Purpose: To assess the relationship between corneal ENDOTHELIAL CELL LOSS after phacoemulsification and the location of the clear corneal incision. Methods: A total of 92 patients (92 eyes) with senile cataracts who met the study criteria were included in this cross sectional study and underwent phacoemulsification.The incision site was determined based on the steep corneal meridian according to preoperative keratometry. ENDOTHELIAL CELL density was measured using specular microscopy in the center and 3 mm from the center of the cornea in the meridian of the incisions (temporal, superior, and superotemporal). Phacoemulsification was performed by a single surgeon using the phaco chop technique through a 3.2 mm clear cornea incision. ENDOTHELIAL CELL LOSS (ECL) was evaluated 1 week, and 1 and 3 months postoperatively.Results: At all time points during follow-up, ECL was comparable among the 3 incision sites, both in the central cornea and in the meridian of the incision (P>0.05 for all comparisons). However, 3 months postoperatively, mean central ECL with superior incisions and mean sectoral ECL with temporal incisions were slightly higher. Superotemporal incisions entailed slightly less ECL than the other 2 groups. Overall, one month after surgery, mean central ECL was 10.8% and mean ECL in the sector of the incisions was 14.0%. Axial length and effective phaco time (EFT) were independent predictors of postoperative central ECL (P values 0.005 and<0.0001, respectively).Conclusion: A superotemporal phacoemulsification incision may entail less ECL as compared to other incisions (although not significantly different). The amount of central ECL may be less marked in patients with longer axial lengths and with procedures utilizing less EFT.

Background: This study aimed to compare the rate of ENDOTHELIAL CELL LOSS (ECL) after penetrating keratoplasty (PKP) for optical versus therapeutic grafts at 3-, 6-, and 12-month postoperatively. Furthermore, the study aimed to investigate postoperative graft viability and the rate of graft rejection during the first year of follow-up for both indications. Methods: This was a prospective, observational, comparative study that included patients who sought medical advice at the cornea outpatient clinic of Ain Shams University Hospitals, Cairo, Egypt. The study recruited 60 patients: group 1 included 30 transplanted corneas of 30 patients who underwent optical PKP for various indications, while group 2 included 30 transplanted corneas of 30 patients who underwent therapeutic PKP for unhealed, resistant infectious keratitis. Specular microscopy was performed for all patients at the 3-, 6-, and 12-month follow-up visits using Nidek CEM-530 specular microscopy. Postoperative clinical examinations were performed at the same follow-up visits to detect graft rejection. Results: There were no statistically significant differences between the groups concerning the postoperative timing of graft clarity or the rate of ECL at 3-and 6-months postoperatively; however, the rate of ECL was significantly greater in group 2 than in group 1 at 12-months postoperatively (P = 0. 03), although the difference was small from a clinical point of view. Moreover, there was no statistically significant difference between the groups in terms of the graft rejection rate. Conclusions: Therapeutic PKP results were comparable to optical PKP with respect to graft viability, the rate of ECL, and the rate of graft rejection 1 year after grafting.

Purpose: the aim of thos survey is establishment of an animal model through which a rapid distortion of the hair CELL of cochlea administering amikacin and furosemide and using distortion product otoacoustic emission (DPOAE) the functioning of rat’s ear would be assessed.Materials and Methods: Forty-eight male Sprague dawley rats (with average of weight 200-250g, 12 weeks post natal) were randomly divided into six equal groups. Except the control group the rest received 0.5mg/g, 0.75mg/g, 1mg/g, 1.25mg/g, and 1.5mg/g, of subcutaneous amikacin respectively. 30 minutes later every rat received 0.1mg/g of furosemide intrapritoneally. DPOAE of rats was measured prior to these injections and 72 hours later. Then tissue section of the rat’s cochlea was prepared.Data were analyzed by means of SPSS (version 17) and ANOVA test and paired sample T test at the significant level of p£0.05.Results: All the cases had a significant decrease in their DPOAE with the frequencies 2KHz-8KHz (p£0.05). The most change in DPOAE was in rats which had received 1mg/g–1.5mg/g amikacin. Histological studies approved distortion of hair CELL even within the apical turn.Conclusion: To establish a deafness model due to losing hair CELLs, it is recommended to use a combination of 1mg/g amikacin and 0.1mg/g furosemide. Besides, DPOAE can be used to approve deafness.

