The ectatic disease of the cornea poses a significant challenge for ophthalmologists because commonly used treatments to improve visual acuity, such as spectacles and contact lenses, may not be effective, especially in advanced stages. In addition, the preferred surgical management, corneal transplantation, has various issues related to tissue availability, the steep learning curve, and postoperative complications such as tissue stability and half-life. Ongoing research for an alternative to keratoplasty has suggested various methods, such as corneal crosslinking, which can improve visual function when combined with other techniques.
View Article and Find Full Text PDFPurpose: The purpose of this study was to investigate the long-term clinical outcome of keratolimbal allograft (KLAL) alone or in combination with keratoplasty, in the management of patients with chronic and delayed-onset mustard gas keratopathy (MGK).
Methods: Patients who had KLAL for MGK with or without corneal transplantation between 2002 and 2016 were recalled to be enrolled in this retrospective interventional case series. The primary outcome was the success rate of the KLAL demonstrated by Kaplan-Meier cumulative survival analysis.
Purpose: To investigate and optimize the accuracy of aphakic refraction (AR) techniques for secondary intraocular lens (IOL) power calculation in aphakic children.
Methods: Thirty-three aphakic eyes of 18 patients who were candidates for secondary IOL implantation were enrolled in the present study. Axial length (AL) measured by optical biometry was used in the biometric formula (SRK-T, Holladay II, and Hoffer-Q).
We describe a modified allogenic intrastromal lenticule implantation technique for management of keratoconus (KCN). Patients with advanced KCN already scheduled for corneal transplantation were enrolled. An allogenic corneal lenticule was implanted inside a stromal pocket created by femtosecond laser.
View Article and Find Full Text PDFPurpose: To investigate the indications, clinical outcomes, and complications of secondary piggyback intraocular lens (IOL) implantation for correcting residual refractive error after cataract surgery.
Methods: In this prospective interventional case series, patients who had residual refractive error after cataract surgery and were candidates for secondary piggyback IOL implantation between June 2015 and September 2018 were included. All eyes underwent secondary IOL implantation with the piggyback technique in the ciliary sulcus.
Purpose: To compare the efficacy of topical 0.03% tacrolimus in combination with systemic corticosteroids versus systemic mycophenolate mofetil (MMF) and corticosteroids in preventing corneal allograft rejection after repeat keratoplasty.
Methods: This prospective, randomized clinical trial enrolled 63 consecutive eyes of 63 patients who underwent repeat keratoplasty after a failed penetrating keratoplasty.
Purpose: To investigate the efficacy of topical (AV) gel-derived eye drops on the healing of alkali-burned corneas in rabbits.
Methods: Thirty alkali-burned corneas of 30 New Zealand albino rabbits were categorized into three groups: AV treatment group that received AV gel-derived eye drops four times a day; medical therapy (MT) group that received conventional treatment; and the control group. Clinical examinations together with digital imaging of the corneas were performed on days 0, 1, 2, 4, and 7.
Primary angle-closure glaucoma (PACG) is a common form of glaucoma in the Far East. Its defining feature is iridocorneal angle closure. In addition to PACG, indications of angle closure are included in the diagnostic criteria of related conditions primary angle-closure suspect (PACS) and primary angle closure (PAC).
View Article and Find Full Text PDFPurpose: To evaluate the effect of suture removal on refraction and keratometry measurements after deep anterior lamellar keratoplasty (DALK).
Methods: This retrospective study enrolled 54 keratoconus-affected eyes that underwent DALK. A combined suturing technique consisting of a 16-bite single running and 8-bite interrupted 10-0 nylon sutures was used at the time of keratoplasty.
Purpose: To develop clinical practice guidelines (CPGs) for prevention, diagnosis, treatment and follow-up of ocular injuries caused by exposure to mustard gas.
Methods: The clinical questions were designed by the guideline team. Websites and databases including National Guidelines Clearinghouse, National Institute for Clinical Excellence, Cochrane, and PubMed were searched to find related CPGs and explore possible answers to the clinical questions.
Purpose: To compare the safety and efficacy of three methods for correcting pre-existing astigmatism during phacoemulsification.
Methods: This prospective, comparative, non-randomized study was conducted from March 2010 to January 2011, and included patients with keratometric astigmatism ≥1.25 D undergoing cataract surgery.
Purpose: To customize clinical practice guidelines (CPGs) for cataract management in the Iranian population.
