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Background: To evaluate the demographic, clinical, and prognostic characteristics of patients diagnosed with COVID-19-associated mucormycosis (CAM) in Iranian patients., Methods: This prospective observational study was conducted in 8 tertiary referral ophthalmology centers in different provinces of Iran during the fifth wave of the COVID-19 pandemic. All patients were subjected to complete history taking and comprehensive ophthalmological examination and underwent standard accepted treatment strategy based on the disease stage., Results: Two hundred seventy-four CAM patients (most were males (150, 54.7%)) with a mean age of 56.8 ± 12.44 years were enrolled. Patients with a history of cigarette smoking (Adjusted Odds Ratio (AOR) = 4.36), Intensive Care Unit admission (ICU) (AOR = 16.26), higher stage of CAM (AOR = 2.72), and receiving endoscopic debridement and transcutaneous retrobulbar amphotericin B (AOR = 3.30) had higher odds of mortality. History of taking systemic corticosteroids during COVID-19 was significantly associated with reduced odds of mortality (AOR = 0.16). Generalized Estimating Equations analysis showed that the visual acuity of deceased patients (LogMAR: 3.71, 95% CI: 3.04-4.38) was worse than that of patients who were discharged from the hospital (LogMAR: 2.42, 95% CI: 2.16-2.68) (P < 0.001)., Conclusions: This study highlights significant risk factors for mortality in patients with CAM, such as cigarette smoking, ICU admission, advanced CAM stages, receiving transcutaneous retrobulbar amphotericin B and worser visual acuity. Conversely, a history of systemic corticosteroid use during COVID-19 was linked to reduced mortality. These findings underscore the critical need for early identification and targeted interventions for high-risk CAM patients to improve clinical outcomes., (© 2024. The Author(s).)

Objective: The primary aim of this study is to calculate the dose-response ratio in patients with different levels of levator function following levator resection in simple congenital ptosis. The secondary outcome is to evaluate the success rate and effect of levator resection on postoperative levator function., Methods: In a retrospective study, the medical records of patients were reviewed for age, gender, laterality, preoperative and postoperative measurements (palpebral fissure height, marginal reflex distance 1, and levator function), magnitude of levator resection, follow-up time, and postoperative complications., Results: Of 154 patients with a mean age of 17.12 ± 11.14 years, 54 patients had excellent levator function, 41 had good function, and 59 had fair function. Following surgery, the mean levator function increased from 8.81 ± 3.40 mm to 11.29 ± 3.25 mm. The magnitude of increase in the 3 groups of excellent, good, and fair was 3.18 ± 2.63, 2.53 ± 2.24 and 1.92 ± 1.80 mm, respectively. The rate of success was 81.8% with no statistically significant difference in the 3 groups. In a multivariate logistic regression, older age, local anaesthesia, and milder ptosis were predictors of success. A table of dose-response ratios was calculated that determined the amounts of levator muscle resection for 1 mm of marginal reflex distance 1 and levator function increase., Conclusions: Levator resection has high success rate in patients with simple congenital ptosis. The function of levator muscle improved significantly following surgery, and the rate of improvement was higher in patients with better preoperative levator function., (Copyright © 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)

Introduction: Facial aging is a multifactorial process in which considerable changes occur in different face structures. Thread lifting is one of the most common minimally invasive treatments related to facial rejuvenation. This study aimed to evaluate the efficacy and safety of jawline, jaw angle, and marionette lines correction in combination with APTOS threads and ELLANSE M types through an innovative technique., Materials and Methods: In this prospective chart review study, 50 patients with ptosis candidates for lower face correction were included between October 2019 and February 2020. To perform correction of the jawline, jaw angle, and marionette lines, APTOS thread (LLN2GS) and ELLANSE M type were used through an innovative technique. The efficacy (6 and 12 months after the surgery) and safety (1, 6, and 8 weeks after the surgery) were assessed by two surgeons independently. Data were analyzed by SPSS ver. 22 for windows (IBM Inc.)., Results: In this study, 50 patients (4 male and 46 female) with Mean ± SD age of 53.84 ± 10.79 years old (Range: 42 years) were included. Regarding the results, patients' level of satisfaction (improved to excellent levels) increased from 74% at 6 months after the surgery to 86% at 12 months after the surgery. Moreover, the level of satisfaction obtained from surgeons (improved to excellent levels) decreased from 96% to 86% at 6 and 12 months after the surgery, respectively. Based on the results, there were substantial and perfect agreements between the surgeon and the independent surgeon to evaluate the surgery efficacy of facial rejuvenation 6 and 12 months after the surgery. No side effects were reported 6 and 8 weeks after surgery., Conclusion: Regarding the results, due to rare complications, deep satisfaction, and short downtime, the correction of the lower face in combination with APTOS thread (LLN2G) and ELLANSE M type through our innovative technique be considered an efficient and safe treatment., (© 2022 Wiley Periodicals LLC.)

