Ocular higher-order aberrations and mesopic pupil size in individuals screened for refractive surgery

AIM: To study the distribution of ocular higher-order aberrations(HOAs) and mesopic pupil size in individuals screened for refractive surgery. · METHODS: Ocular HOAs and mesopic pupil size were studied in 2 458 eyes of 1 240 patients with myopia, myopic astigmatism and compound myopic astigmatism and 215 eyes of 110 patients with hyperopia, hyperopic astigmatism and compound hyperopic astigmatism using the Zywave aberrometer (Busch& Lomb). All patients had correctable refractive errors without a history of refractive surgery or underlying diseases. Root-mean-square values of HOAs, total spherical aberration, total coma and mesopic pupil size were analyzed. Ocular HOAs were measured across a ≥ 6.0 mm pupil, and pupil size measurements were performed under the mesopic condition. · RESULTS: The mean values of HOAs, total spherical aberration and total coma in the myopic group were 0.369 μm, ±0.233, 0.133±0.112μm and 0.330±0.188μm, respectively. In the hyperopic group the mean values of HOAs, total spherical aberration and total coma were 0.418μm±0.214, 0.202±0.209μm and 0.343±0.201μm, respectively. Hyperopes showed greater total HOAs (P <0.01) and total spherical aberration (P <0.01) compared to myopes. In age-matched analysis, only the amount of total spherical aberration was higher in the hyperopic group (P =0.05). Mesopic pupil size in the myopic group was larger (P ≤0.05). · CONCLUSION: The results suggested that significant levels of HOAs were found in both groups which are important for planning refractive surgeries on Iranians. There were significantly higher levels of total spherical aberration in hyperopes compared to myopes. Mesopic pupil size was larger in myopic group.

Ocular toxoplasmosis in Iran:40 cases analysis

·AIM:To report ocular symptoms,funduscopic findings and demographic distribution of ocular toxoplasmosis in Iran·METHODS:In this cross-sectional study,a total of 40 patients with ocular toxoplasmosis (24 female,16 male) were enrolled.The distribution of symptoms and funduscopic findings were studied.·RESULTS:The patients’ age was in the range of 13-52 with the most common age of 19 years old.Twenty-four patients were female (60.0%).The most common presenting sign was visual loss.There was anterior chamber (AC) inflammation in 23 patients (57.5%).Vitritis was presented in 36 patients (90.0%).In 35 patients (87.5%),the retinal lesion was central.In patients with peripheral lesion,3 patients (60.0%) had flashing vs 12.5% chance of flashing in all patients.Older patients had larger lesion (P =0.04).·CONCLUSION:Ocular toxoplasmosis substantially varies among patients with different age,gender,status of immunity,site of lesion and other undetermined factors.One of ocular symptoms,flashing,may necessitate a more precise peripheral fundus examination.·

屈光手术前个体眼高阶像差与中间视觉状态下瞳孔大小(英文)

目的:研究眼高阶像差的分布(HOAs)和mesopic瞳孔的大小在个体中筛选的屈光手术。方法:我们采用Zywave像差分析仪(博士伦)分别对患有近视、近视散光和复性近视散光患者1240例2458眼和患有远视、远视散光和复性远视散光患者110例215眼的高阶像差和瞳孔大小进行检测。所有患者屈光不正均可矫正,无屈光手术史或潜在疾病。HOAs的均方根值、总球面像差、总斜射球面像差和中间视觉状态下瞳孔的大小进行了分析,眼高阶像差测量均在瞳孔≥6.0mm,且瞳孔大小的测量均为在中间视觉状态下进行。结果:HOAs均方根值、总球面像差和总斜射球面像差在近视眼组与远视眼组分别为0.369±0.233μm、0.133±0.112μm、0.330±0.188μm;0.418±0.214μm、0.202±0.209μm、0.343±0.201μm。与近视患者相比,远视患者的总HOAs和总球面像差更大(P均<0.01)。年龄匹配分析显示在远视眼组只有总球面像差较高(P=0.05)。近视眼组的中间视觉状态下瞳孔大小较大(P≤0.05)。结论:实验结果表明两组的HOAs的水平有显著差异,这对于将行屈光手术的伊朗人很重要。远视眼组的总球面像差显著高于近视眼组,中间视觉状态下瞳孔大小在近视眼组较大。

Spontaneous wound dehiscence after penetrating keratoplasty

Spontaneous wound separation may be developed even months after suture removal especially in the context of long-term corticosteroid therapy. A 68-yearold Caucasian woman presented to our cornea clinic with spontaneous wound dehiscence after her third penetrating keratoplasty(PKP) which was performed three years ago. An Ahmed glaucoma valve(New World Medical, Ranchos Cucamonga, CA) was inserted ten months after the third PKP, which successfully controlled intraocular pressure(IOP). At the examination, the last sutures were removed eight months ago and she was using flourometholone 0.1%(Sina Darou, Tehran, Iran)with a dose of once a day. There was one quadrant of wound dehiscence from 8 to 11 o`clock associated with anterior wound gape and severe corneal edema.Resuturing was performed for the patient. At the one month examination, the corneal edema was resolved and best corrected visual acuity was 20/200 mainly due to previous glaucomatous optic neuropathy. Caution about the prolonged use of corticosteroids is necessary. Topical immunosuppressives could be a promising choice in this field.

应用波前像差引导的LASEK治疗近视散光和低、高度近视(英文)

目的：对比在矫正低度近视,近视散光和高度近视时应用波前像差引导的激光上皮瓣下角膜磨镶术（LASEK）的安全性,有效性,可预测性,稳定性和并发症。方法：该回顾性分析共纳入416眼,分为3组,低度近视组159眼,等值球镜-3.68±1.33D;近视散光组161眼,等值球镜-5.99±2.24D,柱镜度2.41±1.07D;高度近视组96眼,等值球镜-7.41±0.80D.制瓣后,进行波前像差为基础的准分子激光削切术。在术后10d,2,6和12mo后评估其安全性,有效性,可预测性和稳定性。结果：术后12mo,低度近视组等值球镜-0.36±0.31D,近视散光组0.15±0.41D,高度近视组0.58±0.68D。低度近视组中,裸眼视力为20/20的患者占90.60%,近视散光组78.90%,高度近视组67%。疗效指标在三组中分别为0.98,1.04和0.92.安全性指标分别为1.00,1.07和1.05。低度近视组有5眼（3.1%）最佳矫正视力提升1行,近视散光组有44眼（27.3%）提升1~3行,高度近视组18眼（19.2%）提升1~2行。低度近视组只有2例产生角膜雾状混浊。在疗效和安全性方面三组比较均无统计学差异。结论：波前像差引导的激光上皮瓣下角膜磨镶术是治疗低度近视,近视散光和高度近视的一种有效安全的方法,而在治疗近视散光时其可预测性、有效性和安全性更佳。

Urrets-Zavalia syndrome in different methods of keratoplasty

INTRODUCTIONUrrets-Zavalia was first described as a syndrome consisting of a fixed,dilated pupil with iris atrophy following penetrating keratoplasty（PKP）in 1963 and back then it was thought that this syndrome was only related to keratoconus patients.Other findings that were not essential for the diagnosis were posterior synechiae,ectropion uvea,pigment dispersion,anterior subcapsular lens opacities and secondary glaucoma syndrome.