حمید قرایی

Cataract surgery is the most common intraocular procedure in theworld. Trauma during surgery causes an inflammatory response in the eye. This studyaimed to determine the effect of 1% prednisolone acetate topical drops on pupil dilation and pain after uncomplicated cataract surgery in diabetic and non-diabetic patients.

In this double-blind clinical trial study, 80 patients with cataracts participated. First, the patients were divided into 2 diabetic and non-diabetic groups, and then each group was randomly assigned to 2 intervention and control groups. Intervention groups received 1% prednisolone acetate drops 4 times, 24 hours before surgery, and artificial tear drops were used for the control group. Tearing, pain, photophobia, itching, foreign body sensation and horizontal pupil diameter were compared between 4 groups using chi-square, independent t tests and analysis of variance.

Prednisolone Acetate 1% topical drops had a significant effect on pupil dilation (P=0.03). Postoperative photophobia in patients receiving prednisolone drops in non-diabetic patients was significantly lower than in the control group (p=0.001). The severity of postoperative itching in patients receiving prednisolone drops in both non-diabetic (p=0.006) and diabetic (p=0.02) groups was lower than their control groups. The amount of pain reduction in the non-diabetic intervention group was higher than the other groups (p=0.04).

The results of this study show that the topical drug prednisolone acetate 1% can be used before cataract surgery as an auxiliary drug to maintain intraoperative dilatation in diabetic and non-diabetic patients and reduce photophobia, pain and itching after surgery.

Ocular emergency is one of the most common problems in the Emergency Department (ED), but a general survey of ocular emergencies has rarely been reported in the literature. This study reviews cases of ocular emergencies presented to the ED of Khatam Hospital (Mashhad) over a 6-months period. A retrospective analysis was done on patients who presented with eye complaints to the ED of Khatam Hospital-Mashhad between March 2007 and August 2007. Ocular diagnoses and hospitalizations due to ocular emergencies in addition to their associated variables were collected and assessed separately. 28,312 patients presented to the ED during the period with eye complaints. The most frequent diagnoses in newly presented patients were grouped as trauma (61%) and inflammatory disorders (22%). A male to female ratio of about 2.5:1 was assessed. Both genders had the peak age in the third decade. There was a trend toward increased numbers in late spring and early summer. There were a total of 431 cases of hospitalization (1.5% of all presented patients) most of them due to traumatic consequences notably globe rupture (38% of all hospitalizations). Ocular occupational casualties estimated to be responsible for 43% of all traumatic injuries occurred between 20-59 years of age. Young males were found to run a higher risk of ocular accidents, especially at work. Individuals under 10 years of age estimated to be particularly at risk for severe ocular traumas e.g. eye penetration. Taking more care of these two specially at risk groups and directing protectional educations and preprations towards their work and play could be suggested.

This study is done to examin the role of smears, cultures, and sntibiotic sensitivity testing in the treatment of infectious keratitis. A prospective study was performed for 100 patients in Rasool Akram hospital ophthalmology department. After routine examination by slit lamp, evaluation of corneal epithlium, stromal edema and infiltration, AC reaction or hypopyon, all underwent corneal scrapings for staining and cultures. Patients were treated with fortified cefazolin and fortified gentamicin. 50 patients (50%) improved without requiring a modification, but in 4 patients (4%) required a chang in treatment base on cultures and antibiotic sensitivity testing. In 43 patients (43%) corneal surgery was perform due to poor response to medication (conj flap in 36 patients and corneal graft in 7 patients). 7 patients (7%) underwent eviseration due to perforated glob and NLP vision at the time of admition. Based on result of this study most bacterial corneal ulcers resolved with broad spectrum emperical antibiotics and sensitivity testing that might be considerd includemore sever or suspected non-bacterial ulcers.