Purpose: To evaluate the success rate, dose-response ratio, and predictive factors of success in patients with residual esotropia (≥25 prism diopter [pd]) following bilateral medial rectus (BMR) recession who underwent bilateral lateral rectus (BLR) resection., Methods: In a retrospective study, medical records were reviewed for 47 patients with equal or more than 25 pd residual esotropia following 6 mm BMR recession. Sex, age at second surgery, the interval between first and second surgery in months, visual acuity, refraction, presence of amblyopia, presence of dissociated vertical deviation or inferior oblique overaction/superior oblique overaction, preoperative and postoperative angle of deviation, amount of BLR resection, and months of follow-up were evaluated. Surgical success was defined as postoperative deviation within 8 pd of orthophoria., Results: The mean age of patients at reoperation was 48.59 ± 21.46 months. The mean near and far residual esotropia before BLR resection was 34.57 ± 11.02 and 33.83 ± 10.99 pd, respectively, reduced to 8.12 ± 1.43 pd in near and 6.32 ± 2.1 pd in far postoperatively. The mean BLR resection dosage was 5.53 ± 1.22 mm and each millimeter of BLR resection (1 mm for each eye) corrected an average of 7.95 pd of deviation in near and 7.40 pd in far. The success rate was 74.5%. After analysis using multivariate logistic regression, there were no factors associated with success., Conclusions: Bilateral rectus resection in patients with a previous BMR recession has acceptable outcomes. The recommended surgical table can be used as a guide by strabismus surgeons in patients with residual esotropia., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Current Ophthalmology.)

Purpose: To evaluate the efficacy of symmetric bilateral medial rectus recession in large-angle esotropic Duane retraction syndrome (DRS) with moderate to severe globe retraction., Methods: In a retrospective study, medical reports of 30 patients with esotropia of equal or more than 20 prism diopters (pd) and moderate to serve globe retraction due to unilateral DRS who underwent symmetric bilateral medial rectus recession were reviewed. Age, gender, laterality, amblyopia, length of follow-up, pre- and postoperative measurements of primary position deviation, ocular ductions and severity of globe retraction and abnormal head posture were evaluated. A successful result was defined as decreasing esotropia to equal or less than 8 pd or equal or less than 8 pd of consecutive exotropia., Results: The mean age of patients at surgery was 13.7 ± 8.5 years old (range: 3-38). The mean preoperative esotropia measured 28.9 ± 9.1 pd in distance and 25.7 ± 7.2 pd in near, which decreased to 4.9 ± 6.1 pd in distance and 3.9 ± 8.8 pd in near postoperatively. The mean bilateral medial rectus recession was 4.9 ± 0.9 mm (range: 3-6 mm). The mean abnormal head posture improved from 19.1 ± 6.9 degrees (range: 10-30 degrees) to 3.3 ± 4.7 degrees (range: 0-15 degrees) postoperatively. At the last follow-up visit, 23 patients (76.7%) had a successful outcome., Conclusions: In the large-angle esotropic DRS patients with moderate to severe globe retraction, symmetric bilateral medial rectus recession, can be conducted to successfully resolve primary position deviation and abnormal head posture.

