Journal of Current Ophthalmology
Volume:28 Issue: 3, Sep 2016

To investigate recent evidence in prophylaxis and management of post-cataract surgery endophthalmitis.
We conducted a literature search using Pubmed database for post cataract surgery endophthalmitis, and relevant articles were selected from original English papers published since 2015.
Forty-nine articles were published regarding post-cataract surgery endophthalmitis from January 2015 to February 2016. A low incidence of post-cataract surgery endophthalmitis has been reported. A growing number of articles are focusing on preventing endophthalmitis using intracameral antibiotics.
Based on the current evidence, intracameral antibiotics seems to be effective in preventing endophthalmitis after cataract surgery.

To assess the anterior segment parameters of keratoconus (KC) eyes at different stages of the disease by a new Scheimpflug camera combined with Placido disk corneal topography (Sirius, CSO, Italy) in a sample of the Iranian population.
A total of 225 eyes of 225 individuals comprising 41 suspect KC, 40 mild KC, 71 moderate KC, 48 severe KC and 25 normal eyes were assessed for the following parameters: corneal thickness at the apex (CTA), thinnest corneal thickness (TCT), anterior chamber depth (ACD), corneal volume (CV), corneal keratometry (K), corneal asphericity (Q), and corneal elevation in the anterior and posterior surface. Also, the Zernike coefficients for the corneal aberrations including total root mean square (RMS), RMS Coma, RMS spherical aberration (SA), RMS Astigmatism, Baiocchi Calossi Versaci front index (BCVf), and BCV back index (BCVb) were noted for all eyes. Data was analyzed using analysis of variance (ANOVA) and post hoc Bonferroni test for comparison of the means of the five groups. P-value was considered significant if it was The TCT, CTA and posterior corneal elevation were significantly different between all comparison groups (P Posterior corneal elevation, corneal thickness and high order aberrations are important indices that need to be considered to diagnose different grades of keratoconus.

To evaluate the correlation between refractive, corneal, and residual astigmatism and higher order aberrations (HOA) in refractive surgery candidates.
Three hundred and seventy-five eyes of 188 patients aged 28.2 ± 6.24 years with a predominance of females (62.7%) were enrolled in this study. Refraction, topography (Orbscan IIz, Bausch & Lomb, Rochester, NY, USA), and aberrometry (Zywave, Bausch & Lomb, Rochester, NY, USA) were performed to determine refractive and corneal astigmatism and HOA for all participants. Ocular residual astigmatism was calculated using vector analysis.
The mean spherical equivalent was −3.59 ± 1.95 D and the mean refractive astigmatism was −1.97 ± 1.3 D. The mean HOA was 0.38 ± 0.15 μm in all cases, which increased with spherical equivalent (p The results of the study showed significant correlations between corneal and refractive astigmatisms and HOA.

To determine age-related changes in corneal viscoelastic properties in healthy individuals.

This observational cross-sectional study was performed at the Department of Ophthalmology, Imam Khomeini Hospital, Ahvaz, Iran and included 302 healthy individuals in 6 age decades (range: 10–69 years). After complete ocular examination, corneal viscoelastic properties were measured by ocular response analyzer and central corneal thickness (CCT) by an ultrasonic pachymeter. Our main outcome measures were corneal viscoelastic properties in different age groups.

Corneal hysteresis (CH) and corneal resistance factor (CRF) showed a significant negative correlation with age (P

In this study, there was a decrease in CH and CRF with an increase in age. Hyperopia and female gender are associated with higher CH and CRF. CCT is higher toward the extremes of life and is significantly correlated with CH and CRF.

To evaluate modes of cataractogenesis in the hypertensive state by using different hypertensive animal models, including fructose, cadmium chloride (CdCl2), Nω-nitro-l-arginine methyl ester (l-NAME), and two-kidney, one clip (2K1C) method.
Male Sprague–Dawley albino rats (150–180 g) were divided into different groups, each group containing six animals. Hypertension was induced in animals via six weeks administration of fructose (10% solution in drinking water), CdCl2 (0.5 mg/kg/day, i.p.), and l-NAME (20 mg/kg/day, p.o.) in their respective groups and NaCl (0.9% solution in drinking water) in the 2K1C group. The Ramipril-treated group (2 mg/kg/day, orally) served as a standard group for the 2K1C animal model. Blood pressure was measured biweekly using non-invasive blood pressure system. The biochemical parameters in serum and eye lenses were evaluated after six weeks of the experimental protocol.
Hypertensive animal models showed significant induction of systolic and diastolic blood pressure and modulation of oxidative stress through depletion of antioxidants, including glutathione peroxidase, catalase, superoxide dismutase, glutathione, and elevation of malondialdehyde in serum and eye lenses. A significant elevation of ionic contents (Na and Ca2) and reduction of total protein and Ca2 ATPase activity in eye lenses were observed in all hypertensive animal models except l-NAME when compared with the normal group. The significant restoration of the antioxidants, Malondialdehyde (MDA) total protein, and ionic contents in the eye lenses concomitant with reduction of blood pressure were observed in the ramipril-treated group as compared to the 2K1C animal model. The results indicate that the fructose, CdCl2, and 2K1C models showed pronounced cataractogenic effects in the rat eye lenses.
Based on our findings, it can be concluded that systemic hypertension significantly increases the risk of cataract formation in the rat eyes via modulation of the antioxidant defense mechanism and electrolyte homeostasis.

