Publications by authors named "Ahmad Masoumi"

18 Publications

  • Page 1 of 1

Superior Rectus Transposition and Medial Rectus Recession for Treatment of Duane Retraction Syndrome and Sixth Nerve Palsy.

J Binocul Vis Ocul Motil 2021 Apr-Jun;71(2):45-49. Epub 2021 Mar 5.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

: To evaluate the outcome of augmented superior rectus transposition (SRT) with medial rectus (MR) recession in patients with Duane Retraction Syndrome (DRS) and sixth nerve palsy.: Twenty four patients (16 DRS and 8 sixth nerve palsy) that underwent the procedure were included. The superior rectus muscle was secured, detached, and re-attached to the sclera along the spiral of Tilaux, adjacent to lateral rectus insertion. A non-absorbable augmentation suture was passed through the sclera, 8 mm posterior to the insertion of the lateral rectus.: At the last follow-up, the effect of surgery in decreasing esotropia in both groups was significant ( = .001 for DRS group, = .002 for sixth nerve palsy). In both groups, abduction deficit improved significantly ( < .001 for DRS and = .008 for sixth nerve palsy). After the surgery, small, asymptomatic vertical deviation in primary position was induced in five patients (20.8%). Post-operatively, none of the patients complained of torsional diplopia. In the 6-month follow-up, compared with the first postoperative visit, an eso-drift at distance or near developed in 11 patients (45.8%). Of the 11 patients with eso-drift, overcorrection (exotropia of 3-14 PD) was present at the first post-operative visit in 5 cases. Four cases showed an exo-drift (2-5 PD) at distance or near over time.: SRT with medial rectus recession improves esotropia and abduction limitation without inducing significant vertical deviations and torsional diplopia. Some of the cases that underwent SRT with MR recession may show an eso-drift. The eso-drift can correct initial exotropia in some cases.
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http://dx.doi.org/10.1080/2576117X.2021.1879985DOI Listing
March 2021

Infectious keratitis: trends in microbiological and antibiotic sensitivity patterns.

Eye (Lond) 2021 Jan 19. Epub 2021 Jan 19.

Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: To report the spectrum and trends of isolated microorganisms and their antibiotic susceptibility profile in patients with infectious keratitis in a 6-year period at a referral centre in Tehran.

Methods: The microbiology records of all corneal scrapings with a diagnosis of infectious keratitis were reviewed.

Results: A total of 6282 corneal scrapings were performed during the study period, of which 2479 (39.5%) samples were culture positive. Pseudomonas aeruginosa was found to be the most common causative agent in patients with keratitis, although Streptococcus pneumonia was the most prevalently isolated microorganism in patients older than 50 years. Fusarium sp. was the most common responsible pathogen in patients with fungal keratitis. The prevalence of bacterial keratitis due to gram positive microorganisms increased over time, however the number of Pseudomonas keratitis decreased in the second half of the study. Gram negative organisms showed a good sensitivity to levofloxacin, however, 34.1% of S. aureus isolates and 29.7% of coagulase negative staphylococci were resistant to this antibiotic. The odds of ciprofloxacin and levofloxacin resistance increased 1.25 and 1.15 for each 1-year increase in culture date, respectively (P < 0.001, P = 0.004).

Conclusions: We documented an increasing trend in the percentage of gram positive bacteria. Levofloxacin monotherapy might still be a good option in patients with gram negative bacterial keratitis, however owing to increasing resistance of staphylococci to fluoroquinolones, a regimen consisting of a combination of fortified antibiotics may be more effective in staphylococcal keratitis.
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http://dx.doi.org/10.1038/s41433-020-01378-wDOI Listing
January 2021

Current diagnostic tools and management modalities of Nocardia keratitis.

J Ophthalmic Inflamm Infect 2020 Dec 2;10(1):36. Epub 2020 Dec 2.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Nocardia species are an uncommon but important cause of keratitis. The purpose of this review is to discus previous published papers relation to the epidemiology, etiology, diagnosis and management of Nocardia keratitis. Nocardia asteroides is the most frequently reported from Nocardia keratitis. Pain, photophobia, blepharospasm and lid swelling are mainly clinical manifestations. Usual risk factors for Nocardia keratitis are trauma, surgery, corticosteroids, and contact lens wear. Several antibiotics were used for treatment of Nocardia infection but according to studies, topical amikacin is the drug of choice for Nocardia keratitis. Topical steroid should not prescribe in these patients. In conclusion, although Nocardia keratitis is rare, early diagnosis and treatment are essential to prevent any scar formation and preserve a good visual acuity.
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http://dx.doi.org/10.1186/s12348-020-00228-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710777PMC
December 2020

MyoRing Implantation with and without Corneal Collagen Crosslinking for the Management of Keratoconus.

