فهرست مطالب dr. hamid fesharaki

Hemodialysis (HD)‑associated ocular abnormalities are one of the causes of morbidity among people undergoing HD. This study evaluates the frequency of ocular abnormalities in end‑stage renal disease (ESRD) patients undergoing HD and their potential link to HD and demographic parameters. This cross‑sectional study examined 242 eyes of 121 patients with ESRD undergoing regular HD after excluding the ineligible subjects. The study was designed in two parts. Medical histories of each patient including age, gender, family history, medication history, past medical history, and duration of HD collected using a structured check list. All patients underwent complete ophthalmologic examination for evaluation of the best corrected visual acuity (BCVA), intraocular pressure (IOP), and anterior and posterior segments. In total, 121 patients, including 68 (56.2%) males and 53 (43.8%) females, were enrolled in the study. The mean ± SD age of the patients and their mean duration of dialysis were 51.59 ± 16.01 and 3.40 ± 2.75 years, respectively. The most prevalent etiology for HD was diabetes mellitus (39.67%), followed by hypertension (38.84%), and the most common ocular fndings included cataract (142 eyes; 58.7%) and ectopic calcifcation of the conjunctiva and cornea (78 eyes; %32.2). There was at least one abnormal ocular fnding in 89.3% of the cases. The BCVA was equal to or less than fnger count in 70 eyes (28.92%). There was a signifcant relationship between conjunctival calcifcation and the duration of dialysis (P = 0.02). There was signifcant association between etiology of HD and conjunctival calcifcation (adjusted odds ratio, 2.44; 95% CI, 1.05–5.67; and P value, 0.03). Such signifcant associations were present for corneal calcifcation (P = 0.009), cataract (P = 0.02), and optic atrophy (P = 0.01). Regular ophthalmologic examinations are recommended due to the prevalence of clinical ocular abnormalities in HD patients.

Te aim of this study is to evaluate the results of photorefractive keratectomy (PRK) in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK).
Tis prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1) wavefront (WF) scan was undetectable during primary examinations; and/or, (2) WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS) mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT).
Tirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. Te amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well.
PRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction.

Te aim of this study is to evaluate the results of photorefractive keratectomy (PRK) in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK).
Tis prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1) wavefront (WF) scan was undetectable during primary examinations; and/or, (2) WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS) mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT).
Tirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. Te amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well.
PRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction.

The aim of this study was to compare the effect of sodium chloride 5 percent and methyl cellulose 2.5 percent in the treatment of corneal edema after cataract surgery using phacoemulosification method.
In a clinical trial study, 70 patients with corneal edema underwent phacoemulsification surgery. They were randomly divided in two groups of 35 patients. Sodium chloride 5 percent drop in the first group and methyl cellulose 2.5 drop in the second group were administered every three hours and corneal thickness was measured before and 1, 4, 8, 15 and 30 days after surgery and compared in the two groups.
Findings: No statistical difference between the two groups was found regarding decrease in corneal edema, but speed of decreasing was faster in methylcellulose group. At 4th day after the surgery, the amount of edema decreasing in sodium chloride group was 5.00 percent as well as 12.19 percent in methyl cellulose group and the difference between the two groups was significant (P Using of methyl cellulose 2.5 percent in treatment of corneal edema after cataract surgery with phacoemulosification method can decrease edema in shorter time than sodium chloride. So we recommend using of methyl cellulose if not contraindicated otherwise.

Compensatory ocular counter-torsion (COCT) is supposed to maintain the eyes aligned with the visual environment following head tilt. Because of some recent controversies the functional capacity of this phenomenon was defined according to the extent of induced astigmatic axis error following head tilt.

Objective autorefractometry was performed on 70 eyes with a regular astigmatism of ≥2D at vertical, right head tilt and left head tilt positions of 5°, 10°, 15°, 20° and 25°. Astigmatic axis error was calculated according to the difference between the defined axis at each tilted head position and the defined axis at the vertical head position. A tiltometer was used for this purpose to show the angle of head tilt without disturbing the process of refractometry.