Background: Cataract is a chronic disorder that is related to antioxidant-oxidant imbalance situation. We aimed to investigate the association between food diversity and serum antioxidant and oxidant indices in cataract patients compared to healthy subjects., Materials and Methods: In this case-control study, ninety volunteers (aged > 50 years) were divided into the cataract ( n = 45) and healthy control ( n = 45) groups. Anthropometric variables, physical activity and stress levels, food diversity score, serum total oxidant capacity (TOC), and total antioxidant capacity (TAC) measurements were done for all participants., Results: Serum TAC, even after adjustment for stress level, was significantly higher in healthy people compared to cataract patients ( P < 0.001). In addition, serum TOC was significantly lower in healthy controls compared to cataract patients ( P < 0.002). In healthy group, there was a weak significant positive association between serum TAC and meats group diversity (r = 0.149, P = 0.047). In addition, there was a moderate negative association between meats group diversity and TOC in the healthy controls (r = -0.712, P = 0.041). In the cataract group, there was a significant negative association between serum TOC and diversity score of fruits (r = -0.811, P = 0.017) and meats group (r = -0.926, P = 0.046) as well as total score of food diversity (r = -0.466, P = 0.003)., Conclusion: It seems that increase in total dietary diversity and food groups' diversity can have a beneficial effect on oxidant situation among cataract patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Research in Medical Sciences.)

Purpose: To evaluate the efficacy of three-muscle surgery for the treatment of large-angle exotropia with particular attention to the success rate and mean dose-response ratio., Methods: In a retrospective study, medical records were reviewed for 48 patients with exodeviation between 50 and 80 prism diopter (PD) who underwent bilateral lateral rectus recession as well as one medial rectus resection. Sex, age at surgery, presence of amblyopia, amount of preoperative and postoperative deviation, total amount of recessed and resected muscles, dose-response ratio, and associated vertical deviations were analyzed., Results: The mean age of patients at surgery was 25.4 ± 14.3 years old (range, 1-55). The mean preoperative deviation was measured 62.8 ± 7.5 PD (range, 50-80 PD). The mean amount of total recession and resection was 23 ± 1.3 mm. After a mean follow-up of 15 ± 25 months (range, 3-144), 85.4% of patients were within 10 PD of orthophoria. The mean postoperative deviation decreased to 3.8 ± 7.5 PD (range, 0-30 PD). A mean dose-response ratio of 2.5 ± 0.3 PD/mm (range, 0.9-3.1 PD/mm) was found. Of all patients, 14.6% demonstrated undercorrection., Conclusion: Simultaneous surgery on three muscles is an effective method in resolving large-angle exotropia and results in excellent outcomes with low risk of undercorrection., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Current Ophthalmology.)

Introduction: To evaluate the surgical efficacy and outcomes related to midface, mandible, neck (and double chin), and nose lifting with APTOS thread lift., Methods: In this prospective review chart study, a total of 58 patients were included (from July 2018 to July 2019). All participants underwent facial thread lifting using APTOS. The patients were followed up first week, third, and sixth month after lifting surgery. Outcomes were assessed by two surgeons and patients based on the GAIS score. All data were analyzed by SPSS-17 software with chi-square test., Results: A total of 58 patients (Mean ± SD: 52.52 ± 10.58) (F: 45, Mean ± SD:53.13 ± 11.27 years, M:13, Mean ± SD: 50.38 ± 9.43 years) were included in the study. The most common sites for the face-lifting surgery were midface and mandibular (N = 45, 77.5%), neck (N = 10, 17.3%), and nose (N = 3, 5.2%), respectively. The level of satisfaction remained unchanged (after 6 months), about 80%, for the patients, increased from 90.7% (first week) to 94.8% (sixth month) after surgery, and increased from 93.1% (first week) to 94.8% (sixth month after surgery). The highest rate of potential complications after the surgery was related to ecchymosis (17 cases, 30%), followed by complications of pain (N = 10, 17.2%), tumefaction (N = 4, 6.9%), and dimple (N = 1, 1.7%) were reported., Conclusion: The results showed that satisfaction in patients and surgeons increased over time (after 6 months). Postoperative (minor) complications were also assessed and ecchymosis was found to be the most common complication. However, the proportion of postoperative complications was relatively low., (© 2020 Wiley Periodicals, Inc.)