To determine the effect of the cyclopentolate 1% on the cylindrical and spherical components of the refraction.
Three hundred seventy-five eyes of 195 subjects, including 74 males and 121 females, aged from 3 to 59 years were refracted before and 30 min after cyclopentolate 1% eye drop instillation. To compare cylindrical data, power vector analysis (J0 and J45 cross cylinder) was applied.
A statistically significant difference between the J0 values of the noncycloplegic and cycloplegic refraction was revealed (P = 0.006) while the J45 values did not significantly differ. 95% limit of agreement for dry and cycloplegic values of the J0 and J45 were −0.22 to 0.25 and −0.19 to 0.20, respectively. Astigmatism difference was separately analyzed in emmetropic, myopic and hyperopic eyes. The J0 difference was significant (P = 0.014) only in hyperopic eyes. Spherical equivalent (SE) values in cycloplegic refraction were significantly more hyperopic than those yielded in dry refraction by mean difference of .16 ± 1.20 diopters (P Our findings indicated that cycloplegic drops caused a statistically significant shift in the “with the rule” and “against the rule” astigmatisms, although the oblique astigmatisms remained unaffected. Further research with larger sample sizes are needed to answer what mechanisms are involved in changing cylinder with cycloplegia.

To estimate the fitting parameters of the hybrid contact lens in patients with corneal ectasia using the rigid gas permeable (RGP) lens.
Thirty-four eyes with corneal ectasia were evaluated in this study. The patients were examined once with the RGP lens and once with the hybrid contact lens. The relationship between the base curvature of the RGP and the vault of the hybrid lens and the correlation between their powers were analyzed.
We found a linear relationship between the base curvature of the RGP lens and the vault of the hybrid lens (P The results of this study could be used for better and faster selection of the first hybrid contact lens.

To determine upper eyelid ptosis prevalence and some related factors in 44- to 69-year-olds of Shahroud in the north of Iran.
In 2009, using multi-stage cluster sampling, 300 clusters of 40–64-year-olds were selected in Shahroud city, and all 5190 participants were invited to be re-examined in 5 years (2014). The current report is the second phase of the study in which 4737 (91.3%) people participated and underwent vision tests, slit lamp examination, biometry, and ophthalmoscopy in 2014. Upper eyelid ptosis was determined by an ophthalmologist.
The prevalence of upper eyelid ptosis was 4.7% [95% confidence interval (CI): 4.1–5.4]; 5.2% in women and in 4.0% in men. The prevalence of bilateral and unilateral ptosis was 1.3% (95% CI: 1.0–1.7) and 3.4% (95% CI: 2.8–4.0), respectively. The observed prevalence of ptosis was 3.1% in the 45- to 49-year age group and 5.8% in 65- to 69-year-olds. The prevalence of ptosis increased with age. In the multiple logistic regression model, ptosis prevalence correlated with older age, diabetes (odds ratio = 1.53, 95% CI: 1.16–2.02) and hypertension (odds ratio = 1.41, 95% CI: 1.03–2.92). Mean corneal astigmatism was 1.02 (95%C]: 0.87–1.18) diopter in ptotic eyes and 0.87 (95% CI: 0.84–0.89) diopter in non-ptotic eyes (p = 0.013).
The present report provides valuable information on the prevalence of ptosis in a population of 45-to 69-year-olds. The prevalence of ptosis in this study was considerably high and significantly increased with age.

To evaluate the perspective of ophthalmology residents in the US about their residency programs and compare the competency of residency programs to international competency levels set by the International Council of Ophthalmology (ICO).
A cross-sectional web-based survey extracted from the ICO published competency standards was sent to program directors of ophthalmology residency programs in the US to forward it to current PGY-3, 4 residents, and residency graduates from 2011 to 2014.
Eighty-seven responses were received, comprising 61 residents and 26 graduates. Most respondents were highly satisfied with their programs (93.6%). Clinic-based training was rated satisfactorily. Insufficient exposure to low-vision rehabilitation (38.5%), refraction and contact lenses prescription (38.5%), and vitreo-retinal surgeries (38.5%) was reported. Respondents were satisfied with their overall surgical experiences, with the vast majority (>83%) rating case volume, complexity, and variety as satisfactory or better. A significant group stated they had insufficient exposure to extra-capsular cataract extraction (26.3%), refractive surgery (19.7%), and orbital surgery (64.5%). All graduates surveyed passed their Ophthalmic Knowledge Assessment Program (OKAP) examinations, and 72% felt their residency programs adequately prepared them for the examinations. All respondents reported insufficient training in certain nonclinical areas, such as practice management, staffing, and administration skills.
Ophthalmology residents in the US express high levels of satisfaction with their residency training programs. While most programs adequately address most ICO core objectives, certain curriculum modifications should be considered.

We describe a patient with endogenous endophthalmitis caused by Acinetobacter spp. as the first clinical presentation of diabetes mellitus.
A 48-year-old otherwise healthy woman was referred with signs and symptoms of acute endophthalmitis in the left eye. Systemic work-up, vitreous tap, and intravitreal antibiotic injection were performed followed by pars plana vitrectomy.
The laboratory tests confirmed the diagnosis of diabetes mellitus. Vitreous culture was positive for Acinetobacter spp., and the organism was sensitive to colistin. One month after surgery, vision was no light perception, and the eye was phthisical.
Diagnostic work-up should be performed even in otherwise healthy patients with endogenous endophthalmitis.

To report a rare case of encephalocraniocutaneous lipomatosis (ECCL) presented with characteristic multiple organ involvement.
A 7-day-old white Iranian girl was referred with ocular, skin and brain abnormalities.
The findings of nevus psiloliparus, eyelid choristoma and intracranial lipoma were consistent with ECCL.
Since the skin and ocular manifestations can be easily observed at birth examination, pediatricians and ophthalmologists should be aware of this condition.