Purpose: To compare biometric changes after implantation of posterior chamber phakic collamer lenses (PCLs) in conventional and Aquaport ICL models.
Patients and Methods: Records of myopic patients who underwent ICL implantation between March 2012 and April 2015 were reviewed. Demographics, manifest and cycloplegic refraction, BCVA, and preoperative IOP were documented. All patients underwent ultrasonic biomicroscopy to determine sulcus-to-sulcus distance and angle parameters under dim illumination (STS, Quantel Biomedical, France), along with topography and keratometric measurements. Patients were recalled postoperatively for repeat ultrasonic biomicroscopy under identical settings. Keratometric values were also obtained using the Galilei Dual Scheimpflug Tomography Analyzer (Ziemer, Switzerland).
Results: Fifty-eight eyes of 30 myopic patients were included; 28 eyes of 15 patients were assigned to the V4b group and 30 eyes of 15 patients to the V4c group. Mean follow-up time was 27.7 ± 9.3 months in the V4b group and 26.6 ± 8.8 months in the V4c group. No significant differences in postoperative refraction or intraocular pressure were observed between groups at 1 and 3 months. All preoperative biometric parameters changed after surgery in both groups. Nasal angle parameters (TIA-nasal and AOD500-N) differed significantly between V4b and V4c lenses, while other biometric indices and lens densitometry showed no significant differences.
Conclusion: The central-hole design of the V4c ICL appears as effective as peripheral iridotomy in V4b lenses in preventing deterioration of anterior-segment biometric parameters and may promote a more uniform aqueous humor outflow at the anterior chamber angle. 

Purpose: To evaluate visual pathway function in individuals with myasthenia gravis using pattern-reversal visual evoked potentials (VEP) and to compare P100 latency and amplitude between affected individuals and healthy controls.
Patients and Methods: A case–control design was used, including 10 individuals with myasthenia gravis (20 eyes) and 10 age-matched healthy controls (20 eyes). Pattern-reversal VEP was recorded monocularly under standardized conditions. P100 latency and amplitudes were measured and statistically compared between groups.
Results: Eyes from the myasthenia gravis group demonstrated significantly prolonged P100 latency (113.1 ± 5.74 ms) compared with controls (98.1 ± 3.33 ms; P < 0.001). P100 amplitude was markedly reduced in the myasthenia gravis group (2.65 ± 1.22 µV) relative to controls (9.00 ± 2.20 µV; P < 0.001).
Conclusion: The results of this study suggest that myasthenia gravis is associated with functional disturbance of the visual pathway, reflected by significant abnormalities in pattern-reversal VEP. Although not diagnostic, VEP may serve as a complementary tool for assessing visual involvement in this condition.

Purpose: To evaluate the reliability, content validity, and cultural appropriateness of the Persian translation of the Asthenopia Questionnaire (ASQ-17) among Persian-speaking adults.
Materials and Methods: Thirty adults aged 20–54 years completed the Persian ASQ-17. Translation followed a forward–backward protocol. Internal consistency was assessed using Cronbach’s alpha for the total scale and its subscales. Content validity was evaluated by 20 experts using the Content Validity Index (CVI). Face validity was assessed through structured cognitive interviews.
Results: The overall scale demonstrated strong internal consistency (α = 0.888). Subscale coefficients ranged from 0.618 to 0.841. All items achieved CVI values between 0.80 and 1.00. Interview feedback confirmed clarity, comprehensibility, and cultural suitability of all items.
Conclusion: The Persian ASQ-17 shows strong reliability, content validity, and face validity, supporting its use for assessing asthenopia symptoms in Persian-speaking adults.