Purpose: To evaluate the results of inferior oblique anteriorization for the treatment of large-angle hypertropia secondary to superior oblique palsy and to determine predictors of success and the occurrence of antielevation syndrome., Methods: In this prospective study, 25 patients with unilateral congenital and acquired superior oblique palsy who had a primary position hypertropia of at least 25 Δ underwent inferior oblique anteriorization in the paretic eye. Postoperative changes in vertical deviation of primary position and contralateral gaze, abnormal head posture, extorsion, associated horizontal deviation, inferior oblique overaction, superior oblique underaction, and elevation in abduction were examined. Surgical success was defined as residual hypertropia in primary position of ≤4 Δ at final examination., Results: The mean age of patients at surgery was 19.8 ± 11.9 years (range, 4-49). The mean preoperative deviation in the primary position was 27.6 Δ ± 3.2 Δ ; in contralateral gaze, 35.0 Δ ± 3.8 Δ ; these measurements decreased postoperatively to 4.7 Δ ± 5.6 Δ and 7.0 Δ ± 5.5 Δ , respectively, after a median follow-up of 8 months. The success rate was 72%, with no difference between patients with a preoperative deviation of 25 Δ -29 Δ and those with deviation of 30 Δ -35 Δ . In a multivariate logistic regression, preoperative extorsion was negatively related to success (OR = 8.01; P = 0.03). At the final follow-up, 4 patients (16%) showed antielevation syndrome and were clinically asymptomatic., Conclusions: In unilateral superior oblique palsy, one-muscle surgery, including inferior oblique anteriorization, can be conducted to resolve large-angle hypertropia of >25 Δ . Excyotorsion is a risk factor that increases the likelihood of failure., (Copyright © 2020 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Aim: To evaluate the moderate-term success and calculate the mean dose-effect ratio in large-angle esotropic patients who underwent three muscle surgery., Methods: In a retrospective study, we reviewed the medical records of 37 patients with large-angle esotropia who underwent bilateral medial rectus recession and one lateral rectus resection. Sex, age at surgery time, amount of recessed or resected muscles in millimeter (mm), pre- and postoperative alignment in prism diopter (D), dose/response ratio, and presence of amblyopia and other associated vertical deviations were recorded., Results: The mean age of subjects at surgery was 12.2±12.3y (range: 1-57). The mean preoperative deviation of 70.4±8.1 D (range: 60-85 D) decreased to a mean of 5.4±8.1 D (range: 0-30 D) postoperatively ( P <0.005). Successful alignment was achieved in 30 of 37 patients (81%) at a mean follow-up of 15.7±20.1mo (range: 3-90). The mean amount of recession and resection was 17.59±1.29 mm, and a mean dose-response ratio of 3.79±81 (range: 2.83-4.66) was determined., Conclusion: Three-muscle surgery for large-angle esotropia results in good moderate-term outcomes without high rates of overcorrection or undercorrection., (International Journal of Ophthalmology Press.)

Purpose: To compare the effects of graded anterior transposition with myectomy in primary inferior oblique overaction (IOOA)., Methods: In a randomized clinical trial study, patients entered into two groups: graded anterior transposition (Group 1) and myectomy (Group 2). In the myectomy method, 8 mm of the inferior oblique (lO) muscle was excised in the lower temporal side, and in the graded anterior transposition group, the IO muscle was recessed according to Wright's method. Patients were followed up for at least 1.5 months. IOOA was graded from 0 to +4. Surgical success was defined as reduced IOOA to a grade of +1 or less., Results: In a randomized clinical trial study, a total of 30 patients (60 eyes) were included in the study (32 eyes in Group 1 and 28 eyes in Group 2). Pre-operation IOOA was 3.18 ± 0.78 and 3.25 ± 0.70 in Groups 1 and 2, respectively. Mean IOOA in Group 1 and 2 was 0.95 ± 0.24 and 0.40 ± 0.10 at 6 months after the surgery, which means the mean correction of the overaction was statistically significant in both methods ( P  < 0.001). The success rate in the myectomy procedure was higher than graded recession. The weakening effect was better in higher grades of overaction ( P  < 0.001). The overall success rate of Groups 1 and 2 was 75% and 96.4%, respectively ( P  = 0.029)., Conclusions: In both groups, IOOA significantly decreased after the operation. The success rate of the myectomy procedure was found to be significantly higher than graded anterior transposition., (© 2019 Iranian Society of Ophthalmology. Production and hosting by Elsevier B.V.)