Methods: First, four CPGs (American Academy of Ophthalmology 2006 and 2011, Royal College of Ophthalmologists 2010, and Canadian Ophthalmological Society 2008) were selected from a number of available CPGs in the literature for cataract management. All recommendations of these guidelines, together with their references, were studied.
Purpose: To compare the clinical outcomes of deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with vernal keratoconjunctivitis (VKC) versus those without VKC.
Methods: In this retrospective comparative study, records of 262 eyes with keratoconus (Group 1) and 28 keratoconic eyes with VKC (Group 2) that had undergone DALK were compiled. Reviewed parameters included length of follow-up, best-corrected visual acuity (BCVA), refractive error, complications and cumulative graft survival.
Purpose: To determine the prevalence of trachoma and risk factors associated with the disease in rural areas of the Sistan-va-Baluchestan province in Iran from 2012-2013. Population-based prevalence data for trachoma is lacking in this region.
Methods: In this population-based cross-sectional study, 80 clusters were selected using a systematic and probability proportional to size method.
Purpose: To determine the sensitivity and specificity of anterior and posterior corneal elevation parameters as determined by Orbscan II (Bausch and Lomb, Rochester, NY, USA) in discriminating between (sub) clinical keratoconus (KCN) and normal corneas.
Methods: This prospective case-control study included 28 eyes with subclinical KCN, 65 with clinical KCN and 141 normal corneas. Anterior and posterior corneal elevation was measured and compared in the central 5-mm corneal zone using Orbscan II.
Purpose: To assess the agreement among ultrasonic pachymetry, the Galilei dual Scheimpflug analyzer, and Orbscan II for central and peripheral (Galilei vs. Orbscan) corneal thickness (CCT and PCT) measurement in normal and keratoconic eyes.
Methods: In this prospective study, CCT and PCT were measured in 88 eyes of 88 refractive surgery candidates and 128 eyes of 69 keratoconic patients with ultrasonic pachymetry, the Galilei, and Orbscan II.
Purpose: To introduce a modification to big-bubble deep anterior lamellar keratoplasty (DALK) which can decrease the risk of Descemet membrane (DM) perforation during air injection.
Method: In Anwar's big-bubble technique, a 27-guage needle is inserted from the trephination site and advanced into the corneal stroma up to the centre. The technique we introduce modifies the original technique in the following fashion.
Purpose: To measure corneal elevations in eyes with subclinical keratoconus and those with keratoconus using the Galilei Scheimpflug analyzer and to determine the optimal corneal elevation cutoff points to maximize sensitivity and specificity in discriminating keratoconus and subclinical keratoconus from normal corneas.
Methods: A total of 136 normal eyes, 23 eyes with subclinical keratoconus, and 51 eyes with keratoconus were enrolled. Maximum anterior and posterior corneal elevation was measured in the central 3-, 5-, and 7-mm zones using the Galilei double Scheimpflug camera.
Purpose: To report the clinical, microbiologic, confocal scan and histopathologic features of Aspergillus flavus keratitis which developed immediately after deep anterior lamellar keratoplasty (DALK).
Case Report: A 28-year-old woman underwent DALK using the big-bubble technique for keratoconus. The operation was uneventful, yielding a bare Descemet's membrane (DM) followed by transplantation of a corneal graft devoid of DM and endothelium.
Purpose: To investigate the incidence, mechanisms, characteristics, and visual outcomes of traumatic wound dehiscence following keratoplasty.
Methods: Medical records of 32 consecutive patients with traumatic globe rupture following keratoplasty who had been treated at our center from 2001 to 2009 were retrospectively reviewed.
Results: The study population consisted of 32 eyes of 32 patients including 25 men and 7 women with history of corneal transplantation who had sustained eye trauma leading to globe rupture.
Purpose: To determine the incidence of clinical keratoconus (KCN) in an Iranian population.
Methods: This prospective surveillance study was conducted in Yazd province in central Iran (population 990,818). During 1 year (July 2008 to June 2009), all new patients with KCN were registered and referred.
Purpose: To report endothelial corneal graft rejection after administration of topical latanoprost eye drops.
Case Report: Two eyes of two patients with a history of multiple intraocular procedures prior to penetrating keratoplasty developed endothelial graft rejection one month after administration of topical latanoprost. Cystoid macular edema developed simultaneously in one patient.