Purpose: To compare ENDOTHELIAL CELL changes induced by different phacoemulsification incision sites using specular microscopy Setting: Department of ophthalmology, Farabi eye hospital, Tehran University of medical sciences, Iran. Design: Randomized controlled trial. Materials & Methods: Sixty-three eyes planned for phacoemulsification were randomly assigned in 2 groups of 32 and 31 eyes each: 3.5mm temporal clear corneal incision and 3.5mm superior scleral tunnel with acrylic foldable IOL implantation. Non-contact specular microscopy was performed in the center and 3mm superior and temporal to the central zone preoperatively as well as 1 and 3 months postoperatively. ENDOTHELIAL CELL density, mean CELL area and CELL size coefficient of variation were compared. Results: Progressive ENDOTHELIAL CELL LOSS and increase in mean CELL area occurred in both groups during the follow up. The CELL LOSS percentage in temporal clear corneal (TCC) group was significantly greater than superior scleral tunnel group in temporal site postoperatively (P-value was 0.059 at 1 month postop. period and 0.004 at 3 months postop. period). CELL LOSS percentage relative to the center of cornea was similar in both groups 3 months after operation but slightly although not significantly greater in TCC group within 1 month postoperation. Conclusion: The temporal clear corneal incision incurs more postoperative ENDOTHELIAL damage than scleral tunnel incision specifically at the temporal site. This is probably because the scleral tunnel incision is placed more posteriorly and therefore induces less direct and indirect ENDOTHELIAL surgical trauma.      

Introduction: Serum Anti ENDOTHELIAL CELL Antibodies (AECAs) play a prominent role in idiopathic Sensorineural Hearing LOSS (SNHL) in that they induce vascular damage (immune mediated).The of the current study is To compare AECAs in serum and perilymphatic fluid of idiopathic SNHL children (<15y) undergoing cochlear implant surgery.Methods: This was a cross sectional study performed in the cochlear implant ward in Rasoul Akram hospital, Tehran, Iran (2008 -2010) on 99 SNHL children undergoing cochlear implant surgery. The data collected from47 idiopathic and 52 non-idiopathic SNHL cases. AECAs were measured by indirect immuno fluorescence assay and compared in sera and perilymphatic fluids between the two groups. P-value<0.05 was considered significant.Results: Idiopathic SNHL was diagnosed in 47.5% of cases. Positive AECA results in serum and perilymphatic fluid were 10% and 12%, respectively. Although AECA results in perilymphatic fluids were different between idiopathic and non-Idiopathic SNHL patients (PV<0.05), AECAs in serum showed no significant difference between the two (PV=0.1). No significant difference was detected between the mean age of idiopathic and non-idiopathic SNHL patients with positive AECAs in serum and perilymphatic fluids (PV=0.2; PV=0.2).Discussion: Idiopathic SNHL was diagnosed in 47.5 % of studied cases. Idiopathic SNHL has a poor out come in children. In cases with idiopathic SNHL, finding AECAs in perilymphatic fluids are more valuable than in the serum. We suggest that serum and perilymphatic fluids testing for AECAs would be helpful in management of idiopathic SNHL cases.Specific immunosuppressive treatments for selected cases suffering from Idiopathic SNHL (only in those older than 5) might be successful in disease management. However, this theory should first be validated by randomized clinical trials.

Purpose: To compare corneal ENDOTHELIAL CELL features after cataract surgery performed using fixed torsional or conventional (Pulse) ultrasound mode.Methods: In this randomized comparative study, 60 eyes were randomly and equally divided into two groups of torsional or longitudinal mode phacoemulsification. All surgeries were performed by an experienced surgeon, and the outcomes were evaluated by a masked examiner. Preoperatively visual acuity (VA), age and mean nuclear grade (LOCS III) were recorded; besides automated confocal microscopy was used to measure ECD, polymegathism and pleomorphism at the Centre of the cornea. All patients underwent clear cornea phacoemulsification in a similar manner. Intraoperative outcome measures were ultrasound time (UST), cumulative dissipated energy (CDE), and total fluid use. Best corrected VA and confocal measurements were repeated after 1 month.Results: Mean preoperative ECD in conventional and torsional phaco mode groups were 2761.61±403.36 and 2690.36±490.92 CELLs/mm2. Postoperative ECD was 2494.30±358.63 and 2436.56±468.39 CELLs/mm2, respectively. The decrease in ECD, and increase in pleomorphism and polymegatism were statistically significant within both study groups (P<.001), but there were no statistically significant differences in preoperative and postoperative measurements between the 2 groups (P>.01). No relevant clinical differences or operative complications were seen in either group. There was no statistically significant difference between intraoperative measures in both groups (P>.01).Conclusion: Both phaco methods provide effective lens removal with no significant difference.