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PURPOSE To compare the long-term outcomes obtained by glaucoma surgeons versus cornea trained surgeons performing Ahmed glaucoma valve (AGV) surgery. METHODS Of the total 376 patients (3 month to 83 year) conducted in this retrospective study, 130 patients with refractory glaucoma were evaluated who had been followed up for at least six months during ten years period. The primary outcome measure was the surgical success of AGV surgery that was categorized in two groups: (A5 ≤ IOP ≤ 21 mmHg and at least 20% reduction in IOP without any glaucoma medications (complete success) and reduction by using one or more glaucoma medications (qualified success) (B) similar to previous criteria but the cutoff for higher IOP at 16 mmHg without vision loss and the need for medication or re-surgery. RESULTS Mean age of the patients was 32.99 ± 24.20 years in the glaucoma surgeon group and 25.18 ± 24.33 years in the cornea trained surgeons group (P = 0.07). The overall success of both methods at the end of four years were 66.7% and 41.7% for the group of glaucoma surgeons and cornea trained surgeons, respectively (p = 0.661). The cumulative success according to criterion A and B was 66.7% in the glaucoma surgeon group and 47.1% in the others surgeon group (P = 0.661). Repeated glaucoma surgery was required in 33.3% and 52.9% of the patients in the glaucoma surgeon and cornea trained surgeons groups, respectively (P = 0.661). Although there was a significant difference for IOP among various follow-up periods (p = 0.004), this difference was not significant between the two groups (p = 0.374).Visual Acuity did not have a signifiant difference between various follow-up periods and surgeons groups (p = 0.419 and P = 0. 690, respectively). CONCLUSION There were comparable outcomes with regard to complications and success rates between glaucoma surgeons and cornea trained surgeons performing AGV surgery.

To compare the outcomes of removing bandage contact lens (BCL) on days 3 and 5 after photorefractive keratectomy (PRK). One hundred patients who underwent PRK (a total of 200 eyes) were enrolled in the present study. The subjects were assigned to two groups. Group 1 consisted of the right eyes of subjects and bandage contact lenses removal were on the 3rd day; Group 2 consisted of the fellow eyes of same subjects and removed bandage contact lenses on the 5th day after PRK. Then, data obtained from both groups were compared. To evaluate complications, the subjects underwent a slit-lamp examination in all visits. Filamentary keratitis was observed in one eye in both groups. The frequency of haze was higher in group 1; however, it was not significant between the two groups. Using mixed model analysis, significant differences were observed in the rate of complications as well as pain and eye discomfort scores between the groups (P

Purpose: to compare the Subfoveal choroidal thickness (SFCT) and Retinal Nerve Fiber Layer Thickness (RNFL) of amblyopic and normal fellow eyes. Design: Prospective, cross-sectional, observational case series. Methods: Forty patients age 12 to 41 years (mean 23.73 ± 6.42) with unilateral amblyopia were studied. Among them, 11(28.2%) patients had amblyopia secondary to strabismus and 29(71.8 %) had anisometropic amblyopia. Optical coherence tomography (OCT) of the peripapillary RNFL thickness of amblyopic and fellow eyes was performed. RNFL thickness measurements were taken from the superior, inferior, nasal and temporal quadrants in the peripapillary region. Also, subfoveal choroidal thickness (SFCT) was measured using spectral domain optical coherence tomography (SD-OCT). Results: Mean global RNFL thickness of the amblyopic and fellow eyes was 104.48 microns and 102.83 microns, respectively. The difference between the two groups was not statistically significant (p>0.05%). The thicknesses of the superior, inferior, nasal and temporal quadrants of the retinal nerve fiber layer between the amblyopic and normal fellow eyes showed no statistically significant difference (p>0.05%). However, the SFCT of amblyopic eye was 11 or more microns thicker than the fellow eye and this was statistically significant different (p 0,05%). As espessuras dos quadrantes superior, inferior, nasal e temporal da camada de fibras nervosas da retina entre o olho amblíope e o normal não apresentaram diferença estatisticamente significativa (p > 0,05%). No entanto, a CSF do olho amblíope foi 11 mícrons mais espessa (ou mais) do que a do outro olho - essa diferença foi estatisticamente significativa (p < 0,05%). Conclusões: Este estudo demonstrou que a CSF dos olhos amblíopes foi significativamente mais espessa do que a dos olhos normais. O processo amblíope pode envolver a coroide, mas ele não envolve a CFNR peripapilar.

