Original Articles


Comparison of Iris Fixated and Scleral Fixated intra Ocular Lens for Correction of Aphakia in Traumatic Cataract with no Proper Capsular Support

Keyvan Shirzadi, Seyed Ali Tabatabaei, Seyed Mehdi Tabatabaei, Mohammad Soleimani

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 2 (2019), 6 April 2019, Page 1-9
https://doi.org/10.22037/joos.v3i2.33970

Purpose: To compare visual outcomes and complications of iris fixated and scleral fixated intra ocular lens (IOL) implantation in patients suffering from traumatic cataract with no proper capsular support.
Patients and Methods: This prospective interventional study was performed in Farabi Eye Hospital, Tehran, Iran, between May 2015 and May 2016. Twenty five patients with traumatic cataract and no proper capsular support for IOL implantation in the bag or sulcus were included and randomly underwent either iris fixated or sulcus fixated IOL implantation. Follow up visits were performed one day, one week, four weeks, three months and six months after surgery. In each visit visual acuity, intra ocular pressure, placement of IOL and anterior chamber reaction were studied.
Results: Thirteen eyes of 13 patients underwent iris fixation and 12 eyes of 12 patients underwent scleral fixation of IOL. The average patient age at presentation was 29.12 ± 16.32. In the follow up visit one week after IOL fixation three patients in each group had significant anterior chamber inflammation. There was no statistically significant difference between the two groups regarding the number of patients with elevated IOP (P = 0.96), dislocated IOL (P = 0.480) and complications such as wound dehiscence and iridocorneal adhesion. Also no statistically significant difference regarding the mean BCVA three months after surgery was observed (P = 0.55).
Conclusion: We did not observe any significant difference in outcome of iris and scleral fixation of IOL in traumatic eye injuries with no effective capsular support. 

Purpose: To evaluate a new method of inferior oblique muscle myectomy with displacement of the external rectus muscles on both sides for correction of exotropia V pattern with severe inferior oblique muscle overaction.
Patients and Methods: In a pilot study, 9 patients with exotropia V pattern strabismus who were referred to Al-Zahra Ophthalmology Hospital, Tehran, Iran, in 2011 were studied in two randomly divided groups: group A underwent conventional surgical treatment including external rectus resection and inferior oblique weakening and in addition received external rectus displacement upwards while group B only received the conventional treatment.
Results:  The mean V pattern before surgery in group A was 41 ± 16.7 prism diopters which changed to 6 ± 10.7 prism diopters after surgery. The mean V pattern before surgery in group B was 37.2 ± 4.3 prism diopters which changed to 19.5 ± 3.1 prism diopters after surgery. In group A, V-pattern correction was 35.0 ± 11.6 prism diopters while it was  20.2 ± 1.2 prism diopters in group B, which indicated a statistically significant difference between the two groups (P = 0.04(.
Conclusion: Our results suggest that the mean V Pattern correction among patients undergoing our modified surgical method was significantly higher than the conventional method. Further comparative studies with a higher number of participants are suggested to confirm our results.

Refractive and Biometric Outcomes Following a Single Dose Intravitreal Bevacizumab Administration

Majid Abrishami, Alireza Eslampoor, Mohsen Roknizadeh, Esmaeil Babaei

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 2 (2019), 6 April 2019, Page 16-20
https://doi.org/10.22037/joos.v3i2.32759

Purpose: To evaluate the effect of intravitreal bevacizumab monotherapy on refractive and biometric parameters among patients with central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO) or clinically significant macular edema (CSME).
Patients and Methods: This prospective study included patients aged between 35-50 years who received a single dose intravitreal injection of bevacizumab in Khatam-Al-Anbia eye hospital, Mashhad University of Medical Sciences, Mashhad, Iran, from 2015 to 2017.  Dry and cycloplegic refraction, visual function, accommodative amplitude, keratometry results, axial length, anterior chamber depth, lens thickness, vitreous length and central corneal thickness, before and 1 and 3 months after injection were evaluated and compared.
Results: Twenty seven patients (fifteen females and twelve males) entered the study with the mean age of 45.18 ± 2.68 years. The mean best corrected visual acuity (BCVA) of patients improved significantly (P = 0.006) three months post injection compared to before injection.  No statistically significant difference was observed between the refractive parameters (dry and cycloplegic refraction), accommodative amplitude, biometric parameters including keratometry, axial length, and lens thickness, before and 1 or 3 months after injection.
Conclusion: Based on our findings bevacizumab monotherapy improved the mean BCVA among patients with CRVO, BRVO, or CSME, but had no significant effect on refractive and biometric parameters of the treated eyes up to 3 months after injection.