J Ophthalmic Vis Res 2020 Oct-Dec;15(4):486-492. Epub 2020 Oct 25.

Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: To evaluate the safety and efficacy of femtosecond laser-assisted MyoRing implantation with concurrent corneal collagen crosslinking (CXL) compared to MyoRing alone for the treatment of progressive keratoconus.

Methods: A total of 60 patients were enrolled in this randomized controlled trial. The patients were randomly allocated into two groups. In the first group, MyoRing was implanted, while in the second, it was inserted in the corneal stroma using the same technique, along with simultaneous CXL. Visual, refractive, topographic, and abberometric outcomes were measured preoperatively and at every postoperative visit.

Results: Data of 47 patients were available at the end of the study; 28 in the MyoRing group and 19 in the MyoRing + CXL group. The mean uncorrected distance visual acuity (UDVA) improved from 0.79 0.39 logMAR to 0.52 0.31 logMAR (P 0.05) in the MyoRing + CXL group and from 0.65 0.38 logMAR to 0.62 0.23 logMAR (P = 0.70) in the MyoRing group. CDVA changed from 0.33 0.19 logMAR to 0.25 0.16 logMAR (P = 0.10) in the MyoRing + CXL group and 0.32 0.22 logMAR to 0.33 0.17 logMAR (P 0.50) in the MyoRing group. The mean keratometry (Km) decreased from 47.5 2.7 D to 43.8 3.2 D (P 0.001) in the MyoRing group and 49.3 3.4 D to 45.1 3.0 D (P 0.001) in the MyoRing + CXL group. Besides, horizontal coma was significantly lower in the MyoRing + CXL group (P = 0.022).

Conclusion: MyoRing insertion combined with CXL is a safe and effective method for the treatment of keratoconus. The visual and topographic outcomes were comparable to that for MyoRing insertion after 10 months; however, horizontal coma was significantly lower in the MyoRing + CXL group.
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http://dx.doi.org/10.18502/jovr.v15i4.7790DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591835PMC
October 2020

Simultaneous photorefractive keratectomy and accelerated collagen cross-linking in high-risk refractive surgery (Tehran protocol): 3-year outcomes.

Int Ophthalmol 2020 Oct 30;40(10):2659-2666. Epub 2020 Jun 30.

Ophthalmology Department, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran.

Purpose: To evaluate safety and efficacy of performing simultaneous photorefractive keratectomy (PRK) and collagen cross-linking (CXL) in myopic patients with preoperative risk factors for developing keratectasia.

Methods: Seventeen eyes of 15 patients with at least one of the following risk factors were recruited: central keratometry (K) between 48 and 50, difference between inferior, superior corneal power (I-S value) between 1.4 and 1.9 and corneal thickness between 450 and 480 µm. Upon final stage of standard PRK, 0.02% mitomycin was applied for 30-50 s, and then, accelerated CXL was performed for 5 min. Pre- and postoperative Oculus Pentacam imaging for keratometry values, measurement of uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were done for all patients.

Results: Mean follow-up time was 32.08 ± 7.79 months (range 25-49 months). Mean age of patients was 28.78 ± 3.80 years. Mean postoperative spherical equivalent was + 0.19 ± 0.42 (- 0.5 to + 1.0 [D]). Mean UDVA and CDVA improved from 0.9062 ± 0.485 log MAR and 0.0148 ± 0.043 log MAR to 0.0173 ± 0.040 log MAR and 0.0057 ± 0.023 log MAR, respectively (P = 0.011, P = 0.735). Mild degree of early postoperative stromal haze was seen which did not persist more than 6 months. There was no late stromal haze, corneal ectasia or other major postoperative complication in the follow-up period.

Conclusion: Combined PRK and accelerated CXL is an efficient and safe procedure for high-risk refractive surgery candidates, with no increased risk of persistent corneal haze.
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http://dx.doi.org/10.1007/s10792-020-01447-9DOI Listing
October 2020

Surgical outcome of patients with unilateral exotropic Duane retraction syndrome.

J AAPOS 2020 06 30;24(3):133.e1-133.e7. Epub 2020 May 30.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Purpose: To describe the clinical features and surgical outcomes of patients with unilateral exotropic Duane retraction syndrome (DRS).