The mean astigmatic axis error was 3.2° ± 1.5° and 18.4° ± 4.2° at the head tilt angles of 5° and 25° respectively. The mean percentage of tilt angle compensation by COCT was 36% and 26% at the head tilt angles of 5° and 25° respectively. There was a direct relation between the head tilt angle and the induced astigmatic axis error (ANOVA, P < 0.001, 95% of confidence interval [CI]). Astigmatic axis error values at right head tilt were significantly lower than their corresponding values at left head tilt (ANOVA, P = 0.04 95% CI).

Any minimal angle of head tilt may cause erroneous measurement of astigmatic axis and should be avoided during refraction. One cannot rely on the compensatory function of ocular counter-torsion during the refraction.

This is a brief celebratory overview of the fruitful life and scientific endeavors of Professor Ali Asghar Khodadoust (b. 1935), a world renowned ophthalmologist, Persian icon of modern ophthalmology and an international pioneer of eye research. The global reputation of Dr. Khodadoust is rooted in his extensive studies on corneal diseases and transplantation biology. As a result of his truly deserved world renown, several famous American ophthalmologists have recognized him as the world’s best corneal graft surgeon. Due to his exceptionally impressive achievements in this field, a clinical finding has been named in his honor, the «Khodadoust rejection line», a sign indicative of a chronic focal transplant reaction.

We aimed to compare peak systolic velocity of central retinal artery (PSV.CRA) and peak systolic velocity of ophthalmic artery (PSV.OA) between patients with retinal detachment who were treated with segmental scleral bucking and scleral buckling with encircling procedure. This study was a descriptive-analytic cross sectional study that was performed in Isfahan university referral centers since April 2010 to April 2011. Of the patients who have undergone scleral buckling surgery, 20 patients belonging to two groups were randomly selected to enroll in the study. Study groups were, patients who have undergone segmental scleral buckling and the other group were patients who have undergone scleral buckling with encircling procedure. Patients were invited to perform color Doppler imaging. PSV-RA and PSV-OA were measured and documented in both operated and unoperated eyes. All of the Doppler’s performed at least three months after ophthalmic surgery. We found significant decrease in PSV.CRA among patients in both groups. In patients who had undergone scleral buckling with encircling procedure PSV.CRA was 11.03 ± 3.04 (cm/sec) and 14.83 ± 4.80 in operated and unoperated eye respectively (P = 0.03). In other hand, who treated with segmental scleral buckling these parameters were 11.02 ± 2.48 and 14.45 ± 4.69 (P = 0.03). PSV.OA did not change significantly in each method. The difference between mean PSV.CRA and PSV.OA in operated eye between two study groups was not significant. PSV.CRA reduced significantly in both surgery methods and PSV.OA changes was not significant. However, the mean PSV.CRA and PSV.OA changes did not show statistically significant difference between surgery methods.

To evaluate the intraocular pressure (IOP) rising effect of anterior versus posterior subtenon injection of triamcinolone in eyes with retinal vein occlusion This prospective nonrandomized study was performed on 57 eyes of 57 patients with macular edema due to retinal vein occlusion. 26 eyes received posterior subtenon injection of 40 mg triamcinolone acetonide [PSTT] and 31 eyes received anterior subtenon injection of 40 mg triamcinolone acetonide [ASTT]. IOP measurement was performed before the injection, and after the injection at one week, two weeks, one month and every month up to six months after the injection. IOP rise was treated accordingly by drops and filtering surgery. IOP rise was found in 8% of the PSTT, and 67% of the ASTT injected eyes (P=0.001). All eyes with IOP rise in the PSTT group were controlled medically. Only 50% of eyes with IOP rise in the ASTT group could be controlled medically and filtering surgery was necessary for 33% of patients in the ASTT group. Visual acuity (VA) improvement was the same for both groups. More patients may have IOP rise after ASTT injection compared to PSTT injections.

