comparison of the effect of donor-recipient trephine size disparity on refractive error in keratoconus

To compare the effect of donor-recipient trephine-size disparity on spherical equivalent, and visual outcomes in penetrating keratoplasty for keratoconus. A prospective randomized clinical study conducted between April 2000 and April 2004 in the Ophthalmology Department, Shaheed Sadoughi Hospital, Yazd, Iran. Forty patients with keratoconus were randomly assigned to 2 groups. In group I [n=20] the patients were operated on with under-sized blade [0.25 mm disparity[D]], and in group II [n=20] with over-sized [0.50 mm D] trephine. The spherical equivalent in group I was -2.61 +/- 2.81 D, and -3.92 +/- 3.2ID in group II. We found a better final visual acuity in group I compared with group II. More myopic shift was observed in group II, with greater disparity. Best-corrected visual acuity [BCVA] was better at the final follow-up in group I, compared with group II. Fourteen patients [70%] achieved BCVA 20/40 or better in group I, whereas in group II only 10 pane/its [5.0%] achieved this vision. Mean keratometry was 44.35D in group I, and 45.05D in group II. We conclude that using donor-recipient under-sized trephine [0.25mm D] can be considered a reliable and effective method in reducing postoperative myopia

Prevalence of retinopathy in hypertensive patients

To determine the prevalence of retinopathy in hypertensive patients referred to a teaching hospital in Yazd, Iran. This cross-sectional study included 213 hypertensive patients referring to a teaching hospital in Yazd, Iran between November 2004 and June 2005. Data were collected using a questionnaire after an interview and ocular examination. Demographic variables, hypertensive retinopathy, familial history of hypertension, duration of diagnosis, and other hypertension side effects such as cardiac, renal, cerebro-vascular complications were analyzed. The Scheie's staging system was used for retinopathy grading. A total of 213 patients [95 men, 118 women] with high blood pressure aged between 25 and 85 years [mean age of 64.47 +/- 10.66 years] were enrolled in this study, wherein 39.9% of patients suffered from retinopathy. This rate was higher in women [45.6%] than in men [33%]. The positive familial history of hypertension was reported in 47.8% of patients. The prevalence rate of retinopathy in patients suffering from mild hypertension was 25.3%, moderate hypertension was 34.5% and severe hypertension 84.6%. Of the patients with retinopathy, 42.36% had grade I, 20% had grade II and 2.35% had grade III retinopathy. The most common ophthalmoscopic findings were arteriolar narrowing [35.13%], arterio-venous nicking [17.12%] and cotton wool patches [9%]. Positive family history of hypertension and target organs involvement are important risk factors for retinopathy. Early diagnosis and treatment of hypertension to prevent complications is essential

Comparison of efficacy and safety of topical ketotifen [zaditen] and cromolyn sodium in vernal keratoconjunctivitis

The purpose of this study is to compare the efficacy of Ketotifen fumarate 0.025% [Zaditen] with Cromolyn sodium 4% eye drops in prevention of itching, tearing and redness in vernal keratoconjunctivitis [VKC]. This double masked randomized single center clinical trial conducted between April and August 2004 in Yazd. One hundred eligible patients with clinical diagnosis of moderate VKC were randomly assigned to Zaditen [Group A, n=50] and Cromolyn sodium [Group B, n=50] eye drops for a 4 week period. Itching, lacrimation, redness and photophobia were scored on a 4-point severity scale. At the follow up visits, the responder rate based on subjects assessment of global efficacy was significantly greater in Ketotifen group [71.5%] than in Cromolyn group [53%]. A clear response to treatment occurred in 94.4% of Zaditen patients and 81.2% of sodium Cromoglycate patients. The investigator's assessment of responder rates also showed that Ketotifen was superior to Cromolyn sodium [p=0.001]. Ketotifen produced a significantly better outcome than Cromolyn [p<0.05] for relief of signs and symptoms of VKC. Ketotifen fumarate treatment significantly reduced the total signs and symptoms score for each patient compared to day 0. Ketotifen had a faster onset of action and provided better symptom relief than Cromolyn: the rapid onset of action and symptom control, make Zaditen a valuable treatment for VKC