Clinical relevance: This study was conducted to evaluate five-year outcomes of MyoRing implantation in patients with keratoconus. The results showed that MyoRing implantation is a minimally invasive procedure and is safe and effective for improving visual acuity and refraction in most patients with keratoconus.Background: The long-term effects of MyoRing implantation on corneal features were studied.Methods: A total of 48 keratoconic eyes of 43 consecutive patients who had undergone MyoRing implantation using the Pocket Maker microkeratome (Dioptex, gmbh, Linz, Austria) and who had completed five years of follow‑ups were included in this retrospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and keratometry (K) readings were measured and assessed pre-operation, and five years post-operatively. As well, post-operation satisfaction was assessed using a validated questionnaire.Results: Five years post-operatively, there was a significant improvement in UDVA, CDVA, K readings, spherical equivalent (SE), and manifest sphere and cylinder (p

Purpose To evaluate the effects of intravitreal bevacizumab (IVB) injection on chronic central serous chorioretinopathy (CSC). Methods In this prospective interventional case series, a total of 22 eyes of 22 patients, diagnosed with unresolved CSC for three months or longer, received 1.25 mg IVB injection. Also, in case of failure to achieve success parameters, double dose IVB injections continued in order to reach the complete subretinal fluid (SRF) absorption. A complete ophthalmic assessment was carried out one day, one week, and one-month post-injection, and then a monthly visit was performed, and re-injection was done if needed. Visual acuity, subretinal space volume (SSV), central macular thickness (CMT), and contrast sensitivity were measured and compared among baseline values and final post-treatment values. Results The mean best corrected visual acuity increased significantly from 0.70 ± 0.22 to 0.17 ± 0.15 logMAR (P

PurposeTo evaluate the QOL and vision-related QOL in patients suffering from coexisting glaucoma and cataract.MethodsThis cross-sectional-analytical study was carried out on 222 cases including 163 patients suffering from coexisting glaucoma and cataract as patients’ group and 59 healthy individuals as the control group. Data were gathered via the use of EuroQol five-dimensional (EQ-5D) and National Eye Institute-Visual Functioning Questionnaire 39 (NEI-VFQ 39(. Then, the obtained results were compared before and one month after cataract surgery in patients and control groups. ResultsThe mean and 95% confidence interval of overall vision-related QOL score in healthy individuals and patients during pre- and post-operation phases were 86.65 (69.3 – 104.0), 48.7 (9.4 – 88.1) and 56.1 (12.2 – 100.0), respectively. There were significant differences among the three compared groups in terms of all NEI-VFQ 39 items (PConclusion In patients suffering from coexisting glaucoma and cataract, the overall QOL and vision-related QOL scores were improved after cataract surgery. However, there was a significant difference between them and healthy individuals.

Aims To determine the effect of intravitreous Bevacizumab injection on reducing diabetic macular edema in patients with good vision. Method : This clinical trial was conducted on diabetic patients with centrally involved macular edema and good vision over a period of one and a half year. 22 eyes of 12 patients with a visual acuity of Snellen equivalent of 20/25 or better in the non-proliferative stage with the central macular thickness of more than 300 microns in optical coherence tomography (OCT) were evaluated. In the injection group 1.25 Mg of bevacizumab (Avastin) was injected intravitreally and the control group was followed up. Macular thickness and visual acuity were measured in two groups at first and sixth months after injection. Results Intravitreal bevacizumab was injected in 12 eyes (55%) and 10 patients were followed-up as a control group (45%). The mean central macular thickness was 319 µm at first visit and 301 µm at month six in the treatment group and in the control group it was 318 µm and 328 µm respectively. The mean macular thickness of the treatment group was significantly decreased (p = 0.031), but the difference was not statistically significant between two groups (p = 0.581). The mean visual acuity in the treatment group was 0.045 Log MAR at first visit and 0.033 Log MAR at the sixth month follow up, these values in the control group were 0.1 Log MAR and 0.045 Log MAR respectively and did not differ statistically between the two groups (p = 0.373) Conclusion Although the mean macular thickness was reduced in the treatment group with visual acuity of 20/25 or better but the difference was not significant during follow-up at least in a short period. Therefore, the role of underlying factors other than VEGF alone can be notable in the pathogenesis of the disease.