To report normal interpupillary distance (IPD) values in different age groups of an Iranian population.This study was performed on 1,500 randomly selected subjects from 3,260 consecutive out-patients with refractive errors referred to Farabi Eye Hospital, Isfahan,Iran over a period of two years (2008 to 2010). Measurement of refractive errors and IPD for far distance were performed using an autorefractometer (RMA-3000 autorefractometer,Topcon, Tokyo, Japan). Mean IPD in adult subjects was 61.1±3.5 mm in women and 63.6±3.9 mm inmen.

This study performed to assess the safety of cataract extraction with phacoemulsification and intraocular lens (IOL) implantation in patients with high axial length compared with patients with normal axial length.

Atotal of 866 eyes were enrolled in this study; all subjects underwent phacoemulsification and IOL implantation for treatment of cataract. Seven hundred and nine eyes fell in the normal group with axial lengths ranging between 21 and 24.5 mm, and 157 eyes were considered myopic with axial length equal or greater than 26 mm. The two groups were compared regarding intraoperative surgical complications, such as vitreous loss, posterior capsular rupture, nucleolus drop, and undesirable implantation of IOL in the anterior chamber.

Age was a risk factor in both groups, with each year increase of age, the chance of incidence of intraoperative complications increased 1.04-folds (P = 0.03). And with 1 mm increase in axial length, the incidence of complications raised 1.22-folds (P = 0.007). There was no significant correlation between axial length and incidence of vitreous loss, although the incidence of posterior capsular rupture and nucleus fragment drops increased with increment in the axial length. Sex of the patients and side of the left or right eye were not found to be significant risk factors.

As the results illustrate, in this survey, age and high axial length were statistically significant risk factors for incidence of intraoperative complications of cataract surgery with phacoemulsification technique. Anticipation of these complications and also preparation and prophylactic measures may decrease incidence of these complications.

To evaluate the therapeutic effect of posterior sub-tenon methyl prednisolone in anterior ischemic optic neuropathy, No class 1 study has shown any conclusive medical or surgical treatment for non-arteritic anterior ischemic optic neuropathy (NAION). Efficacy of systemic or intravitreal steroids was suggested by some studies. This study was performed to evaluate the efficacy and safety of posterior sub-tenon injection of methyl prednisolone in eyes with acute NAION. In a double blind randomized clinical trial, forty patients with a recent onset NAION were randomly assigned into case and control groups. The case group received a single posterior sub-tenon injection of 40 mg methyl prednisolone; the control group received a sham injection. The patients had complete eye examination including visual field measurement and fluorescein angiography and systemic evaluation at the beginning. Eye examination was repeated at 2, 4, 6 and 8 week steps of the follow-up. Visual field was rechecked at the end of the follow-up. Statistical analysis used: SPSS 11.5 system, paired sample t-test; independent sample t-test, χ2, and ANOVA. Visual acuity (VA) improved 0.3 logMAR (three lines of Snellen chart) in the case group (P<0.030), no visual improvement was observed in the control group (P<0.589). Comparison between the two groups showed improvement in VA (P=0.021 at two weeks, and P=0.053 at 8 weeks), visual field pattern standard deviation (PSD), (P=0.034) and optic disc edema, (P=0.000) in the treatment group. No case of globe perforation or severe intraocular pressure (IOP) rise was detected. Posterior sub-tenon injection of methyl prednisolone was preferred to observation in acute NAION.

To compare keratometric measurements using a Javal type manual keratometer with IOLMaster in eyes undergoing photorefractive keratectomy (PRK) for myopia. In this comparative case series, we studied patients aged 21 to 27 years scheduled for myopic PRK. Keratometry was performed preoperatively and three months after the procedure using a Javal type manual keratometer and the IOLMaster. We compared postoperative measurements obtained by both instruments with the clinical history method (CHM). Seventy eyes of 35 patients with mean age of 23.45±1.55 years were studied. Mean preoperative spherical equivalent was -4.53±1.3 D. Average preoperative IOLMaster and manual keratometric readings were 45.95±1.23 D and 46.32±1.18 D, respectively. Postoperatively, mean IOLMaster measurements was 38.03±0.68 D and that of manual keratometry was 43.15±1.1 D. Compared to CHM measurements, the 95% limits of agreement were -5.95 to -0.85 for the IOLMaster and -1.44 to 4.04 for manual keratometry. Keratometric measurements with the IOLMaster and a Javal type manual device are comparable after PRK; both are largely deviant from the CHM and can yield misleading results.

