Original Articles


A New Method for Nucleus Extraction in Complicated Cataract Surgery

Nader Nassiri, Kourosh Sheibani, Saman Nassiri , Sara Kavousnezhad, Arvin Porkar Rezaeyeh, Nariman Nassiri

Journal of Ophthalmic and Optometric Sciences, Vol. 6 No. 4 (2022), 16 March 2024, Page 1-4
https://doi.org/10.22037/joos.v6i4.43345

Purpose: This manuscript introduces a novel method for extracting nuclei in patients undergoing complex phacoemulsification procedures.
Patients and Methods: We employed a new nuclear extraction technique in 107 cases of posterior capsule rupture, extensive subluxation or dislocated lenses, and extracapsular cataract extraction. The procedure involved creating a large partial-thickness corneal groove, followed by capsulotomy and the placement of a preplaced suture. Subsequently, we converted the corneal groove into a full-thickness incision, lifted the anterior corneal lip using the preplaced suture to expose the anterior chamber, and inserted two 23-gauge needles from opposite directions into the nucleus body for gradual extraction. Patients were monitored for a minimum of six months postoperatively.
Results: We successfully employed this method in 107 nucleus extractions. No complications were observed during the follow-up period of at least six months.
Conclusions: We have developed a safe, simple, and easily learned method for extracting large subluxated nuclei in patients undergoing complex phacoemulsification procedures. This method has the potential to reduce the risk of vitreous loss.

Safety and Efficacy of Intraocular Phakic Contact Lens Implantation in Keratoconus Patients

Hamidreza Heidari, Seyed Hashem Daryabari, Farhad Nejat, Setare Besharatzad, Shiva Pirhadi, Khosrow Jadidi

Journal of Ophthalmic and Optometric Sciences, Vol. 6 No. 4 (2022), 16 March 2024, Page 5-12
https://doi.org/10.22037/joos.v6i4.44331

Purpose: To evaluate the safety and efficacy of toric implantable phakic contact lens (IPCL) implantation in the treatment of patients with keratoconus.
Patients and Methods: We included 17 eyes from 10 consecutive keratoconus patients who underwent toric IPCL implantation (IPCL V.2, Care Group Sight Solutions, India) in this study. The primary measures were uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), sphere, astigmatism, and intraocular pressure (IOP). These parameters were assessed preoperatively and at 1, 3, and 6 months postoperatively. Intraoperative and postoperative complications were also evaluated.
Results: The mean age of the patients entering the study was 36 ± 8.8 years. The preoperative BCVA was 0.75 ± 0.21 diopter, improving to 0.86 ± 0.11 diopter postoperatively (P = 0.017). The mean UCVA improved significantly from a preoperative measurement of 0.09 ± 0.11 diopter to 0.78 ± 0.15 diopter postoperatively (P < 0.001). The mean spherical equivalent (SE) showed an enhancement from -6.8 ± 2.1 diopters preoperatively to -0.7 ± 0.3 diopters at the postoperative assessment (P < 0.001). The mean IOP increased from 15.3 mmHg to 16.2 mmHg (P = 0.007) which was statistically significant but clinically insignificant. Additionally, none of the patients experienced postoperative complications such as endophthalmitis, uveitis, IPCL rotation, cataracts, or cystoid macular edema (CME) within the six months following the procedure.
Conclusion: The implantation of IPCL in patients with keratoconus appears to be safe and effective. However, further studies with longer follow-ups and larger sample sizes are recommended to validate these findings.

Comparison of Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty Post-Operative Results among Keratoconus Patients

Farid Karimian, Amir Faramarzi, Seyed Ali Mosavi , Mahdi Yaseri

Journal of Ophthalmic and Optometric Sciences, Vol. 6 No. 4 (2022), 16 March 2024, Page 13-20

Purpose: To compare post-operative results among keratoconus patients undergoing penetrating keratoplasty (PKP) in comparison with deep anterior lamellar keratoplasty (DALK) and to study the risk factors for transplant rejection.
Patients and Methods: In this retrospective cross-sectional study, the records of all keratoconus patients referred to Labbafinejad Eye Hospital, Tehran, Iran, who underwent penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK) from 2006 to 2016, were investigated. For all patients entering the study information related to surgical corneal transplantation techniques, post-operative follow-up and post-operative results were recorded.
Results: In total the records of 216 patients (106 in the PKP and 110 in the DALK group) were included. The rate of graft rejection was 13 % and 34.3 % in DALK and PKP groups respectively (P <0.001). The graft failure rate was 7.8 % in DALK and 2.4 % in PKP group (P = 0.12). No statistically significant difference in post- operation BCVA or the number of patients with astigmatism of more than 4 diopters was observed when comparing the study groups. The higher age of patients at the time of transplant, the presence of post-surgical vascularization, and interface complications were correlated with a higher chance of transplant rejection.
Conclusion: The rate of graft rejection is significantly higher after PKP than DALK among keratoconus patients undergoing corneal transplant. The higher age of patients at the time of transplant, the presence of post-surgical corneal vascularization and interface complications were the observed risk factors for graft failure in both groups.