To identify pre-operative factors that influence post-operative performance of a full-ring intra-corneal implant (MyoRing) for the management of keratoconus.In a retrospective study, medical records of 70 keratoconus eyes of 70 consecutive surgical patients with a mean age of 28.54 ± 6.52 years, who underwent MyoRing implantation using the PocketMaker microkeratome (Dioptex GmbH), were included and analysed before implantation and for visual outcome. Variables assessed included age, gender, keratoconus shape, uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent and keratometry reading. After the last follow-up, the eyes were graded for MyoRing implantation performance into worst, moderate and best subgroups.The mean values of uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, manifest sphere and cylinder improved significantly post-operatively (p 0.05). A statistically significant difference was found in the mean spherical equivalent (p = 0.046) and uncorrected distance visual acuity (p = 0.001) between moderate and best subgroups. No statistically significant correlation was found between age, sex, keratoconus shape, keratometric values, corrected distance visual acuity and visual outcome.According to this new grading system for MyoRing implantation performance, pre-operative uncorrected distance visual acuity and spherical equivalent are considered as the most important indicators for surgical performance in MyoRing treatment of keratoconus.

AIM: To compare the outcomes of removing bandage contact lens (BCL) on days 3and 5 after photorefractive keratectomy (PRK).Methods: One hundred patients underwent PRK (totally 200 eyes) were enrolled in the present study. The subjects were assigned to two groups. BCL removal was performed in group 1 on the day 3 after PRK from the right eye, but the removal in the group 2 was performed 5 days after the surgery from the left eye. Then, data obtained from both groups were compared. To evaluate complications, the subjects underwent slit-lamp examination in all visits.Results: Filamentary keratitis (FK) was observed in one eye in both groups. The frequency of haze was higherin group 1; however, it was not significant between two group. Using mixed model analysis, significant differences were observed in the rate of complications as well as pain and eye discomfort scores between the groups (P Conclusion: Majority of post PRK corneal epithelial defect is healed on day 3. However, keeping BCL for 5 days postoperatively, instead of the three days produces slightly lower rate of total complication.

Purpose: Evaluating the impact of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and intravitreal bevacizumab (IVB) injection to manage refractory diffuse diabetic macular edema (DME).Methods: In the current prospective interventional clinical study, eyes with refractory diffuse DME with no response to a minimum of three times IVB injections, and best corrected visual acuity (BCVA) of equal or more than 20/200 and equal or lower than 20/60 were subjected to PPV with ILM peeling and intravitreal avastin injection. Pre- and post-operative assessments were a comprehensive ophthalmologic evaluation, fluorescein angiography, and optical coherence tomography (OCT). BCVA, central macular thickness (CMT) and contrast sensitivity (CS) were major outcomes. Results: Fifteen eyes of 13 cases (mean age: 63±5.19 (range, 54-70) years) were subjected to operation and a follow-up of 3 months. Average BCVA at last test was 0.74 ± 0.19 LogMAR that showed no improvement compared with its value before intervention (0.84 ± 0.14 LogMAR) (P=0.073). Average CMT at last test was 328.26±129 µm that was significantly lower compared with its value before operation (450.8±114 µm) (P=0.002) and a significant improvement in CS was found (from 16.66 ± 8.99 mm to 18.13 ±1.22mm;p=0.003). CMT and BCVA (correlation coefficient =0.419,p=0.120), BCVA and CS (correlation coefficient =-0.336,p=0.221) , and CS and CMT (correlation coefficient =-0.07,p=0.979) were found with no significant correlation. Conclusion: PPV with ILM peeling and IVB regarding refractory diffuse DME reduced macular width along with CS improvement, but does not significantly improve visual acuity.

