مجله چشم پزشکی بینا
سال بیست و دوم شماره 4 (تابستان 1396)

The aim was to examine morphologic alterations of cultured human retinal pigment epithelial (ahRPE) cells when encapsulated with different concentrations of fibrin glue and platelet gel.
The cultivated ahRPE cells were encapsulated with 84mg/dl concentrations of Fibrin glue and then evaluated for morphological changes.
The cultured ahRPE cells demonstrated dendritiform morphology in early days of encapsulation with FG scaffold. However, after digestion of Fibrin glue, epithelial morphology was again dominant. Electron microscopic result revealed the interconnection between the cell and three-dimensional scaffold.
Based on this study, the interconnection between the RPE cells and Fibrin scaffold led to morphological changes in the RPE cells, which was observed in the first days. However, after Fibrin digestion, the epithelioid morphology was again dominant.

This study reported preparation and thickness profiles of pre-cut endothelial keratoplasty tissues in donated photorefractive keratectomy (PRK) eyes. Precut tissues for endothelial keratoplasty were dissected from PRK donor whole eyes by using Moria microkeratome at the Central Eye Bank of Iran. The tissues were then subjected to specular microscopy and Visante optical coherence tomography. Endothelial cell density (ECD) and thickness measurements of the precut tissues were evaluated. Additionally, eye bank post-operative reports of the transplanted corresponding endothelial tissues were reviewed. Between October 2015 and March 2016, 25 donor whole eyes from 14 sero-negative donors with the diagnosis of prior PRK were dissected to provide precut endothelial keratoplasty lenticules. The mean central thickness of the precut tissues was 128±34µm. A mean increase of 26.2 µm was observed from central to pericentral parts of the precut tissues. The mean increase of thickness from central to peripheral locations was 90.4 µm. There was a statistical difference in the mean increase of thickness between 2 peripheral locations (P = 0.047). All the precut tissues had a very good to excellent endothelial rating with the mean ECD of 3164.6±311.0 cell/mm2. On review of the postoperative reports, all the corresponding precut tissues were transplanted uneventfully and none of the reports indicated posterior flap detachment or loss of graft clarity. Thin precut tissues with high endothelial cell density can be successfully prepared from donated PRK whole eyes for endothelial keratoplasty. The increase of thickness towards peripheral locations of the precut tissues, despite being statistically asymmetric, was not clinically significant.

To evaluate the risk factors for pterygium in the dry, high altitude province of Ilam, Iran.
The study included patients who presented to ophthalmology clinic. The patients were divided into two groups: 210 diagnosed with pterygium or pinguecula (unilateral or bilateral), and 210 healthy controls. Demographic variables, living environment, disease type, disease laterality, family history of pterygium as well as history of smoking, working outdoors, baking, welding, ocular conditions (trachoma keratopathy, glaucoma, refractive error, and dry eye), use of glasses, ultraviolet light exposure, and systemic conditions were collected from both groups and compared for risk assessment.
Univariate analysis revealed that age (P = 0.001), sex (P = 0.001), family history of pterygium (P=0.001), positive history of smoking (P This study tested more risk factors related to the prevalence of pterygium compared to previous studies. It also confirmed previously established risk factors. Family history of pterygium and blepharitis were risk factors that have not been reported in previous studies and were found to be significantly associated with the development of pterygium in this study.

This study aimed to compare outcomes and recurrence rates of amniotic membrane transplant (AMT) plus intraoperative mitoycin C (MMC) and conjunctival rotational autograft (CRA) plus intraoperative MMC in pterygium surgery.
A total of 92 eyes from 92 patients with primary nasal pterygium were included in the study . All the patients were randomized to undergo either AMT or CRA. Forty-three patients underwent AMT plus intraoperative MMC (AMT Group) and 49 patients underwent CRA plus intraoperative MMS (CRA Group). The patients were followed-up after 1 day, 1 week and 2 weeks as well as after 1, 3, 6, and 12 months, postoperatively. The main outcome measurement was a recurrence rate after surgery.
In the AMT group, 22 patients were male while 21 patients were female. Moreover, in the CRA group, 25 patients were male while 24 patients were female (p=0.923). The mean age was 46.4 years in the AMT group and 47.7 years in CPA group (p=0.634). The mean pterygium size was 3.4 mm in the AMT group and 3.3 mm in the CRA group (P=0.320). Furthermore, the mean follow-up time was 10.5 months in the AMT group and 10.8 months in the CPA group (p=0.535). Nine of the 43 eyes (20.93%) in the AMT group developed recurrence compared with four of the 49 eyes (8.16%) in the CPA group (P=0.145).
Although no statistically significant difference was present between the two groups, the recurrence rate seemed to be less clinically significant in the CPA group.

