Biomedical subjects

M A Javadi

Publications and source records attributed to M A Javadi.

9 recordsLinked to original sources

PubMed2001

Intra-ocular lens implantation in children.

Intra-ocular lens (IOL) implantation in a growing eye of a young child brings several problems unique to this age group. Better understanding of the rate of refractive growth in children's pseudophakic eyes may help predicting future refractions in these eyes more accurately. Opacification of the posterior capsule, if remained intact, interferes with visual rehabilitation in children. Primary posterior capsulectomy and anterior vitrectomy provides the clarity of visual axis. Optical rehabilitation of children with unilateral aphakia is usually problematic. Posterior chamber IOLs are preferred to anterior-chamber IOLs for secondary implantation. In the absence of adequate capsular support and contact lens intolerance, a scleral-fixated IOL can be implanted. Scleral fixation of a posterior chamber IOL has encouraging short-term results but the long-term risks are not known yet. Intra-ocular lens implantation in infants is associated with major complications and is not recommended at present. The occurrence of open angle glaucoma is a sight-threatening late complication of pediatric cataract surgery. Intra-ocular lens implantation plays a protective role against aphakic glaucoma in children.

Aphakia, Postcataract↗

PubMed2000

Cataract surgery and intraocular lens implantation in anterior megalophthalmos.

Six eyes of 4 patients with anterior megalophthalmos, 2 men and 2 women ranging in age from 32 to 47 years, had extracapsular cataract extraction or phacoemulsification and standard posterior chamber intraocular lens implantation. All had a family history of anterior megalophthalmos. Follow-up was from 6 to 30 months. All patients had a preoperative visual acuity of worse than 20/60, which improved to 20/20 in 5 eyes. Zonular dehiscence was observed during surgery in 3 cases, leading to vitreous loss in 1 case that developed a retinal detachment after 3 months.

Adult↗

PubMed1999

Primary capsulectomy, anterior vitrectomy, lensectomy, and posterior chamber lens implantation in children: limbal versus pars plana.

PURPOSE: To compare the results of a limbal versus a pars plana approach for primary posterior capsulectomy and anterior vitrectomy in the management of childhood cataract. SETTING: Department of Ophthalmology, Labbafinejad Medical Center, Tehran, Iran. METHODS: A randomized, controlled, double-masked clinical trial of 45 eyes was conducted. After being matched, 38 eyes were included in the study and were divided into 2 equal groups for data analysis. All eyes had lensectomy and posterior chamber intraocular lens (PC IOL) implantation. Primary posterior capsulectomy and anterior vitrectomy were performed through the limbus in half of the eyes and the pars plana in the other half. Main outcome measures included visual acuity, estimated red reflex, postsurgical inflammatory reaction, corneal clarity, posterior synechias, iris capture, IOL position, capsulectomy size, glaucoma, cystoid macular edema, retinal tear, and postoperative refraction. RESULTS: No statistically significant differences were found between the 2 approaches in the outcome measures. CONCLUSION: The anatomic and visual results were encouraging when posterior capsulectomy and anterior vitrectomy, using a limbal or pars plana approach, were combined with lensectomy and PC IOL implantation in children. The application of these techniques depends on surgeon experience and skill.

Anterior Eye Segment↗

PubMed1997

Surgical management of cataract and posterior chamber intraocular lens implantation in Fuchs' heterochromic iridocyclitis.

BACKGROUND: To determine the inflammatory course and level of visual rehabilitation after cataract extraction and posterior chamber lens implantation in patients with Fuchs' heterochromic iridocyclitis complicated by cataract. METHODS: In a clinical trial, 32 eyes (visual acuity of 20/160 or worse) of 30 patients underwent extracapsular cataract extraction (19 eyes) or lensectomy (13 eyes) accompanied by posterior chamber intraocular lens implantation. Indirect ophthalmoscopy was performed intraoperatively prior to intraocular lens implantation and the extent of vitreous haze was assessed. If vitreous haziness was 3+ or more, core vitrectomy (two eyes) or three-port pars plana deep vitrectomy (four eyes) was performed. RESULTS: After an average follow up of 14.4 months (6 to 24 months), there was no statistically significant increase in cell and flare in the anterior chamber and vitreous or in keratic precipitates compared with the preoperative status of the eyes. However, 12% of the eyes developed synechiae (anterior and/or posterior) in comparison to preoperative condition (p < 0.05). Eight-seven percent of the eyes gained visual acuity of 20/40 or better (P < 0.005). Using the logistic regression model, a higher level of preoperative inflammation was associated with reduced likelihood of gaining visual acuity of 20/25 or more (OR = 0.25, 95% CI 0.049, 1.255). The complications of surgery were synechiae, 12%; opaque posterior capsule, 12%; vitreous loss, 3%; chronic glaucoma, 3%; and retinal detachment, 3%. CONCLUSIONS: Implantation of a posterior chamber intraocular lens can be well tolerated in patients with Fuchs' heterochromic iridocyclitis. Vitrectomy, whenever indicated in addition to cataract extraction, improves visual rehabilitation.