Therapeutic options for corneal ectasia are evolving, with emphasis on the intra-stromal corneal ring for delaying or eliminating the need for penetrating keratoplasty. A 33-year-old man with grade 4 keratoconus and rising intolerance of the hard contact lens underwent a combination of a new innovative ring and graft with suture in the left eye. Excellent structural support and stability of the cornea were observed immediately post-operatively and 12 months after surgery. It appears as a feasible and safe therapy option for keratoconus eyes with reference to the instability and asymmetry of the cornea. Hence, as a safe and effective technique, it can be performed easily.

This paper seeks to evaluate the depth and outcomes of MyoRing implantation using two mechanical dissection procedures including: PocketMaker microkeratome in opposition to the Melles hook method. This retrospective study was carried out on 39 eyes of 38 keratoconus patients (28 male and 10 female) with the mean age of $$ 28.97\frac{+}{.}10.37 $$ years and had undergone MyoRing implantation by the two mentioned methods. The MyoRing was inserted into the corneal pocket which was made manually in 18 eyes (Melles hook group) or with PocketMaker microkeratome in 21 eyes (PocketMaker group). The mean follow up time was $$ 9.81\frac{+}{.}3.7 $$ months with pre-operative and post-operative ophthalmic examination including uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), keratometry readings and central corneal thickness measurement. AS-OCT (Casia, SS-1000, Tomey, Nagoya, Japan) imaging was used to measure MyoRing insertion depth, exactly. Pre-operative and post-operative UCVA (LogMAR) mean change for the PocketMaker and Melles hook groups were recorded at 0.75 ± 0.32 and 0.78 ± 0.33, respectively. Similarly, BCVA (LogMAR) mean change were 0.27 ± 0.22 and 0.23 ± 0.22. Mean keratometry (Kmean) change were 6.06 ± 4.18 and 6.56 ± 3.55 respectively. UCVA change (P = 0.767), BCVA change (P = 0.77) and Kmean change (P = 0.693) showed that there was no statistically significant difference between both groups for any parameter. Depth measurements achieved from AS-OCT images showed that there was no statistically significant difference in pocket depth between two methods of MyoRing implantation (P = 0.413). The results of Myoring implantation outcomes using mechanical dissection via PocketMaker microkeratome as against Melles hook are comparable.

Phakic intraocular lens (pIOL) models have indicated an association between cataract formation and inadequate vaulting. In this study, the efficacy and safety of low-vault posterior chamber pIOLs in the correction of myopia were examined over 3 years. From 316 patients undergoing surgery, 14 eyes with a low vault (≤ 150 μm) were examined from 14 patients. After implanting the Visian Implantable Collamer pIOL for the correction of myopia (moderate and high), the pIOL vault, endothelial cell loss, uncorrected distance visual acuity (UDVA), corrected DVA (CDVA), and detrimental events were examined over 3 years. Based on the findings, the mean spherical equivalent reduced from − 8.15 ± 3.29 before surgery to − 1.02 ± 0.75 diopters 3 years after the surgery. In terms of visual outcomes, the mean UDVA (Log MAR) significantly increased from 0.95 ± 037 to 0.27 ± 0.28, and the mean CDVA also increased from 0.99 ± 0.11 to 0.06 ± 0.08 (P

