[comparison of ocular hypotensive response to betaxolol and timolol and their topical and systemic side effects]

This is a study to compare the efficacy and side effects of betaxolol and timolol in lowering the IOP of primary open angle glaucoma or ocular hypertension. This Double-blind randomized cross-over clinical trial was conducted on 29 eyes of 20 patients with primary open angle glaucoma or ocular hypertension. Each patient received timolol 0.5% and betaxolol 0.5% [SINA DAROU] twice daily for four weeks in two phases. Before and between the two courses of treatment there was a wash-out period. At the end of the study the effect of these two drugs on intraocular pressure [lOP], mean arterial blood pressure, pulse rate, and basic tear secretion in addition to ocular symptoms were evaluated and statistically analyzed. The study was performed on 29 eyes of 20 patients with baseline IOP of 28,45 +/- 1.64 mmHg. After 4 weeks of treatment, timolol and betaxolol reduced IOP by 7.24 +/- 1.97 mmHg 25.36 +/- 1.22% and 3.55 +/- 1.18 mmHg 12.52 +/- 0.82%, respectively [P<0.001] and the difference between the two groups was also significant [P<0.001]. Mean arterial blood pressure was reduced with betaxolol and timolol by 6.37 +/- 3.96 mmHg [P<0.001], and 6.30 +/- 3.84 mmHg [P<0.001], respectively, but the difference between two groups was not statistically significant. Pulse rate was reduced with timolol and betaxolol by 7.37 +/- 3.22 beats /min, and 7.41 +/- 3.77 beats /min, respectively P>0.05. No significant difference was considered between two groups. Mean reduction in basic tear secretion with timolol and betaxolol was 1.31 +/- 0.66 mm/5min and 1.48 +/- 0.82 mm/5min, respectively; intergroup comparison was also not significant. Patients in 62.1% of the betaxolol group and 27.2% of the timolol group complained about eye burning. The differece between two groups was significant [P<0.01]. lacrimation-eye pruritis and bitter tastes was more in betaxolol group. Other symptoms were similar between two groups. Timolol is superior to betaxolol in treatment of early glaucoma or ocular hypertension, but both drugs should be used with caution in patients with cardiovascular compromise

success rate of external dacryocystorhinostomy with and without silicone intubation

Primary acquired obstruction of Nasolacrimal duct is the most common cause of Tearing in adults requiring surgery. The aim of this research is evaluating the results of external dacryocystorhinostomy with and without silicone intubation in NLDO. This randomized clinical trial study was done on 80 patients with nasolacrimal duct obstruction. These were divided into two groups of Ex. DCR with and without silicone intubution incidentally. Overall success rate were 77.5% in Ex. DCR and 90% in Ex. DCR with silicone intubation [p<0.05] Ex. DCR with silicone intubution is a procedure with more successful results comparing the other method. This can be advised as routin procedure for the management of nasolacrimal duct obstruction

[Comparison of results and complications of external DCR with endoscopic DCR in primary nasolacrimal duct obstruction]

Epiphora is one of the most common complaints of patients that refer to ophthalmology clinics and primary nasolacrimal duct obstruction is the main cause of this problem in adults. Dacryocystorhinostomy [D.C.R] is the surgical treatment of epiphora that can be done by two basic methods: external and endonasal [Microscopic orEndoscopic]. The aim of this study was comparison between results and complication of these two methods in treatment of patients with primary nasolacrimal duct obstruction. This prospective randomized double blind clinical trial study was done in Emam Khomeini Hospital of Hamedan University of medical sciences during 1380-1381. According to patients' history, physical examination findings and results of regurgitation and dacryoscintigraphy tests, we divide 50 cases in two groups, randomly. External group was operated by classic DCR skin incision and creation of two lacrimal sac flap, andendoscopic group was operated by intranasal drilling of lacrimal bone, finding of lacrimal sac by lacrimal probe and complete removal of medial wall of lacrimal sac. After surgery all patients were fallowed up in two 4 and 6 month periods and results and complications were studied in each group. In 92% of both groups epiphora was resolved clinically but nasalacrimal duct obstruction in irrigation test were seen in 16% of external group and 8% of endoscopic group [P>0.05]. Pain in second week of surgery, hematoma and bleeding was equal in both groups but only 76% of external group were pain free in first week after surgery. In contrast, nasal discharge in endoscopic group was significantly higher than external group. On the basis of our findings, results of endoscopic DCR is similar to external method and because of lack of scar and lower complication rate, this minimal invasive method can substitute classic external method successfully

Topical mitomycin-C 0.01% versus dexamethazone phosphate 0.1% in refractory vernal keratoconjunctvitis

To compare the efficacy and safety of topical mitomycin- C 0.01% versus dexamethazone phosphate 0.1% in patients with refractory vernal keratoconjunctivitis [VKC]. In this double blind randomized clinical trial, patients with refractory VKC were randomly assigned to treatment with topical mitomycin-C 0.01% eye drops [N=27] or dexamcthazone phosphate 0.1% [N=27], four times daily for 20 days. Symptoms including foreign body sensation, tearing, itching, mucous discharge and signs including conjunctival hyperemia, conjunctival giant papillae, limbal hypertrophy, and Trantas dots, were compared before after treatments between the two groups. There was a statistically significant decrease in signs and symptoms in the mitomycin-C group at the end of 20 days of treatment such that two cases [7.4%] of the mitomycin group and 26 cases [96%] of the dexamethazone group required another medication. [P=0.000]. Short-term low dose topical mitomycin-C may be considered for acute exacerbations of severe VKC

Effects of oral tranexamic acid vs oral prednisolone on rebleeding in traumatic hyphema

To evaluate the effect of oral tranexamic acid, oral prednisolone and placebo on prevention of recurrent hemorrhage in traumatic hyphema. This randomized placebo-controlled double-blind clinical trial was performed on 182 subjects affected by hyphema after blunt trauma. The patients were hospitalized for at least 5 days and were randomly assigned for receiving oral tranexamic acid [75 mg/kg/day; 3 divided doses], oral prednisolone [0.8 mg/kg/day; 2 divided doses] and oral placebo [3 times a day]. Recurrent hemorrhage was measured during the course of hospitalization. Rebleeding was significantly more frequent in the placebo group [26.7%] versus the prednisolone [15.0%] and tranexamic acid [13.3%] groups [P= 0.0032%], but there was no statistically significant difference between the two latter groups. There is no significant difference between oral prednisolone and tranexamic acid in reducing the rate of rebleeding in traumatic hyphema

[Role of anxiety in idiopathic acute anterior uveitis]

To evaluate the role of anxiety in idiopathic acute anterior uveitis. In this case-control study, three groups including 30 patients with uveitis, 30 patients with conjunctivitis, and 30 healthy control were enrolled for estimating the anxiety level by employing Zung anxiety assessment and a structured clinical interview. T test and Chi square test were used for statistical analysis. Mean anxiety level was 37.5, 33.5, and 33.5 in the anterior uveitis, conjunctivitis, and control groups, respectively. [P<0.001] Severe anxiety was present in 23%, 7% and 17% of the uveitis, conjunctivitis and the control groups, respectively. The individuals were male in 60%, 53%, and 57% and were married in 77%, 70%, and 83% of the uveitis, conjunctivitis and control groups, respectively. Mean age uveitis, conjunctivitis, and control groups was 42.6 yr, 33.6 yr, and 31.1 yr, respectively. [P<0.01, F=3.09] The present findings have verified that anxiety may be effective in idiopathic acute anterior uveitis