Purpose: To compare outcomes of intralesional triamcinolone acetonide (TA) injection and incision and curettage (I&C) in the treatment of chronic chalazion., Methods: Patients with chronic chalazion were randomized in two groups. The patients in the TA received an intralesional injection of TA and patients in the I&C underwent I&C. The patients were followed up 3, 7, 14, 21, 28, and 45 days after the procedures. We defined success as 90% regression in the size of the lesion., Results: There were 26 patients in the TA and 25 patients in the I&C enrolled in this study. Complete resolution was achieved in 16 patients (61.5%) in the TA group and 21 patients (84%) in the I&C ( P  = 0.072). Sex, initial size, and chalazion location did not influence treatment success in either group ( P  > 0.05). Lesion recurrence occurred in 9 patients (34.61%) in the TA group and 2 (8%) in the I&C ( P  = 0.04). The average times to resolution were 8.8 ± 5.6 and 5.1 ± 4.5 days in the first and second groups, respectively ( P  = 0.03). Drug deposition occurred in 24 (92.3%) patients in the TA group, and ecchymosis occurred in 14 (56%) patients in the I&C ( P  = 0.004) group. Intraocular pressure (IOP) in the TA group and visual acuity (VA) in both groups remained unchanged., Conclusions: Both TA injection and I&C modalities are effective in the treatment of chronic chalazia. Advantages of I&C in comparison to TA include less recurrence, shorter duration of complications, and a higher success rate.

Purpose: To assess the effect of experimental anisometropia and monovision on stereopsis using the Titmus, Randot, and TNO stereoacuity tests., Methods: Sixty adult volunteers were enrolled in the present study. Four different types of anisometropia-myopia, hyperopia, and astigmatism (both 90° and 45°)-were induced by placing trial lenses over the dominant eye (from 3 to 1 D). Stereoacuity was measured using the Titmus, Randot, and TNO tests., Results: In all the anisometropia types, stereopsis deteriorated with increase in anisometropia in the three stereoacuity tests performed ( P < 0.001). The largest decrease in stereopsis was attributed to 3 D myopic anisometropia-6.51 ± 2.10, 6.59 ± 2.35, and 7.36 ± 1.89 arc seconds in Titmus circles, Randot circles, and TNO, respectively. Minimal change in stereopsis was observed in 1 D astigmatism of 45°., Conclusion: Any type of anisometropia may reduce stereoacuity; this reduction is most noticeable with myopic anisometropia, especially in the TNO test, probably due to the lack of monocular cues., Competing Interests: There are no conflicts of interest.

Objective: To evaluate the effect of artificial anisometropia in dominant and nondominant eyes on stereoacuity., Methods: In this descriptive analytic study, 60 healthy adult volunteers 18-37 years of age (mean age: 25.58 years) without any ocular disease were enrolled at Tabriz Nikookari eye hospital over a 1-year period. Anisometropia (unilateral myopia) was induced by placing trial lenses over the dominant and nondominant eyes in 1-diopter (D) increments ranging from 1 to 3 D. Stereoacuity was measured using the TNO, Randot, and Titmus stereotests and values were converted into Napierian logarithm (ln) and compared between the 2 eyes., Results: Of the 60 adults (25 male and 35 female subjects), the right eye was dominant in 49 (81.7%) of the cases. Stereoacuity levels were reduced proportionately to the degree of anisometropia in all participants. Mean stereoacuity was 4.3, 5.5, and 7.4 ln for dominant eyes and 4.1, 5.4, and 7.3 ln for nondominant eyes using the TNO test by applying 1, 2, and 3 D lenses, respectively (p > 0.05). Corresponding values were 3.5, 4.6, and 6.6 ln for dominant eyes and 3.4, 4.6, and 6.5 ln for nondominant eyes by the circles subcategory of Randot test, respectively (p > 0.05). The scores were 3.8, 4.7, and 6.5 ln for dominant eyes and 3.8, 4.7, and 6.4 ln for nondominant eyes by the circles subcategory of Titmus test, respectively (p > 0.05)., Conclusion: Artificial anisometropia could reduce stereoacuity. However, ocular dominance has no effect on the amount of stereoacuity reduction., (Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)