Evaluating the Diagnostic Accuracy of the iCare Rebound Tonometer Compared to the Goldmann Applanation Tonometer

Mohammadmehdi Hatami , Milad Arandan

Journal of Ophthalmic and Optometric Sciences, Vol. 6 No. 4 (2022), 16 March 2024, Page 21-26

Purpose: To compare the diagnostic accuracy of the iCare rebound tonometer and the Goldmann Applanation Tonometer (GAT).
Patients and Methods: A comparative assessment of intraocular pressure (IOP) was conducted on patients visiting the vision clinic at Torfeh Eye Hospital. The IOP of both eyes of each patient was initially measured by one individual using the iCare tonometer device. Then, the patients were referred to the ophthalmology department, where the IOP of both eyes was measured using the GAT by an ophthalmologist who was unaware of the IOP results obtained with the iCare tonometer.
Results: The mean age of the patients entering the study was 49 ± 17 years. The mean IOP measured with the GAT was 14.47 ± 5.92 mmHg with a range of 6 mmHg to 75 mmHg. With the iCare tonometer, it was 14.44 ± 6.42 mmHg, with a range of 6.1 mmHg to 80.7 mmHg, indicating no statistically significant difference between the two devices. There was a very strong correlation (r: 0.864; 95% confidence interval 0.732-0.983; P < 0.001) between the measurements by GAT and the iCare device. The correlation strength did not show a substantial difference between male (r: 0.885) and female patients (r: 0.816). The correlation was strong among patients with low IOP (r: 0.631), normal IOP (r: 0.797), and high IOP (r: 0.781) eyes.
Conclusion: iCare tonometer IOP readings have acceptable correlation with GAT readings and can be considered a reliable alternative to GAT for measuring IOP by primary health providers.

 

Case Reports


A Rare Case of Visual Decline due to Intradiscal Ozone Therapy in a Patient with Spinal Stenosis

Seyed Mohammad Masoud Shushtarian, Reza Pour Mazar

Journal of Ophthalmic and Optometric Sciences, Vol. 6 No. 4 (2022), 16 March 2024, Page 27-29
https://doi.org/10.22037/joos.v6i4.44203

Spinal stenosis is generally described as the narrowing of the spinal canal, causing compression of the spinal cord. Ozone therapy, which is a minimally invasive method, can be used to treat these patients. Like any other therapeutic method, this technique may have certain side effects. Here we report a case of severe visual decline caused by anterior ischemic optic neuropathy in a 75-year-old male patient who underwent ozone therapy for spinal stenosis.

Vitreous Prolapse Following Choroidal Effusion after Ahmed Glaucoma Valve Surgery: A Case Report

Maryam Yadgari, Ehsan Yazdani

Journal of Ophthalmic and Optometric Sciences, Vol. 6 No. 4 (2022), 16 March 2024, Page 30-33

Vitreous prolapse is a condition in which the vitreous gel is displaced into the anterior chamber, typically caused by a ruptured posterior lens capsule or a zonular defect. Choroidal effusion, characterized by fluid accumulation in the suprachoroidal space, is a common complication of glaucoma surgery and ocular hypotonia. We present a case of a 53-year-old male who developed vitreous prolapse following choroidal effusion and hypotonia after Ahmed glaucoma valve surgery.

Review Articles


Covid-19: The Significance of Uniform Sampling and Reporting Methods in Global Health Care Systems

Kourosh Sheibani , Nader Nassiri, Mozhgan Hashemieh

Journal of Ophthalmic and Optometric Sciences, Vol. 6 No. 4 (2022), 16 March 2024, Page 34-36

The objective of this mini review is to highlight the critical deficiencies in employing consistent and accurate data collection methods during the Covid-19 pandemic. These shortcomings have resulted in confusion, misinterpretations, stigmatization, and disparate predictions, ultimately hindering the global response to this potentially devastating pandemic. This article emphasizes the importance of uniform sampling and precise data reporting to overcome these challenges.