Methods: The medical records of patients with unilateral exotropic DRS who underwent surgery between March 2015 and February 2018 were reviewed retrospectively.

Results: A total of 40 patients (mean age, 18.75 ± 12.54 years; 21 males [53%]) were included. In 28 patients (70%) the left eye was involved. All patients had globe retraction and head turn toward the opposite side of the affected eye. Remarkable upshoot/downshoot movement was detectable in 11 patients (28%). The mean deviation for near and distance improved from 24.37 ± 12.34 (range, 6-77) and 19.67 ± 10.76 (range, 4-60) to 4.25 ± 8.61 (range, 0-50) and 2.62 ± 6.15 (range, 0-35) after the first surgery (P <0.001 for near and far deviation). Mean postoperative follow-up was 7.82 ± 9.45 months. Two patients required reoperation. Different types of surgeries, including lateral rectus recession (with or without Y-splitting), lateral and medial rectus recession (with or without Y-splitting of the lateral rectus muscle), bilateral lateral rectus recession, and lateral rectus recession with vertical rectus nasal transposition were performed. Twenty-four patients (60%) were successfully treated with only a single recession of the ipsilateral lateral rectus muscle. The mean lateral rectus recession was 7.45 ± 0.73 mm (range, 6-8.5 mm), and the mean dose-response for lateral rectus recession was 2.79 ± 0.64/mm for near and 2.45 ± 0.67/mm for distance.

Conclusions: Simple lateral rectus recession (with or without Y-splitting), even in the presence of significant deviation (through 35), seems to be a successful procedure for management of patients with unilateral exotropic DRS.
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http://dx.doi.org/10.1016/j.jaapos.2020.03.005DOI Listing
June 2020

Optical coherence tomography angiography in best vitelliform macular dystrophy.

J Curr Ophthalmol 2019 Dec 16;31(4):442-445. Epub 2019 Jul 16.

Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Purpose: To report best vitelliform macular dystrophy (BVMD) with an intriguing pattern of vascular flow on optical coherence tomography angiography (OCTA).

Methods: Four eyes of two patients with BVMD were evaluated. Complete ophthalmic examination including best corrected visual acuity (BCVA), spectral domain optical coherence tomography (SD-OCT), and OCTA were performed. Diagnosis was confirmed by electroretinography (ERG) and electrooculography (EOG) testing.

Results: All eyes had the electrophysiologic confirmation of the BVMD. The first patient was 35 years old with BCVA of 20/20 and pseudohypopyon stage macular lesion in right eye (RE) and BCVA of 20/32 and vitelliruptive stage macular lesion in the left eye (LE). The second patient was 18 years old with BCVA of 20/25 and macular lesion in vitelliform stage in the RE and BCVA of 20/60 and choroidal neovascularization (CNV) in the LE. In all eyes, a distinct foveal avascular zone (FAZ) was not detectable in OCTA, with a bridging vessel in the FAZ. A dense subretinal capillary network compatible with CNV in the LE of second patient was observed.

Conclusion: In our cases, we found bridging vessel in the FAZ, and it may be due to the effects of bestrophin on the calcium content and vascular endothelial growth factor (VEGF) secretion of the retinal pigment epithelium (RPE) cells.
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http://dx.doi.org/10.1016/j.joco.2019.06.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896442PMC
December 2019

Effect of night work on image quality of optical coherence tomography angiography.

J Curr Ophthalmol 2019 Dec 17;31(4):438-441. Epub 2019 Sep 17.

Refractive Error Research Center, Paramedical College, Mashhad University of Medical Sciences, Mashhad, Iran.

Purpose: To assess the effect of night shift work on image quality and artifacts when performing optical coherence tomography angiography (OCT-A).

Methods: In a prospective case series study, twenty nurses underwent OCT-A in two separate sessions: early in the morning before duty shift and at the end of a night shift. Quantitative measurements of horizontal and vertical saccadic, blink, and stretch artifacts and also signal strength of the images were recorded. Moreover, using visual analogue scale of pain (VAS), the perceived pain and discomfort by blue focus light and red scanning laser were recorded.

Results: Vertical and horizontal saccades, blink, and stretch artifacts were significantly higher after the night shift ( = 0.004,  = 0.015,  < 0.001, and  < 0.001, respectively). Signal strength was not significantly different between the two measurements ( = 0.71). Also, the level of discomfort which was experienced by blue focus light and red scanning laser light was significantly higher after the night shift ( = 0.009 and  = 0.004, respectively).