Purpose: To compare the effectiveness, safety and stability of the results of transepithelial photorefractive keratectomy (tPRK) with conventional photorefractive keratectomy (PRK) for low to moderate myopia. Methods: In this prospective non-randomized case-control study, patients with low to moderate myopia were assigned to the tPRK group (cases) or the PRK group (controls). In the tPRK group, eyes were treated using the Amaris excimer laser (SCHWIND eye-tech-solutions GmbH and Co. KG, Germany). Outcome measures included postoperative pain using McGill Pain Questionnaire, epithelial healing time, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, and safety and efficacy indexes which were compared between the study groups. Results: Three hundred forty eyes of 170 patients were enrolled in this study. Each study group comprised of 170 eyes of 85 patients. There was a significant difference between the two groups regarding the postoperative pain scores in favor of the tPRK group (P = 0.04). The tPRK group had a shorter epithelial healing time than the conventional PRK group postoperatively (P = 0.01). Mean UCVA was significantly better in the case group than in the control group at the postoperative month 2 (P = 0.01). Regarding the safety and efficacy indexes, the tPRK group had better results than the conventional PRK group (P < 0.01 for both comparisons). Conclusion: Transepithelial PRK seems to be superior to conventional PRK for treatment of low to moderate myopia in terms of postoperative pain, epithelial healing time, visual recovery and safety and efficacy indexes.

Introduction: This study aimed to evaluate the effectiveness of neurofeedback on attention deficit hyperactivity disorder. Methods: This is a quasi-experimental study without a control group. The study population included all children aged 5 to 12 years old affected with attention deficit hyperactivity disorders in Tehran, Iran who were referred to psychiatric clinics and given the diagnosis. The sample included 12 children with attention deficit hyperactivity disorder who were selected based on their availability (non-random sampling). They received 30 sessions of neurofeedback treatment, 2 times per week. Before and after neurofeedback training, the children were evaluated and compared with the use of cognitive assessment system test. Data were analyzed using dependent T-test. Results: The total mean score for pretest was 88.81 while the total mean score for the post test was 82.23. The mean in pretest for attention hyperactivity disorder was higher than the mean in the post test. Moreover, The difference of pretest and post test scores of children affected with learning disorder associated with ADHD was calculated that showed significant (P=0.003). Conclusion: Neurofeedback is effective in the improvement of attention deficit hyperactivity disorder.

Purpose: To evaluate long-term follow-up data on implantation of a full-ring intra-corneal implant (MyoRing) for management of keratoconus. Methods: A total of 40 keratoconic eyes of 37 consecutive patients who had undergone MyoRing implantation using the Pocket Maker microkeratome (Dioptex, GmbH, Linz, Austria) and completed 3 years of follow-up appointments were included in this retrospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and keratometry (K) readings were measured and evaluated preoperatively, and 3 years, postoperatively. Results: No intraoperative complications were observed in this case series. Three years postoperatively, there was a significant improvement in UDVA, CDVA, K readings, spherical equivalent (SE), and manifest sphere and cylinder (P < 0.05 for all comparisons). UDVA was significantly improved from 1.14 ± 0.27 to 0.30 ± 0.21 LogMAR (P = 0.001), CDVA was also improved from 0.52 ± 0.23 to 0.18 ± 0.12 LogMAR (P = 0.001), SE was decreased by 4.35 diopters (D) and average keratometric values were reduced by 2.34 D (P = 0.001). Overall, 81% of subjects were moderately to highly satisfied 3 years after surgery and 64.90% agreed to have the fellow eye implanted with MyoRing. Conclusion: MyoRing implantation using the Pocket Maker microkeratome was found to be a minimally invasive procedure for improving visual acuity and refraction in the majority of the patients with keratoconus.

PURPOSE: To evaluate the relationship between injection site and pain severity following intravitreal injection of bevacizumab (IVB). DESIGN: Prospective, randomized, four-armed, clinical trial. METHODS: The present study was a prospective, randomized, four-armed clinical trial, which included 1004 eyes from 1004 patients. Patients receiving IVB were randomly assigned into four groups: superotemporal (ST); superonasal (SN); inferotemporal (IT); and inferonasal (IN) injections. The visual analog scale (VAS) was used to assess pain. Primary study variables were the relationship between pain severity and injection site, number of previous injections, age, sex, and indication for injection. Secondary variables included best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes 1 month post IVB. RESULTS: Overall mean pain score was 2.86 ± 2.2. Indications for injection were diabetic macular edema (84.1%), neovascular age-related macular degeneration (7.7%), and macular edema secondary to retinal vein occlusion (8.2%). The mean VAS scores in the SN, IN, ST, and IT groups were 1.5 ± 1.7, 3 ± 2.3, 4 ± 2, and 3 ± 2.1, respectively. Pain severity was significantly correlated with injection site (p