To evaluate refractive, visual, topographic, and wavefront outcome of photorefractive keratectomy (PRK) for treatment of myopia and myopic astigmatism with two different excimer laser systems: Technolas 217z and Lasersight LSX excimer lasers.

183 eyes of 95 patients enrolled in this clinical trial. Patients underwent PRK in a Sadra refractive surgery center with Technolas or Lasersight system by a single surgeon between 2007 and 2011. For PRK we used Technolas 217z in one group and Lasersight LSX excimer laser in another group. Subjects examined before and 24 months after surgery evaluating vision, refraction, Orbscan topography, and Wavefront analysis. Data collected, analyzed with SPSS 16. We used Student t-test for statistical data analysis.

83 eyes were in the Lasersight group and 100 eyes in the Technolas group. Pre-op spherical equivalent refraction was not different in two groops. After surgery it was -0.93 ± 0.73 in Technolas and -0.19 ± 0.40 in Lasersight group, the difference was statistically significant (P < 0.001). Post-op difference vector of astigmatic correction was 0.44 ± 0.58 in Technolas and 0.41 ± 0.26 diopters in Lasersight group (P = 0.04). Post-op LogMAR Acuity was 0.015 ± 0.027 in Technolas and 0.0005 ± 0.005 in Lasersight group (P < 0.001). Post-op Q value of asphericity was 0.24 ± 0.33 in Technolas and 0.46 ± 0.37 in Lasersight group (P < 0.001).

Post-op spherical equivalent refractive outcome, best corrected distance visual acuity and satisfaction were better in Lasersight group. We did not find any difference regarding post-op wavefront analysis between groups.

Photorefractive keratectomy or PRK is a good way to correct mild, moderate and severe myopia and astigmatism. Because of several reports about the sight threatening of Hyperopic PRK, it’s effectiveness is less known. This study was done to characterize the refractive changes after excimer laser PRK for correction of hyperopia > 3 diopters and to assess refractive state and changes in astigmatism after 1year.

In an interventional study, thirty eyes of nineteen patients were participated. Their mean refractive error was +5.45 diopters and mean astigmatism was -1.42D. All of the patients were treated by Technolas 217-z excimer laser. Post operative SE (sphere equivalent), UNCVA (uncorrected visual acuity), BCVA (best corrected visual acuity) and all of the complications examined at 12 months later.

The mean post operative refraction was +1.00D (range-2.00 to +5.00), the mean SE was 0.55D and mean astigmatism was -0.95D (range -0.25 to-2.00D). Mean BCVA was unchanged or improved in 83.4% of cases (pre op log MAR = 0.10 and post op log MAR = 0.11) but five eyes (16.6%) lost 1 or 2 lines of snellen BCVA. In 46.6% refraction was within +/-1.00D and 80% was within +/-2.00 from target refraction. The grade corneal haze in eighteen eyes (66%) was 0 or 0.5 and in one eye was 3 and neither developed to grade 4.

Hyperopic PRK has a low predictability for high hyperopia but it is effective for low hyperopia. We do not recomended PRK in highly hyperopic-astigmatic eyes.

Controversy has recently risen about the presence of compensatory ocular countertorsion (COCT) after head tilt. This study was performed to define the functional range of this phenomenon. Cycloplegic autorefraction was performed on 80 eyes with regular astigmatism 2D. Objective autorefraction was performed in normal position, right and left head tilt positions of 5º, 10º, 15º, 20º, and 25º. Any change in astigmatic axis after head tilt was considered as COCT defect. The authors designed a tiltometer which was fixed over the patient's head without disturbing proper refractometry in various head positions. Enrolled eyes had no other ocular disease except refractive error. Seventy eyes completed the study process. Mean age of the patients was 26.5±10 (15-48) years. Mean amplitude of COCT was 1.87°±1.81 (0°-5°) at 5° and 6.91°±4.96 (0º-20°) at 25° head tilt angles. COCT values with left head tilt were significantly lower than COCT values with right head tilt (P<0.026). Incyclotorsional compensation in each eye was not necessarily equal to the excyclotorsional compensation of the fellow eye, but this torsional discrepancy was not overal significant (P>0.237). COCT was found to be an unreliable phenomenon. Any minimal head tilt can induce erroneous measurement of astigmatic axis during refractometry.

