dr. noushin bazzazi

Glaucoma is one of the leading causes of blindness, and its major risk factor is elevated intraocular pressure. Intraocular pressure measurement is a major examination in patients with glaucoma for diagnosis and treatment follow-up. This study was carried out with the purpose of comparing the accuracy of two types of conventional tonometers for measuring intraocular pressure. In this descriptive cross-sectional study, after complete ophthalmologic examinations, intraocular pressure was measured in 142 patients (284 eyes), two times at 5-minute intervals using both Goldmann and Keeler tonometers. The obtained results were analyzed with paired t-test and Pearson’s correlation test. Mean intraocular pressure in subjects that were in normal pressure range (<21mmHg) was obtained 14.03±2.35mmHg with Goldmann tonometer, and 14.28±3.05mmHg with Keeler tonometer. The mean difference of the two methods was 0.25±0.70 (p=0.015) and the correlation coefficient between two methods was calculated 0.83 (p<0.0001). Mean intraocular pressure in high intraocular pressure range (³21mmHg) was obtained 26.16±5.1mmHg with Goldmann tonometer, and 26.92±5.58mmHg with Keeler tonometer. The mean difference of the two methods was 0.76±0.44 (p=0.003), and correlation coefficient between two methods was calculated 0.97 (p<0.0001). Based on the results of this study, both used tonometry methods had acceptable accuracy in normal intraocular pressure range, but in high-risk cases such as glaucoma, Goldmann applanation tonometer is preferred as the gold standard.

To report a case of retained silicone tube Case report : We report a case of 48-year-old Iranian lady who referred to the department of otolaryngology with 18 years history of epiphora and intermittent mucopurulant discharge from the left lacrimal canaliculi. She had external dacryocystorhinostomy (DCR) with silicon stenting for epiphora 18 years ago but epiphora had continued after surgery. Preoperative irrigation test revealed partial obstruction and in diagnostic nasal endoscopy the previous rhinostomy site was patent. She was operated with revision endoscopic DCR approach and an impacted 15 millimeters piece of silicon tube was removed from lacrimal sac. This case should alert surgeons to the possibility of foreign bodies as a cause of persistent epiphora after DCR surgery.

To compare the efficacy of adding an opposite clear corneal incision (OCCI) on the steep meridian versus performing surgery on the steep meridian alone during phacoemulsification in reducing pre-existing corneal astigmatism. This randomized clinical trial was performed on 120 eyes with corneal astigmatism of > 1D undergoing phacoemulsification. Incisions were made based on the type of astigmatism as follows: superior or superior + OCCI for with-the-rule and temporal or temporal + OCCI for against-the-rule astigmatism. Patients were followed with refraction, keratometry and topography. Statistical analysis was performed using one- and two-way ANOVA and Tukey-a test. Mean corneal astigmatism was 1.82±0.86 D in the superior + OCCI group and 1.74±0.86 D in the temporal + OCCI group preoperatively which decreased to 1.31±0.59 (P=0.013) and 1.19±0.64 (P=0.009) postoperatively respectively. No significant change occurred in the amount of astigmatism in any of the two single incision groups. Paired OCCI on the steep axis is a useful technique to correct mild to moderate pre-existing astigmatism with no need for particular skill or additional instruments.