Conclusion: Our study suggests that night shift may affect image quality of OCT-A by imposing more artifacts.
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http://dx.doi.org/10.1016/j.joco.2019.08.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896443PMC
December 2019

Multimodal imaging in posterior microphthalmos.

J Curr Ophthalmol 2019 Sep 4;31(3):335-338. Epub 2019 Feb 4.

Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Purpose: To evaluate the multimodal imaging including optical coherence tomography angiography (OCTA) findings in patients with posterior microphthalmos (PM).

Methods: In an observational case series, four eyes of two patients, eight and twenty-three years old, with clinical proven PM underwent complete ophthalmic examination, including refraction, fluorescein angiography, optical coherence tomography (OCT), OCTA, B-scan ultrasonography, axial length measurement using IOL Master optical measuring, and Pentacam evaluation.

Results: Both patients were high hyperopic with partial thickness retinal fold in macula, retinoschisis, and foveal hypoplasia. Axial length was less than 17 mm with scleral thickening in all eyes. OCTA showed absence of foveal avascular zone (FAZ) in both superficial and deep capillary plexuses. Pentacam showed corneal steepness, shallow anterior chamber, and low anterior chamber volume.

Conclusion: OCTA findings showed absence of avascular zone in both superficial and deep capillary plexuses, while OCT shows partial thickness retinal fold and retinoschisis.
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http://dx.doi.org/10.1016/j.joco.2019.01.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742752PMC
September 2019

Whole organ sheep kidney tissue engineering and in vivo transplantation: Effects of perfusion-based decellularization on vascular integrity.

Mater Sci Eng C Mater Biol Appl 2019 May 6;98:392-400. Epub 2019 Jan 6.

Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: During the past decade, increased efforts have been made to develop alternative management options instead of dialysis and homograft renal transplantation for end-stage renal disease. State-of-the-art methods employ tissue engineering to produce natural acellular scaffolds that could resolve the concern of allograft rejection and obviate the need for immunosuppressive therapy. Complete decellularization of kidney with intact extracellular matrix is crucial for in vivo compatibility and success of transplantation. Herein, we evaluate the efficacy of two different whole organ decellularization protocols, vasculature integrity, and in vivo transplantation of sheep kidneys.

Materials And Methods: Eight sheep kidneys were decellularized by perfusion-based method utilizing two different protocols (Protocol 1: 1% Triton X-100 and 0.5% SDS vs. Protocol 2: 1% SDS). The samples were evaluated by histopathology in terms of decellularization and extracellular matrix preservation. Computerized tomography angiography was performed to evaluate vasculature. Subsequently, both methods were transplanted in four sheep and monitored for vascular integrity and extravasations in short-term.

Results: Scaffolds obtained from both protocols were entirely decellularized. However; the extracellular matrix was better preserved in protocol 1 compared to protocol 2. In addition, the vascular integrity was intact in decellularized scaffolds treated with Triton X-100 plus SDS (protocol 1). After transplantation, the samples treated with protocol 2 showed extravasation of fluid in the interstitial space while the samples treated with protocol 1 showed intact extracellular matrix and vasculature.

Conclusions: This study demonstrated the efficacy of well-preserved acellular scaffold and vasculature network in post renal transplant outcome in a sheep model. These results have potential to pave the road for further investigations in acellular whole organ transplantation.
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http://dx.doi.org/10.1016/j.msec.2019.01.018DOI Listing
May 2019

Short prism adaptation test in patients with acquired nonaccommodative esotropia; clinical findings and surgical outcome.

J AAPOS 2018 10 15;22(5):352-355. Epub 2018 Sep 15.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Purpose: To evaluate the surgical outcomes in patients with acquired nonaccommodative esotropia operated on based on a short prism adaptation test (PAT) and to determine the subgroup of patients most responsive to PAT.

Methods: In this prospective interventional cases series, patients with acquired nonaccommodative esotropia were enrolled. Patients wore Fresnel trial lenses based on the results of alternate prism-cover testing. With the Fresnel prism in place, alignment was measured after 20 minutes. If deviation increased, the power of prism was increased to neutralize this angle. The test was repeated every 20 minutes to achieve motor stability. Patients were classified as either prism responders (if the angle of deviation increased >10 compared to the entry angle) or prism nonresponders. All patients underwent bilateral medial rectus muscle recession. Prism responders underwent surgical correction based on the enhanced angle.