To determine the effect of intravitreal triamcinolone (IVT) injection on visual acuity in patients with ischemic central retinal occlusion (CRVO).

This randomized clinical trial was performed on patients with ischemic CRVO referred to the retina clinic at Feiz Hospital in 2007-2008. Inclusion criteria were: duration of CRVO less than one month, normal IOP, no sign of diabetic retinopathy or hypertensive retinopathy, no history of laser therapy and ocular surgery and vascular diseases. Patients were randomly allocated to two groups: intervention group (injection of 0.1cc IVT) and control group (no injection). Follow up examinations for all patients were scheduled 1, 2, 3 and 6 months after injection. The results were analyzed by SPSS13 and t-test.

Overall, 52 patients (22 male and 30 female) entered the study. Mean age was 60.5+9.7 (range: 30-80) years. Duration of signs was 21+5.5 days in the control group and 19+6 days in the IVT group (P= 0.66).All patients had signs of ischemic CRVO. Mean baseline visual acuity was 1.75+0.20 logMAR in the IVT group and 1.91+0.08 logMAR in the control group (P= 0.1). VA improvement in the IVT group was greater in comparison with the control group at one month (P= 0.019) however this difference was not significant at other follow-up examinations. In addition, the difference in IOP between before and after the injection was not significant (P= 0.802).

This study showed that in patients with CRVO, intravitreal injection of triamcinolone, has no significant long-term effect on visual acuity.

To compare the effects of standard tissue saving method and personalized techniques of photorefractive keratectomy (PRK) on aberration changes in fellow eyes.

This randomized controlled trial was performed on patients who were referred to Isfahan Parsian Clinic during 2007. After a comprehensive ophthalmologic examination, PRK was randomly performed using tissue saving (TS) technique in one eye and personalized (P) technique in the fellow eye. Aberrometry was performed pre- and 6 months postoperatively.

This study included 296 eyes of 148 (67 male and 81 female) patients with mean age of 29.1±7.0 years. The two groups had no significant difference in terms of laterality, pupil size and level of myopia preoperatively (P=0.65). Uncorrected visual acuity was 20/25 or more in 88.9% of the TS group and 92.6% of the P group (P=0.83). Mean refractive error 6 months postoperatively was -0.50±0.36 diopter (D) in the TS group and 0.31±0.43 D in the P group (P=0.95). Mean root-mean-square (RMS) value was -0.41±0.17 preoperatively and 0.86±0.43 postoperatively in the group TS (P<0.01). Corresponding figures were 0.47±0.39 and 0.77±0.43 in the P group (P<0.01). The two groups did not differ regarding pre- and postoperative RMS.

Postoperative aberrations may be increased with both tissues saving and personalized techniques of PRK with no significant difference between them in this regard.

To report the efficacy, safety, predictability and complications of photo-refractive keratectomy (PRK) with intraoperative application of mitomycin-C (MMC). This historical cohort study was performed on 1,250 eyes of 625 patients who underwent PRK using the Technolas 217 excimer laser machine by a single surgeon with intraoperative use of MMC 0.02% up to 2 minutes, depending on depth of ablation. A complete ophthalmologic examination was performed which included refraction, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and slitlamp biomicroscopy. Outcomes were analyzed after one year of follow-up. The mean preoperative spherical equivalent refractive error was -4.85±2.27 (range, -2.50 to -13.5) diopters (D). Mean depth of ablation was 89±22 microns and mean time to reepithelialization was 4.5±1.7 days. At final follow-up, UCVA of 20/20 and 20/40 or more was achieved in 92.1% and 99.2% of eyes, respectively. One year post-operatively, 69.4% and 91% of eyes were within ±0.50 D and ±1.00 D of emmetropia. Overall, 62 eyes (4.9%) developed one or two lines of decrease in BCVA, and 50 eyes (4%) developed corneal haze which was grade 1 or 2 in most cases; grade 3 and 4 corneal haze was found in 4 and 2 eyes, respectively. No other adverse event was noted during the study period. PRK with intraoperative application of MMC provides excellent visual outcomes with acceptable safety and predictability, and entails minimal side effects