In this study, fusional vergence amplitudes were compared in patients with symptomatic and asymptomatic near exophoria.
This cross-sectional study included 102 patients with near exophoria and asthenopia and 86 with asymptomatic near exophoria, all of whom were aged 15-35 years and had best corrected far visual acuity better than 20/25. Far and near fusional vergence amplitudes were evaluated in all the patients. The subjects were not hyperopic.
We observed significant between group differences in near negative fusional vergence (NFV) break (15.91±4.90 PD vs. 14.73±4.60 PD, p=0.013), near NFV recovery (12.33±3.90 PD vs. 13.79±3.97PD, P=0.009), and far NFV recovery (5.58±3.50 PD vs. 4.50±2.70 PD, P=0.019). Other vergence amplitudes did not differ significantly.
Although it was previously assumed that asthenopia is related to convergence insufficiency (CI), it seems that asthenopia in patients with near exophoria may be related to increased amplitudes of negative vergence.

To evaluate the effect of acupuncture therapy on patients with retinitis-pigmentosa.
This was a prospective, interventional, self-control, case series study of 43 eyes of 23 RP subjects, each receiving 10 half-hour body acupuncture sessions with a standardized protocol. Pre- and post-treatment tests included BCVA, UCVA, NVA (Snellen chart), perimetry (Humphry perimeter), and full-field ERG (Metrovision-Monopack system). Statistical testing was carried out by SPSS-19. P-value≤0.05 was considered statistically significant. The samples were selected using convenient sampling.
In the UCVA, BCVA and NVA tests, improvements after the acupuncture therapy were statistically and clinically significant (p=0.048, p=0.0005 and p=0.002, respectively). Moreover, in the perimetry test, the changes of mean Foveal threshold (MFT) and mean deviation (MD) were statistically, but not clinically, significant (p=0.031 and p=0.02, respectively). In the ERG variables, changes in the scotopic b/a ratio and photopic b/a ratio were significant clinically, although not significant statistically. There was no statistically significant difference between different age groups and sexes. Subjective symptoms of improvement were observed in almost all the cases.
Acupuncture therapy can be advantageous to retinitis pigmentosa patients’ visual function improvement.

To examine the relationship between family supportive relationships with self-efficacy and resilience in patients undergoing corneal transplants.
The study population in this descriptive-correlation research were randomly selected from patients who were candidates for corneal transplantation. The questionnaire were used in this study evaluating family social support in chronic patients scale, coping with self-efficacy scale and Connor-Davidson resilience scale. Finally, all the scores were analyzed.
The research findings suggested the impact of self-efficacy and resilience on supportive familial relationships in patients who were candidates for corneal transplantation at the significance level of P=0.05.
According to the findings of the study, there was a significant relationship between the family support and the two components of self-efficacy and resilience, showing the role of family support in improving the quality of life of patients with corneal transplants.

Glistenings are fluid-filled microvacuoles that form within the intraocular lens (IOLs) optic when the IOL is in an aqueous environment. They are observed in all types of IOLs but have been mainly associated with hydrophobic acrylic IOLs. Experimental and clinical studies suggest that various hydrophobic acrylic IOLs on the market exhibit different tendencies toward Glistenings. Factors influencing Glistening formation include IOL material composition, manufacturing technique, packaging, associated conditions such as glaucoma or those leading to breakdown of the blood–aqueous barrier, as well as concurrent use of ocular medications. Although the impact of Glistenings on postoperative visual function and the evolution of Glistenings in the late postoperative period remain controversial, IOL explantation has rarely been reported. The phenomenon of surface light scattering has also been described in association with hydrophobic acrylic IOLs. Its mechanism of formation is controversial but may be related to long-term phase separation water near the IOL surface, although not seen as microvacuoles.
Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned.

This study attempted to describe a case of subcutaneous, subconjunctival and orbital emphysema secondary to compressed air injury.
Case Report: A 5-year-old boy was accidentally injured by compressed air to his right eye. Periorbital and subconjunctival emphysema and proptosis were developed. A computed tomography scan showed periorbital subcutaneous and intraorbital emphysema around the right eye as well as intracranial and cervical emphysema. He was examined under sedation and subconjunctival air was aspirated. He was prophylactically treated with topical and systemic antibiotics to prevent infection. Emphysema had completely resolved after 3 weeks.
Conjunctival and orbital emphysema as well as intracranial and cervical emphysema can occur without orbital bone fractures and clear entrance site, and needs emergent management to save vision and upper respiratory tract.