The efficacy of viscocanalostomy for uncontrollable primary open-angle glaucoma in a developing country.

PURPOSE: To evaluate the safety and efficacy of viscocanalostomy in the management of medically uncontrollable primary open-angle glaucoma (POAG) in a developing country. MATERIALS AND METHODS: This is a prospective, non-randomized case series of 14 consecutive eyes with medically uncontrollable POAG, all subjected to viscocanalostomy. The main outcome measure was success rate based on the intraocular pressure (IOP) level achieved post-operatively. The procedure was considered a complete success if IOP was less than 21 mmHg without any anti-glaucoma medication. Qualified success was defined as IOP of less than 21 mmHg with anti-glaucoma medication. All patients had a regular follow-up of at least 12 months. RESULTS: IOP was reduced from a mean baseline value of 27.9 ± 7.3 mmHg (range: 21-40 mmHg) to a mean final value of 16.0 ± 2.7 mmHg (range: 13-22 mmHg), which was statistically highly significant (P < 0.005). The mean number of pre-operative anti-glaucoma medications was 3.0 ± 0.4 (range: 2-4), which was reduced significantly (P < 0.0001) to 0.3 ± 0.6 (range: 0-2) at the last follow-up visit. One year post-operatively, complete success was achieved in 71% and qualified success was observed in 21.4% of patients, summing up to an overall success rate of 92.4%. There were no major complications in any of the patients. CONCLUSION: Viscocanalostomy could be performed effectively and safely for control of POAG in developing countries.

Mechanical superficial keratectomy for corneal haze after photorefractive keratectomy with mitomycin C and extended wear contact lens.

PURPOSE: To evaluate the clinical results of a mechanical keratectomy with mitomycin C (MMC) and extended wear contact lens (EWCL) for the treatment of corneal haze after photorefractive keratectomy (PRK) of high myopia. SETTING: Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Iran. METHODS: : In a retrospective interventional case series, we enrolled 15 eyes of 9 patients who previously underwent PRK for high myopia and developed corneal haze and regression. Mechanical removal of corneal haze was done by using a surgical blade number 15. Then, MMC (0.02%) was used for 2 minutes. An EWCL was applied for 1 month. The main outcome measures were uncorrected visual acuity, best-corrected visual acuity, spherical equivalent (SE), and corneal haze grade. All patients were followed for a minimum of 6 months. RESULTS: The mean age of the patients was 25.66 ± 7.03 years; 7 patients were men and 2 patients were women. The mean best-corrected visual acuity before superficial keratectomy was 20/80 (range, 20/200-20/50) and improved to 20/20 after treatment (P < 0.05). Thirteen eyes (86.6%) achieved an uncorrected visual acuity of at least 20/40. The mean preoperative SE was 3.91 ± 1.30, and the mean final postoperative SE was -0.85 ± 1.19 (P < 0.05). Eight eyes (53%) were within 1 diopter of emmetropia. Corneal haze in all patients declined to a trace haze or complete clearness. No recurrence occurred during the mean follow-up time of 12 months. CONCLUSIONS: Superficial keratectomy with MMC and EWCLs is effective in reducing persistent and refractory corneal haze after PRK.

Corneal Crosslinking for Keratoconus in Iranian Patients: Outcomes at 1 year following treatment.

AIM AND DESIGN: A retrospective, nonrandomized, single-center clinical study was designed to evaluate the outcomes of corneal collagen crosslinking (CXL) for progressive keratoconus in Iranian patients 12 months after CXL. SETTINGS: This study was carried out at Navid Didegan Eye Center, a private clinic, Mashhad, Iran. MATERIALS AND METHODS: Ninety-two eyes of 53 subjects with progressive keratoconus were evaluated in this study. All eyes completed 1-year follow-up. The outcome measures were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), sphere and cylinder refraction, keratometry, and corneal thickness. Comparison of baseline and 1-year postoperative data is reported in this study. The Wilcoxon signed-ranked and Student's t-tests were used for statistical analyses. P < 0.05 was statistically significant. RESULTS: The mean age was 21.5 ± 3.4 years (range, 16 -30 years). Thirty-one (58.5%) of the subjects were men and 22 (41.5%) were women. Mean baseline UCVA and BSCVA were 0.61 ± 0.31 and 0.06 ± 0.12 logarithm of minimal angle of resolution (logMAR), respectively. One year postoperatively UCVA was 0.31 ± 0.25 logMAR and BSCVA was 0.0 ± 0.01 logMAR. UCVA and BSCVA were statistically higher postoperatively (P < 0.001, both parameters). The mean astigmatism decreased by 0.78 ± 1.49 diopter (D) with significant variation during the follow-up period (P < 0.001). Mean baseline simulated keratometry (SIM K) was 46.94 ± 2.37 D and decreased to 46.0 ± 2.33 D on year postoperatively (P < 0.001). CONCLUSION: Corneal CXL seems to be efficient in stabilization of progressive keratoconus progression in Iranian patients at 1 year of followup.