We describe an intrastromal corneal graft technique that uses femtosecond laser to create a desirable corneal lenticule with precise diameter, depth, and shape as well as an intra-stromal pocket in keratoconus patients. The technique seems to be a feasible and safe treatment option to treat keratoconic eyes with reference to the irregularity and instability of cornea. The technique can be performed easily and appears safe and effective. At 7 days postoperatively, all eyes were white and quiet, and the grafts were clear. No graft folds or interface complications were observed at the 12-month follow-up using Visante optical coherence tomography., Video abstract

We evaluate the efficacy and safety of Keraring 355° intrastromal corneal ring segment (ICRS) implantation aided by PocketMaker microkeratome for the correction of keratoconus. Patients underwent ICRS insertion using mechanical dissection with PocketMaker microkeratome and completed 6 months of follow-up. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, topographic findings, safety, efficacy index, and adverse events were reported for six months postoperatively. We evaluated 15 eyes of 15 patients (12 men) with a mean age of 28.87 ± 6.94 years (range 21–49 years). At final postoperative examination, there was a statistically significant reduction in the spherical equivalent refractive error compared to preoperative measurements (−5.46 ± 1.52 to −2.01 ± 1.63 D,P<0.001). Mean preoperative UCVA (logMAR) before implantation was 0.79 ± 0.48, and postoperative UCVA was 0.28 ± 0.15,P=0.001. Mean preoperative BSCVA (logMAR) before implantation was 0.36 ± 0.21; at final follow-up examination BSCVA was 0.18 ± 0.9,P=0.009. MeanKdecreased from 48.33 to 43.31 D,P<0.001. All patients were satisfied with ICRS implantation; 86.7% were moderately to very happy with the results. No intraoperative or postoperative complications were demonstrated. This preliminary study shows that ICRS (Keraring 355°) implantation is an efficient, cost-effective, and minimally invasive procedure for improving visual acuity in nipple type keratoconic corneas.

Introduction Nonarteritic anterior ischemic optic neuropathy (NAION) is a rare condition but one of the most important ocular side effects of sildenafil. Case Presentation We presented a 65-year- old man with the history of sudden painless loss of vision in both eyes following taking sildenafil. Conclusions Fundus examination revealed blurred margin and elevated disc in both eyes. Visual field defects were bilateral inferior altitudinal defects, and optical coherence tomography (OCT) displayed a prominent nerve fiber layer edema in both eyes. We asserted that use of sildenafil may lead to reduce blood pressure and interfere with microcirculation in the optic nerve head. So, the potential risks of unregulated over-the-counter sexual enhancement supplements such as sildenafil must be educated to the patients using these supplements.

Introduction Lens luxation generally happens secondary to trauma and hereditary disorders into the vitreous body. However, spontaneous dislocation especially into the anterior chamber occurs rarely. We report an unusual case with spontaneous anterior dislocation of a posterior chamber intraocular lens (IOL) 4 years after cataract surgery. Case Presentation A 42-year-old woman was referred to ophthalmology department with complaint of sudden onset blurring of vision in the left eye 4 years after cataract surgery. No history of trauma and systemic disorder was reported and no capsular fibrosis was found during eye examination. The patient underwent corneoscleral incision under general anesthesia and the IOL was extracted using a viscoelastic material. Conclusions To our knowledge, this is the first reported case in the literature. This report may imply that IOL related factors could be considered for spontaneous dislocation of intraocular lenses.