Results: Of the 28 subjects enrolled, 14 (50%) were prism responders and 14 (50%) were classified as prism nonresponders. After 6 months, 100% of prism responders and 92.9% of nonresponders were aligned within 8 of orthotropia at distance and near fixation. None of the patients with an entry angle of >30 were prism responders.

Conclusions: In our study cohort, a short PAT with an endpoint of motor stability in patients with acquired nonaccommodative esotropia was associated with a good surgical outcome and a low rate of over- and undercorrection. PAT may be unnecessary for patients with an angle of deviation of >30.
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http://dx.doi.org/10.1016/j.jaapos.2018.05.018DOI Listing
October 2018

Effect of venting incisions on graft attachment in Descemet's stripping automated endothelial keratoplasty.

J Curr Ophthalmol 2018 Jun 28;30(2):142-146. Epub 2017 Dec 28.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: To investigate the impact of venting incisions on the adherence of graft to the recipient's stroma in Descemet's stripping automated endothelial keratoplasty (DSAEK).

Methods: Fifty-six patients were enrolled in this study. Patients were randomly allocated into two groups. Twenty-eight patients had a DSAEK procedure with venting incisions. The second group was treated by conventional DSAEK with no venting incisions. Slit-lamp examination and anterior segment optical coherence tomography (AS-OCT) were performed in day one and 14 days after surgery to investigate graft attachment. The thickness of cornea and lenticle were also evaluated by AS-OCT. BCVA (logMAR) was measured the day before the surgery and 14 days postoperatively.

Results: Subclinical graft detachment in the first day after surgery was significantly lower in patients who had a DSAEK procedure and venting incisions ( = 0.02), but no difference was noted in the rate of clinical graft detachment on day one ( = 0.24) and subclinical and clinical graft detachment on day 14 ( = 0.24,  = 0.50, respectively). The thickness of the cornea and lenticle after the surgery were statistically similar between the two groups ( = 0.903,  = 0.402, respectively). No difference in the improvement of BCVA was observed between the venting and non-venting group ( = 0.143).

Conclusions: Routine use of venting incisions may not be necessary in the standard DSAEK procedures. More studies with larger sample sizes are needed to better confirm the results of this study.
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http://dx.doi.org/10.1016/j.joco.2017.11.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033781PMC
June 2018

Decellularized human fetal intestine as a bioscaffold for regeneration of the rabbit bladder submucosa.

J Pediatr Surg 2018 Sep 1;53(9):1781-1788. Epub 2018 Feb 1.

Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: We aim to report a method to create a natural acellular scaffold from human fetal small intestine for augmentation cystoplasty in rabbits.

Methods: Fetal intestines were decellularized by immersion in a hypotonic solution. The success of this protocol was evaluated by histological analysis, scanning electron microscopy and measurement of collagen and sulfated glycosaminoglycan of the acellular tissues. Eight mature rabbits were selected and acellular scaffolds were implanted on the exposed urothelium. Urodynamic studies and cystography were performed after six months. At 14, 120 and 180days animals were sacrificed and augmented bladders were resected.

Results: Histological analysis revealed formation of muscular layer and blood vessels in implanted scaffolds similar to normal bladder. These findings demonstrate the effective seeding of scaffold by host bladder cells. The tissue architecture of recellularized scaffold was similar to the native bladder.

Conclusions: Fetal intestine acellular matrix could be an exceptional scaffold for bladder augmentation cystoplasty and may pave the road for future studies in order to be used for clinical application.
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http://dx.doi.org/10.1016/j.jpedsurg.2018.01.018DOI Listing
September 2018

Updates on corneal collagen cross-linking: Indications, techniques and clinical outcomes.

J Curr Ophthalmol 2017 Dec 12;29(4):235-247. Epub 2017 Sep 12.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: To review the historical background and basic principles of collagen cross-linking, to bring together the data regarding the outcomes and complications of collagen cross-linking and finally to explore the efficacy and safety of new variations of this technique.

Methods: A literature review was performed using PubMed and Scopus. The following keywords were used for literature search: cross linking, crosslinking, cross-linking, keratoconus, keratectasia.

Results: In contrast to traditional treatment modalities for keratoconus (KCN), this new technique addresses the progression of the disease. Several clinical studies have been conducted to assess the efficacy of corneal collagen cross-linking (CXL) in the last decade. The results were promising as collagen cross-linking showed significant improvement in visual acuity and keratometric values. Moreover, initial results show that it is a safe procedure with few reported complications.

