surgical success rate at 1 year, 2 years and 3 years were 91.3 %, 82.6 %, 78.3 % respectively. The mean number of drugs needed to control IOP was significantly lower compared to preoperative mean at each postoperative visit up to three years.


Stabilization Time of Refractive Errors and Astigmatism after Cataract Surgery Using Phacoemulsification and Foldable Intraocular Lens Implants

Ali Sharifi , Seyed-Hashem Daryabari, Majid Shams , Hamid Sharifi

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 1 (2019), 1 January 2019, Page 6-10

Purpose: To evaluate the stabilization time of astigmatism and refractive errors after cataract surgery using phacoemulsification and foldable lens implantation.
Patients and Methods: The present cross-sectional study was carried out with convenience sampling method and included patients who underwent cataract surgery using phacoemulsification and implantation of foldable intraocular lens. The patients were evaluated and their data including age, sex, uncorrected visual acuity, best corrected visual acuity,  corneal cylinder, cylinder axis,  Sim K, and intra ocular pressure were recorded prior to the surgery as well as in days 2, 3, 4, weeks 1, 2, 5 and day 75 post surgery.
Results: Eighty one eyes of 77 patients with mean age of 61.39 ± 10.9 years were evaluated. The mean follow up time was 60.5 ± 48.86 days. The mean keratometry before surgery was 44.90 ± 1.85 diopters, while the mean axial length, the mean intraocular pressure and the mean astigmatism were 23.15 ± 1.98 mm, 14.01 ± 2.95 mmHg and 0.99 ± 1.10 diopters, respectively. The mean postoperative keratometry at last visit was 45.34 ± 1.80 diopters, and the mean intraocular pressure and astigmatism were, 12.46 ± 2.87 mmHg and 1.14 ± 0.96 diopters, respectively. The mean time for refraction stabilization was 11.46 ± 11.40 days and the mean stabilization time for astigmatism was 10.18 ± 11.34 days.

Conclusion: In the present study the mean stabilization time for refraction and astigmatism after cataract surgery in an Iranian population using phacoemulsification and foldable lens implantation was comparable with previous studies.


Safety Outcomes of Intrastromal Injection of Sodium Hypochlorite in the Normal Rabbit Cornea

Mohammad Soleimani, Elham Delrish, Navid Mohsenzadeh, Sima Sheikhghomi , Mohammad Mehrpour, Zahra Soleimani, Fereshteh Tayebi, S.Saeed Mohammadi, Bita Momenaei, Arzhang Gordiz, Fatemeh Abdi

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 1 (2019), 1 January 2019, Page 11-15

Purpose: To investigate side effects of intrastromal sodium hypochlorite (NaOCl) injection in normal rabbit corneas and to investigate its possible use in treatment of fungal corneal infections.
Methods: We conducted a prospective, non-randomized study in a healthy cornea rabbit model. Intrastromal injection of one hundred µl of NaOCl 5 % in one eye and NaOCl 10 % in the other eye was performed in 5 rabbits. Clinical examinations including the study of conjunctival injection, corneal edema, corneal opacity or melting, and limbal ischemia were performed on days 1, 7, 14 and 21after injection.  Specular microscopy and pathological studies were also performed three weeks after corneal injections in enucleated eyes.
Results: NaOCl 5 % injection was associated with normal endothelial morphology and cell count in specular microscopy. Some irregularities and drop out was associated with NaOCl 10 % injection. 
Conclusion: Intrastromal injection of NaOCl 5 % could be a safe method to treat fungal corneal infections.

Evaluation of Central Corneal Thickness after Cataract Surgery in Eyes with Pseudoexfoliation Syndrome

Mohsen Gohari, Neda Karimi , Masoud Reza Manaviat

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 1 (2019), 1 January 2019, Page 16-19

Purpose: To compare central corneal thickness after phacoemulsification in patients with and without pseudoexfoliation syndrome.
Patients and Methods: A total of 130 eyes who were candidates for phacoemulsification (60 eyes with pseudoexfoliation syndrome and 70 eyes without pseudoexfoliation syndrome) in Shahid Sadoughi Hospital, Yazd, Iran were included in this prospective study. Before the surgery and one day postoperatively CCT were measured in all eyes using Lenstar LS 900 biometer (Haag-Streit(®)) and compared between the case and control groups.
Results: Central corneal thickness before surgery was not significantly different between two groups (509 ± 29.28 µm in study group and 516 ± 32.11 µm in the control group, P = 0.27). Postoperatively, CCT in pseudoexfoliation group (589 ± 36.91 µm) was significantly higher than the control group (553 ± 32.77 µm) (P ˂ 0.001). 
Conclusion: The mean central corneal thickness was significantly higher in patients with pseudoexfoliation compared to patients without pseudoexfoliation after cataract surgery. We suggest that phacoemulsification in cataract surgery candidates with pseudoexfoliation should be performed more carefully and with special considerations.

Review Articles

Ophthalmic Manifestations of Acute Leukemia: A Review

Mozhgan Hashemieh , Maryam Yadgari

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 1 (2019), 1 January 2019, Page 20-29

Acute leukemias are the most prevalent neoplastic disorder among children. In these patients the leukemic cells or blasts have replaced normal hematopoietic cells in bone marrow and have spread to different extramedullary sites. Increased survival among leukemic patients in recent decades has led to diagnosing some previously less recognized complications among these patients. One of these morbidities is ophthalmic involvement. The presence of ophthalmic involvement among leukemia patients is associated with poor prognosis. Ophthalmic involvement is more common in patients with AML and in adult patients. Leukemia may involve any ocular tissue such as conjunctiva, sclera, cornea, anterior chamber, iris, lens, vitreous, retina, choroid and optic nerve. In this review, the ocular manifestations of leukemia have been discussed.

Ocular Brucellosis: A Brief Update

Ali Abbas Heydar, Mohammad Soleimani, Zahra Soleimani

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 1 (2019), 1 January 2019, Page 30-35

Brucellosis is a zoonotic disease of important health significance in endemic areas such as Iran. Brucellosis can affect any organ or system in the human body. Ocular involvement is rare and can lead to poor visual prognosis if not treated early. The most common ocular manifestation of brucellosis is uveitis, although any ocular structure can be involved. The diagnosis of ocular brucellosis is based on clinical examination as well as culture and serological tests. The classical treatment regimen includes doxycycline and rifampin. Early diagnosis and prompt treatment are effective in preventing blindness. Here we breifly review the manifestations, diagnostic tools, and treatment of ocular brucellosis.

Case Reports

Traumatic Central Retinal Vein Occlusion: A Case Report

mohsen gohari, Esmaeil Babaei

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 1 (2019), 1 January 2019, Page 36-39

Here we report a healthy 48-year-old man who experienced severe loss of vision in the left eye due to central retinal vein occlusion (CRVO) after head trauma. The patient was visited by us three days after the trauma. All systemic workups were normal. Anterior segment examination showed subconjunctival hemorrhage in the left eye. Anterior chamber was deep and clear and intraocular pressure was normal. Relative Afferent Pupillary Defect (RAPD) was negative. A dilated fundoscopic examination of the left eye revealed a moderately congested optic nerve with dilated and tortuous retinal veins scattered throughout the fundus with dot, blot, and flame-shaped hemorrhages. A few yellowish white cotton-wool spots were also seen. A fluorescein angiogram in the left eye confirmed a nonischemic CRVO.
Although isolated CRVO following trauma is a rare condition, ophthalmologists should be aware of the potential for blunt head trauma causing CRVO.