Evaluation of the Effect of Oral Vitamin B1 on Pain Due to Corneal Neuropathy after Cataract Surgery

Bahareh kermani, Shiva Kargar, Reza Ghasemi Nejad Afshar, Akbar Mehralizadeh, Mahdi Neshan, Ali Reza Yusefi, Eshagh Barfar, Mohammad Ali Sheikh Beig Goharrizi, Salman Daneshi

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 2 (2019), 6 April 2019, Page 21-32
https://doi.org/10.22037/joos.v3i2.36319

Introduction: Cataracts are the leading cause of low vision and blindness in the world, and the only effective treatment for cataract vision impairment is surgery, which has common complications such as eye pain and burning, inflammation, and postoperative headache. The aim of this study was to evaluate
the effect of vitamin B1 on oral pain on corneal neuropathy after cataract surgery in Jiroft.
Method and Materials: This randomized clinical trial study was performed on cataract patients who were candidates for surgery and referred to Imam Khomeini Hospital in Jiroft in 2020. Demographic information was collected through a designed checklist and the Numerical Pain Scale (NRS) was used to measure postoperative severity in the eye. The collected data were analyzed using SPSS-V21 software.
Results: In this study, 130 patients with cataracts (intervention group: 65 and control group: 65) were studied. The intervention group consisted of 27 men (41.5 %) and 38 women (58.5 %) and the control group consisted of 25 men (38.5 %) and 40 women (61.5 %). On the third day and one week after surgery, there was no significant difference in the amount of eye pain and irritation caused by surgery in the intervention and control
groups, and in the three months after surgery, the intervention group had mild eye pain and irritation.Conclusion: The results of this study showed that taking vitamin B1 orally affects eye irritation and pain caused by corneal neuropathy after cataract surgery and reduces eye irritation and pain intensity during 3
months.

Case Reports


The Use of Subconjunctival Erythropoietin Injection to Treat Avascular Bleb after Trabeculectomy: A Case Report

Maryam Yadgari, Iman Ansari , Kiana Hassanpour

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 2 (2019), 6 April 2019, Page 33-36
https://doi.org/10.22037/joos.v3i2.33974

Purpose: To report a patient with avascular bleb after trabeculectomy who showed promising results after subconjunctival erythropoietin injection.

Case Report: A 45-year-old woman with the diagnosis of primary open-angle glaucoma and history of trabeculectomy three years prior was admitted to our center. The corrected distance visual acuity (CDVA) was 20/20 in both eyes. Her ocular examination revealed an avascular and cystic bleb in the right eye. Seidel test was negative while bleb sweating was observed after fluorescein staining of the bleb area. Intraocular pressure (IOP) was 5 mmHg in the right eye. Erythropoietin (2000 unit in 0.1 ml) was injected subconjuctivally around the bleb area in the temporal quadrant. Six weeks after the injection, the bleb area just superior to the conjunctiva showed an increased fibrosis formation while the IOP remained the same as before injection.

 

Subconjunctival Myolipoma Confirmed with Immunohistochemical Analysis: A Case Report

Fahimeh Asadi-Amoli, Mohammad Soleimani, Zohreh Nozarian, Reza Garebaghi , Tooba Ghazanfari , Maryam Parvizi, Keivan Rezaei, Seyed Ali Tabatabaei

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 2 (2019), 6 April 2019, Page 37-41
https://doi.org/10.22037/joos.v3i2.33972

Purpose: To report the clinicopathological features of a rare case of subconjunctival myolipoma and its treatment results.
Case Report: A 17-year-old female patient referred to our center with a white-pink mass in her left upper bulbar conjunctiva. The lesion extended to the forniceal conjunctiva. The patient had otherwise normal complete ocular examinations and underwent complete surgical excision of the mass due to cosmetic concerns. The tumor was examined with light–microscopy, following hematoxylin and eosin (H&E), Masson-trichrome, and immunohistochemical (IHC) staining.A definite diagnosis of subconjunctival myolipoma was acheived following the pathological assessment. Six months postoperatively, no tumor recurrence was noted, and ocular examinations were within normal limits.

Review Articles


Elevated Intraocular Pressure after Pars Plana Vitrectomy: A Review

Maryam Yadgari, Mansoor Shahriari , Pirouzeh Farsi

Journal of Ophthalmic and Optometric Sciences, Vol. 3 No. 2 (2019), 6 April 2019, Page 42-51
https://doi.org/10.22037/joos.v3i2.34900

Intraocular pressure (IOP) elevation is a well-known complication after pars plana vitrectomy with or without tamponade. The mechanism of increase in IOP can be open angle, closed angle or both. Oxidative stress is hypothesized to have a significant role in the pathogenesis of post vitrectomy elevated IOP and the presence of the lens probably has a protective role. The use of silicone oil and intraocular gases as tamponade is related to higher risk of post-operative elevated IOP and causes longer-term IOP elevation. Anti-inflammatory agents, mydriatics, anti-glaucoma medications especially aqueous suppressants, glaucoma surgery and laser procedures might be used for controlling post vitrectomy elevated IOP. Glaucoma shunt implantation and cyclodestructive procedures are the most important surgeries performed for treatment of uncontrolled intraocular pressure after vitrectomy.