A rare case of human subconjunctival setariasis due to Setaria equina infection is reported herein. A 15-years old girl was referred with a 24h history of edema and redness in her left eye. On slit lamp examination, a thread-like cylindrical worm was moving in the subconjunctival area. The worm was extracted, stained and measured 110mm in length 510μm in width. The isolated worm was identified as adult female S. equina based on morphometric criteria. Identification of the species of the worm was confirmed using molecular methods. For this purpose, the 12S rRNA gene was PCR-amplified and the purified amplicon was directly sequenced. After alignment, phylogenetic analysis revealed that the 12S rRNA sequence of this worm (Accession no.: KU291446) showed 100% identity with that of S. equina. This is the first case in Iran and provides evidence that S. equina can be an etiological agent of subconjunctival infection was isolated and diagnosed as where it located Middle East., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To evaluate the factors affecting improvement of stereopsis following successful surgical correction of childhood strabismus in adults., Methods: In a prospective study, consecutive patients with childhood-onset, comitant, horizontal, constant strabismus; stereoacuity of more than 480 seconds of arc in TNO stereo test (absent stereopsis in TNO); and who had successful postoperative alignment (within 10 prism diopters [PD] of orthotropia) were enrolled. Postoperative stereopsis testing was performed using the TNO stereo test at 3 months after surgery., Results: A total of 34 patients (20 exotropes and 14 esotropes) were included. The mean age at the time of surgery was 26.08±10.53 years (range, 14-53 years). Stereopsis was improved in 8 of 34 patients (23.5%). Postoperative alignment had influence on improvement of stereopsis; 38.1% of patients who had orthotropia gained stereopsis, whereas none of patients who had horizontal heterotropia (esotropia or exotropia) of 10 PD or less gained stereopsis (p=0.01). Misalignment of 10 years' duration or longer did not preclude the development of postoperative stereoacuity (p=0.31). There was a statistically insignificant increase in improvement of stereopsis in nonamblyopic group (30.4%) compared with amblyopic group (9.1%) (p=0.22). Also, there was a statistically insignificant increase in improvement of stereopsis in exotropes (35%) compared with esotropes (7.1%) (p=0.1). The angle of preoperative deviation had no influence on improvement of stereopsis (p=0.44)., Conclusion: A postoperative correction of orthotropia was the only predictive factor for improvement of stereopsis in adults with childhood strabismus.

Purpose: The purpose of this study was to compare the success rate of monocanalicular versus that of bicanalicular silicone intubations of the nasolacrimal duct for nasolacrimal duct stenosis (NLDS) in adults (patent nasolacrimal duct with resistance to positive-pressure irrigation)., Materials and Methods: In a prospective randomized clinical trial, 52 eyes of 38 patients with NLDS underwent either monocanalicular silicone intubation (MCI) (n = 26 eyes) or bicanalicular silicon intubation (BCI) (n = 26 eyes). All procedures were performed by 1 oculoplastic surgeon. Tube removal was planned for 3 months postoperatively. Treatment success was defined as the complete resolution of epiphora or intermittent epiphora with normal dye disappearance test at 6 months after tube removal., Results: The surgical outcome was assessed in 25 eyes with MCI and 21 eyes with BCI. The mean (SD) age of treatment was 52.7 (18.6) years for MCI and 49 (18.8) years for BCI. Treatment success was achieved in 19 of 25 eyes (76%) in the MCI group compared with 16 of 21 eyes (76.2%) in the BCI group. Differences between the 2 groups proved to be not significant (P = 0.9). The only complication was peripunctal pyogenic granuloma in 2 eyes with BCI., Conclusions: Both MCI and BCI were successful in a similar percentage of patients with NLDS. The main advantages of the former technique were simple insertion and easy removal of the tube.

Aim: To report the characteristics and clinical presentations of retinoblastoma in a series of pediatric patients from Iran., Methods: In this retrospective study, profiles of pediatric patients with retinoblastoma archived in a referral eye hospital in north-west of Iran during 7 years (n=40 patients with 57 eyes) were reviewed. Demographics, as well as the laterality, clinical manifestations and the types of treatment were the major endpoints. The Student's t test, Mann-Whitney U-test, Chi-square or Fishers' Exact test was used for analysis where appropriate., Results: There were 23 cases (57.7%) with unilateral and 17 cases (42.5%) with bilateral involvement. The male to female ratio was 1 to 1.4 with a mean admitting age of 24.0±11.3 (range: 5-62) months. The mean diagnosis delay was 7.4±9.6 months (range: 10 days to 13 months). The most common presenting sign was leukocoria (97.5%) followed by proptosis (7.5%), strabismus (7.5%), hyphema (5%), orbital cellulitis (5%) and glaucoma (2.5%). Enucleation was performed in 95.7% of the cases with unilateral involvement and at least one eye of the patients with bilateral disease. A second enucleation was performed in other 3 patients (17.6%) of the latter group., Conclusion: This is the first study evaluating a series of Iranian children with retinoblastoma.