Hyperopia is a type of refractive error and photorefractive keratectomy (PRK) is one of the surgical procedures for correction of various types of refractive errors. In this study we decided to evaluate the efficacy and results of PRK on hyperopia of more than 3 diopters 4 months after surgery. Overall, 30 eyes of 19 patients (18-66 years of old) for this clinical trial study were selected from the patients referred to an eye center clinic for PRK. All of these eyes were operated by Technolas 217 Excimer laser system. 4 months postoperative results were compared with preoperative data. Pre and postoperative results were compared using t-paired test via SPSS software.Postoperative spherical equivalent of patients were - 2.00 to + 5.00 diopter. In 30% of patients there was overcorrection and in 70% of patients there was Undercorrection. None of the patients were in the range of emetropia. Postoperative SE of 46.6% of patients was in the range of ± 1.00 diopter and 80% of patients were in the range of ± 2.00 diopter. The mean preoperative best corrected visual acuity (BSCVA) of patients 0.8 ± 0.18 as well as postoperative BSCVA. The mean of uncorrected visual acuity (UCVA) was 0.13 ± 0.1 and the mean of postoperative UCVA vs 0.51 ± 0.25. The mean of preoperative sphere was +5.45±2.06 and post operative one was + 1.00 ± 1.62 diopter. The mean of preoperative astigmatism was - 1.42 ± 1.13 that change to - 0.95 ± 0.55 postoperatively.Photorefractive keratectomy has a poor predictability and efficacy for hyperopia of more than + 3.00.

In this paper, we present a case with acute vision loss due to ethambutol therapy.A sixty-three year-old man underwent tuberculosis treatment (Ethambutol, Izoniazid, Rifampicin, Pirazin Amid) six years before this report. Acute bilateral vision loss occurred three months later while receiving ethambutol treatment. Total vision loss in one eye, and partial vision loss in another eye and optic atrophy were found on physical and neurological examinations.Ethambutol is one of the major drugs in tuberculosis treatment. It is usually well tolerated; however an Important side effect of this drug is retro bulbar optic neuropathy, which should be considered.

Complaining of tearing was found in some of our patients after phacoemulsification surgery for senile cataract. Secondary acquired lacrimal drainage obstruction has been proposed to happen due to different causes. This study was performed at Feiz hospital in Isfahan, Iran from September to December of 2004 to evaluate the effects of phacoemulsification surgery on tear drainage in eyes with senile cataract. This cohort study was performed on 110 patients with senile cataract who had phacoemulsification and posterior chamber lens (PCL) implantation surgery under topical anesthesia in one eye. Included patients had fluorescein disappearance and taste test duration of xxx; 5.5 minutes in both eyes before operation. Tear drainage function tests were repeated for one week and one month after surgery in both eyes and obtained data were compared. The incidence of lacrimal drainage impairment in eyes treated for senile cataract was 35% at one week and 20% at one month after phacoemulsification surgery. The mean taste test duration time was 3.84 ± 0.77 minutes before surgery, 7.30 ± 4.80 minutes at one week and 6.31 ± 4.42 minutes at one month after surgery (P < 0.001 and P < 0.001 respectively). No post operation tear drainage impairment was observed in the sound eyes of the patients. Impairment of lacrimal drainage can be predisposed by cataract surgery in eyes with senile cataract. KEY WORDS: Lacrimal drainage, cataract surgery, phacoemulsification