Purpose: To compare 20 % autologous serum (AS) with preservative-free artificial tears (PFAT) for epithelial healing and early outcomes after photorefractive keratectomy (PRK).
Patients and Methods: Prospective, contralateral-eye clinical trial including 60 myopic patients (120 eyes). In each patient, one randomly assigned eye received 20 % AS and the fellow eye PFAT post-PRK. Primary outcome was time to complete epithelial closure. Secondary outcomes included day-by-day postoperative pain (Days 1–3), epithelial defect (ED) size (Days 1–2), corneal haze, and uncorrected visual acuity (UCVA) at 12 weeks. Standardized PRK technique and identical bandage contact lenses were used. Paired-eye statistics were applied (paired t-test or Wilcoxon as appropriate; χ² for categorical data; α=0.05).
Results: Epithelial closure time did not differ between groups (AS 3.00 ± 0.33 vs. PFAT 3.03 ± 0.21 days; P=0.655). Mean Day-1 pain was numerically lower with AS overall (AS 3.28 ± 1.75 vs. PFAT 3.60 ± 1.83), and significantly lower among women (AS 3.39 ± 1.96 vs. PFAT 4.11 ± 2.05; P = 0.003). Pain declined to near-zero by Day-2 in both groups (AS 0.07 ± 0.31 vs. PFAT 0.08 ± 0.38). ED size was similar on Day-1 (AS 5.50 ± 0.73 vs. PFAT 5.56 ± 0.73) and Day-2 (AS 3.33  ± 0.60 vs. PFAT 3.47  ± 0.79). No eye developed haze.  
Conclusions: After PRK, 20 % AS and PFAT yield comparable epithelial closure (~3 days) and 12-week visual outcomes. AS may reduce early postoperative pain, particularly in women, warranting larger paired-eye trials to confirm this signal.

Purpose: To examine how Iran’s Health Transformation Plan (HTP), introduced in 2014 to expand coverage and reduce out-of-pocket costs, shaped the country’s COVID-19 response and to identify lessons for future health crises.
Materials and Methods: A systematic review of studies published between 2014 and 2023 was conducted in line with PRISMA standards. Sources included international databases, national policy documents, and institutional reports. Twenty-five studies met inclusion criteria. Data were synthesized thematically and interpreted using Kingdon’s Multiple Streams Framework.
Results: The HTP improved access to health services but provided limited resilience during COVID-19. Lockdowns were partial and delayed; digital tools were mostly informational hotlines rather than case-based tracing; laboratory and testing capacity expanded slowly; and social protection programs largely excluded informal workers. Vaccine rollout was delayed by early restrictions on Western imports but accelerated later through domestic production and alternative imports. Across domains, the absence of interoperable data systems, particularly a National Vulnerability Database, restricted targeted interventions.
Conclusion: The HTP enhanced visibility but lacked adaptability in crisis. Durable resilience requires interoperable data governance, inclusive social protection, and decentralized preparedness. The findings provide transferable lessons for health reforms under fiscal and geopolitical constraints.

Cataract surgery in adults with amblyopia can lead to improved visual acuity in the amblyopic eye, with several studies reporting a significant correlation between pre- and postoperative corrected distance visual acuity (CDVA). While some amblyopic eyes may experience a slight deterioration in visual acuity, many show stability or improvement after surgery. The extent of improvement varies, with some patients achieving 6/12 or better uncorrected visual acuity (UCVA) and nearly all achieving 6/12 or better best-corrected visual acuity (BCVA).

Purpose: To highlight the importance of comprehensive dilated examination in refractive surgery candidates and to demonstrate how early detection of lenticonus can prevent misdiagnosis and suboptimal management.
Case Report: Lenticonus is a rare ocular anomaly characterized by protrusion of the anterior or posterior surface of the crystalline lens due to thinning of the lens capsule, resulting in reduced visual acuity and irregular astigmatism that is often not adequately correctable with spectacles or contact lenses. A 29-year-old female presented to our refractive surgery center with compound myopic astigmatism and a high astigmatic component. 
Conclusion: Comprehensive dilated examination of the fundus and lens should be routinely performed in all refractive surgery candidates to prevent misdiagnosis and facilitate early detection of conditions such as lenticonus, allowing appropriate management.