Objective: To evaluate aberrometric changes in corneas with keratoconus implanted with intrastromal corneal ring segment (Keraring 355) during a 3-months follow-up. Design: Prospective, consecutive case series Methods: In this interventional study, 22 eyes of 21 keratoconic patients with mean age of 29 ± 6 years who underwent KeraRing 355 intrastromal corneal ring insertion using a Pocket Maker Microkeratome for channel creation and completed at least three months of follow-up were included. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), refractive outcome, Orbscan finding and corneal aberrations were assessed. Results: Three months postoperately, Low order aberration (defocus and astigmatism) decreased significantly (P

Purpose To report complications after the implantation of Keraring 355° intrastromal corneal ring (ICR; Mediphacos, Belo Horizonte, Brazil) in keratoconic eyes using a Ziemer LDV femto- second laser (Ziemer AG, Switzerland) for channel creation. Materials and methods Five eyes suffering from keratoconus underwent Keraring 355° insertion using Ziemer LDV for corneal pocket creation. Intraoperative and postoperative complications were recorded. Results While intraoperatively there were no complication, postoperatively all cases showed severe side effects. Conclusion In this small case series, intracorneal ring (Keraring 355°) implantation using a femtosecond laser for channel creation was related to a number of significant postoperative problems in all cases. The most common complication was corneal melting (postoperatively). How to cite this article Jadidi K, Mosavi SA, Nejat F, Alishiri A. Complications of Intrastromal Corneal Ring Implantation (Kera- ring 355°) using a Femtosecond Laser for Channel Creation. Int J Kerat Ect Cor Dis 2014;3(2):53-56.

To investigate the effects of intravitreal injection of bevacizumab (IVB) with or without anterior chamber paracentesis on intraocular pressure (IOP) and peripapillary retinal nerve fiber layer (PRNFL) thickness.In this prospective randomized clinical trial, 90 eyes with center involving diabetic macular edema or wet type age-related macular degeneration (AMD) were randomly assigned to receive IVB either without (group A) or with (group B) anterior chamber paracentesis. IOP was measured before and within 2 min, 30 min, 24 hours and 3 months after injections. Peripapillary spectral-domain optical coherence tomography (SD-OCT) was performed before and 3 months after injections.Mean IOP changes 2 minutes, 30 minutes, 24 hours, and 3 months after injections were 26.4 ± 5.7 mmHg (P 0.001), 6.5 ± 6.3 mmHg (P 0.001), 0.2 ± 2.9 mmHg (P 0.99) and 0.5 ± 2.4 mmHg (P 0.99) in group A and -1.3 ± 2.4 mmHg (P 0.001), -3.2 ± 1.8 mmHg (P 0.001), -3.1 ± 1.8 mmHg (P 0.001) and -1.8 ± 2.2 mmHg (P 0.001) in group B, respectively Mean baseline average PRNFL thickness was 85.3±5.6 μm and 85.6 ± 5 μm in groups A and B respectively. Mean PRNFL thickness changes after 3 month was -2 ± 2 μm (P 0.001) in group A and 0 ± 2 μm (P = 0.101) in group B. Mean PRNFL thickness in group A decreased more than group B (P 0.001).Conventional method of IVB injection was associated with acute IOP rise and significant PRNFL loss 3 months after injection. Anterior chamber paracentesis prevents acute IOP rise and PRNFL loss.

Introduction: Sectoral retinitis pigmentosa (RP) is a rare clinical condition. Case Presentation:We present a 60-year-old femalewith a history ofmild night blindness and decreased vision in the left eye for about 15 years. Conclusions: Fundus examination revealed retinal pigmentary changes in the inferotemporal sector and reduced arterial caliber. In addition, fundus autofluorescence, fluorescein angiography,multifocal electroretinogramscans and electro-oculogramconfirmed these clinical findings. To the best of our knowledge, the present study is the first to describe sectorial RP in the inferotemporal sector of Iranian origin.