Purpose: To compare the results of conventional hang-back and anchored hang-back technique for bilateral lateral rectus muscle recessions in patients with exotropia., Methods: In a prospective, randomized clinical study, 60 patients underwent lateral rectus muscle recession by either conventional hang-back or anchored hang-back technique. Patients were then followed for 6 months; postoperative deviation and complications were compared. Surgery was considered successful if the postoperative deviation was within 10(Δ) of orthophoria., Results: The mean age of patients was 14.2 ± 10.3 years (median, 12 years) in the conventional hang-back group and 11.5 ± 9.3 years (median, 8 years) in anchored group (P = 0.85). The mean preoperative deviation at distance and near between the 2 groups was not statistically significant. The mean postoperative deviation was 8(Δ) ± 9(Δ) at distance and 7(Δ) ± 9(Δ) at near in the conventional group and 9(Δ) ± 8(Δ) at distance and 8(Δ) ± 8(Δ) at near in the anchored group. (P = 0.48 for distance, P = 0.98 for near). After 6 months, 63% of the conventional group and 60% of the anchored group were within 10(Δ) of orthophoria. Complications such as globe perforation, A and V patterns, and vertical deviations did not occur in either group. There were no statistically significant differences in the success rates (P = 0.79) or complications between the 2 groups., Conclusions: The placement of additional posterior scleral sutures to "anchor" the insertion did not improve outcomes in lateral rectus muscle recession surgery., (Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.)

Purpose: To compare bilateral medial rectus advancement (BMRA) and bilateral lateral rectus recession (BLRR) for the treatment of consecutive exotropia., Methods: This randomized clinical trial was performed on 14 patients with consecutive exotropia. Inclusion criteria were history of bilateral medial rectus recession, exotropia ≥20 PD with far-near discrepancy <10 PD. Exclusion criteria consisted of more than once medial rectus recession, restricted adduction, history of operation on the lateral rectus, positive forced duction test of the lateral rectus, concomitant neurologic disorders and follow-up less than 6 months' duration., Results: Seven patients underwent BMRA and 7 patients underwent BLRR. Mean age was 11.4±6.9 (range 5 to 21) years in the BMRA group and 13.7±7.1 (range 5-22) years in the BLRR group (P=0.44). Two patients in the BMRA group and 3 subjects in the BLRR group were amblyopic. Mean preoperative exotropia was 27.8±6.3 PD and 39.2±14.8 PD (P=0.09) which was reduced to 4.2±2.3 PD and 3.4±2.2 PD (P=0.94) in the BMRA and BLRR groups respectively. Successful alignment was achieved in 71.4% and 85.7% of cases in the BMRA and BLRR groups respectively (P=0.94). All amblyopic patients achieved successful alignment postoperatively., Conclusion: Bilateral medial rectus advancement and bilateral lateral rectus recession are comparable in efficacy for treatment of consecutive exotropia.

Purpose: Anterior transposition of the inferior oblique muscle (ATIO) has been reported to be an effective treatment for dissociated vertical deviation (DVD). In this study, we evaluated the effectiveness of this surgical procedure in patients with DVD alone and in those with DVD with concurrent overactive inferior oblique muscle and compared the results., Methods: Nineteen eyes with DVD alone (group 1) and 15 eyes with DVD and concurrent inferior oblique overaction (group 2) underwent ATIO. The amount of DVD and inferior oblique overaction before and after the operation was measured and statistically analyzed., Results: The average follow-up time for group 1 and group 2 was 9.4 and 9.0 months, respectively. Of a total of 34 eyes, 7 had DVD of more than 15 prism-diopters (pd) [four eyes from group 1 and three eyes from group 2] in which the residual DVD after surgery was more than 5 pd. However, in the 27 eyes with DVD of 15 pd or less (15 from group 1 and 12 from group 2), the residual DVD after the operation was less than 5 pd. (Fisher's exact test, P = .014)., Conclusion: ATIO is an effective method for correcting DVD with and without inferior oblique overaction, especially in deviations of less than 15 pd.