Adolescent↗

PubMed1996

Transmission of rabies by corneal graft.

Viruses such as human immunodeficiency virus, herpes simplex virus, cytomegalovirus, hepatitis B, hepatitis C, and rabies can be transmitted to the recipient by corneal transplantation. Very few cases of rabies have been reported. Here we report two cases of rabies transmitted by the same donor. Both of the recipients died of rabies.

Adult↗

PubMed1995

Results of penetrating keratoplasty in CHED. Congenital hereditary endothelial dystrophy.

Congenital hereditary endothelial dystrophy is characterized by a diffuse bilateral corneal opacity (edema). Its inheritance has been reported to be both autosomal recessive and dominant. All our cases seemed to be autosomal recessive. There seems to be a prevalence of the recessive gene in the Iranian population. The dystrophy might be misdiagnosed as congenital glaucoma, as in several of our cases. We have operated on 37 eyes of 21 patients during the past 10 years. Our visual and anatomical success rate has been very good, with 92% clear grafts and only an 8% rejection rate, in contrast to poor prognosis that has been previously reported. In children, suture removal should be started 3 months postoperatively. Partial amblyopia was preexistent in all cases, but deep amblyopia was not common.

Adolescent↗

PubMed1993

A comparison between donor-recipient corneal size and its effect on the ultimate refractive error induced in keratoconus.

A prospective randomized clinical study was performed to see the effect of donor-recipient corneal size on the ultimate refractive error induced in keratoconus at our facility. The patients were randomly divided into two groups, A and B. In Group A, the difference in size between the donor and the recipient cornea was 0.25 mm (18 patients). In Group B, the difference in size between the donor and the recipient cornea was 0.50 mm (20 patients). Both groups underwent the surgical procedure with the same surgeon (M.A.J.) and the same technique. Two months after suture removal, keratometry readings and refractive errors induced were compared. The mean keratometry reading in Group A was 43.3 diopters; in Group B, the reading was 44.8 diopters. There was a mean difference of 1.5 diopters between the two groups (p = 0.01). The mean refractive error in terms of spherical equivalent in Group A was -1.55 diopters and in Group B was -3.33 diopters. There was a difference of -1.8 diopters between the two groups (p < 0.05).

Adolescent↗

PubMed1992

Superficial juvenile granular dystrophy.

Seventeen cases of a superficial corneal dystrophy are presented. The lesions are subepithelial, limited mainly to Bowman's layer. This dystrophy, although clinically different from classic granular dystrophy, is pathologically similar to it. Treatment, consisting of superficial keratectomy to 15% to 20% of corneal thickness, did not require lamellar grafting and produced good visual results. A new classification of granular dystrophy is proposed.

Adolescent↗

PubMedDate not supplied

Limbal stem cell deficiency in the context of autoimmune polyendocrinopathy.

PURPOSE: To report two sisters with bilateral progressive visual loss and photophobia secondary to stem cell deficiency due to multiple endocrine deficiency. METHODS: Case reports and review of medical literature. RESULTS: The younger sister had severe photophobia and decreased visual acuity since May 2000. Despite multiple outpatient visits no definite cause was found and conservative treatments failed. On slit lamp examination severe meibomian gland dysfunction, loss of eyelashes, decreased tear meniscus, diffuse corneal vascularization, and delayed punctate fluorescein staining of corneal epithelium were detected. She also had episodes of hypotension, oral candidiasis, and seizures. Her systemic workup revealed multiple endocrine deficiency (Addison's disease and hypoparathyroidism). Hormone replacement therapy with fludrocortisone and oral calcium accompanied by punctual occlusion led to significant clinical recovery . The older sister showed a similar pattern but interestingly the onset was later and the signs and symptoms were milder. CONCLUSIONS: In the pediatric age group with diffuse corneal vascularization and no definite cause, systemic workup should be done to rule out multiple endocrine deficiencies. The therapy consists of hormone replacement therapy and management of dry eye.

Adolescent↗