Background Tractional retinal detachment (TRD), a major vision threatening complication, is one of the most common eye emergencies. The most common cause of TRD is proliferative diabetic retinopathy (PDR). The aim of this study was to evaluate the effect of simultaneous usage of bevacizumab and silicone oil injection after vitrectomy for the treatment of diabetic tractional retinal detachment Methods Twenty five patients (25 eyes) with severe proliferative diabetic retinopathy were recruited into the study. All eyes underwent a single intravitreal injection of bevacizumab 1.25 mg in 0.05 mL along with silicone oil injection after vitrectomy for the management of tractional retinal detachment or vitreous hemorrhage due to severe proliferative diabetic retinopathy. Patients were then scheduled for postoperative clinical examinations at one, three and six months. The main outcome measures were regression of neovascularization, intraocular pressure, visual acuity and retinal reattachment. Results This study evaluated 25 eyes of 25 patients (12 men, 13 women) with a mean age of 55.68 ± 6.94 years (range 21 to 49 years). In all eyes visual acuity improved and retinal attachment was accomplished. The mean preoperative visual acuity was 2.01 ± 0.03 Log MAR which significantly improved to 1.10 ± 0.50 Log MAR in 6th month after surgery (P < 0.000). Active neovascularization regressed significantly (P < 0.004) and intraocular pressure was controlled in 88% of patients. Conclusions The findings of our study may suggest that simultaneous injection of Bevacizumab and silicone oil after vitrectomy improve early results. We have found it to be particularly useful in diabetic eyes with tractional detachments of short duration.

Central retinal artery occlusion (CRAO) following cosmetic surgery seems to be rare and disastrous disease inducing sudden visual loss. Even if tough treatment is prescribed initially, the prognosis of visual recovery is more regretable. In this paper, we report one case of CRAO combined with ptosis resulting from simultaneous autologous fat injection and BoNT/A treatment in theglabellar area for cosmetic problems. We confirmed CRAO by fluorescein angiography. There are many possible causes of visual loss following cosmetic surgery; however, the commonest form is autologous fat injection up to now. To our knowledge, there have been little reports of CRAO combined with ptosis in autologous fat injection procedures. These facts must be kept in mind by all cosmetic plastic surgeons and ophthalmologists of the importance of careful measures and immediate treatment of iatrogenically induced ocular complications.

Purpose: To report a rare case of keratoconus concurrent with granular corneal dystrophy in a family of Iranian origin. Methods: Case report. Results: Keratoconus combined with granular dystrophy developed bilaterally in a family from Iran. The father, mother and her elder son have both keratoconus and corneal granular dystrophy. Thus, the keratoconus in this family is thought to be of autosomal recessive inheritance. Histologic evaluation showed characteristic features of keratoconus and other corneal dystrophies were excluded. Conclusions: To our knowledge, this is the second reported case in the literature. The concurrence of keratoconus and granular dystrophy raises the possibility of a genetic linkage of the diseases. Moreover, the diagnosis of keratoconus in patients with granular dystrophy is important because impairment of vision might be the result of keratoconus and could be treated with contact lenses instead of keratoplasty.

Purpose: To compare the epithelial defect size after epithelial removal by Weck-Cel sponge (Medtronic) spatula and blunt scalpel hockey blade. Method: This prospective study comprised 100 cases of PRK with mean age of 26±5 years (range, 19 to 45) performed at Bina Eye Specialist Hospital from January to march 2012. The size of epithelium removal was the same in all patients and it was 8.5 mm2. Each patienst’s right eyes epithelium was removed by Weck spounge and it was removed by Haki spatula in the left eye. The residual epithelial defect size was measured in both eyes after 4 days from surgery. Result: Of 200 eyes that met the inclusion criteria, the mean preoperative spherical equivalent (SE) refractive error in right eyes was -2.6±1.5 (Range: -1 to -7 D) versus 2.6±1.4 (Range: -1 to -6.5D) in left eyes (P= 0.527 ). The mean epithelial defect size after 4 days in right eyes was 1.5+- 0.77 and it was 1.46 +- 0.77 in the left eyes (P = 0.623). Conclusion: This sudy showed that there is no difference between corneal epithelial defect size in two methods of PRK surgery after corneal epithelial removal .We consider both methods to be comparable in terms of efficacy and believe the choice of one method over the other rests on the surgeon’s decision and experience.