Conclusion: CXL is an emerging treatment method in ophthalmology that offers the possibility to effectively treat progressive KCN.
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http://dx.doi.org/10.1016/j.joco.2017.07.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735256PMC
December 2017

Trachoma: Past, present and future.

J Curr Ophthalmol 2016 Dec 19;28(4):165-169. Epub 2016 Sep 19.

Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.

Purpose: To review the background, epidemiology and current management of trachoma in endemic areas and worldwide.

Methods: Review of literature.

Results: Trachoma is one of the leading causes of preventable blindness in developing countries. It was reported as one of the seven most neglected tropical diseases that can be prevented via drug administration. Its infliction is primarily aimed at those living in areas deprived of clean water and proper sanitation. It is estimated that trachoma is the cause of visual impairment in about 2.2 million people worldwide of which about 1.2 million are completely blind. With implementation of the SAFE (surgery, antibiotics, facial cleanliness, and environmental control) strategy with support from the International Trachoma Initiative (ITI) the incidence of trachoma has decreased significantly in the Middle East and North Africa region.

Conclusion: With the enhancement of socioeconomic and sanitary status of people, advent of new generations of antibiotics, training of expert ophthalmologists and eye care facilities the prevalence of trachoma is decreasing.
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http://dx.doi.org/10.1016/j.joco.2016.08.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093790PMC
December 2016

Early Outcomes of Coronary Endarterectomy in Patients Undergoing Coronary Artery Bypass Surgery.

Heart Surg Forum 2016 Apr 4;19(2):E059-63. Epub 2016 Apr 4.

Cardiac Surgery and Transplantation Research Center, Tehran University of Medical Sciences, Tehran.

Background: Coronary endarterectomy (CE) is performed as an adjunct to coronary artery bypass surgery (CABG); however, the efficacy of this technique is still controversial. We aimed to evaluate the impact of CE combined with CABG when compared with isolated CABG.

Methods: Patients who underwent CABG between July 2007 and June 2014 were included. 70 of 2452 patients (2.8%) underwent CE in addition to CABG. Early results were compared with isolated CABG and predictors of adverse outcome were measured in stepwise multivariate logistic regression analyses.

Results: The incidence of comorbidities including prior myocardial infarction, diabetes mellitus, and three-vessel coronary disease in CE patients was higher; however, mortality (4.3% versus control 3.6%; P = .762) and postoperative complications were not significantly increased in this group of patients (except supraventricular arrhythmia). Although age greater than 70 years, impaired ejection fraction, intraoperative intraaortic balloon pump, and prolonged cardiopulmonary bypass time were important predictors of adverse outcomes, CE was not associated with increased mortality or postoperative morbidities.

Conclusion: Despite the higher risk profile of patients who underwent CE, this technique was not identified as an independent risk factor for adverse postoperative outcomes.
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http://dx.doi.org/10.1532/hsf.1352DOI Listing
April 2016

Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial.

Pediatr Surg Int 2014 Jun 17;30(6):663-8. Epub 2014 Apr 17.

Pediatric Urology Research Center and Department of Pediatric Urology, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, 62 Qarib St, Keshavarz Blvd, 1419733151, Tehran, Iran (IRI),

Purpose: To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).

Methods: Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (FES, 15 children) and control (sham stimulation, 15 children) groups. All patients underwent urodynamic study (UDS) before and 6 months after FES considering detrusor leak point pressure (DLPP), mean maximal detrusor pressure, and mean maximal bladder capacity. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and 6 months after treatment. A 15-course FES was performed for 15 min and 3 times per week. Children were followed for at least 6 months.

Results: Of UDS variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0-3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).

Conclusion: This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.
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http://dx.doi.org/10.1007/s00383-014-3503-0DOI Listing
June 2014

Sheep colon acellular matrix: Immunohistologic, biomechanical, scanning electron microscopic evaluation and collagen quantification.

J Biosci Bioeng 2014 Feb 29;117(2):236-241. Epub 2013 Aug 29.

Pediatric Urology Research Center, Section of Tissue Engineering and Stem Cell Therapy, Department of Pediatric Urology, Children's Hospital Medical Center, Pediatric Center of Excellence, 62 Qarib St, Keshavarz Blvd, Tehran 1419733151, Iran.

Colon decellularization provides three-dimensional biologic scaffold without any cell elements with preservation of extracellular matrix in order to enable autologous cell seeding for tissue augmentation without any immunological response. This study was performed to investigate the safety and feasibility of sheep colon decellularization as a first step of colon tissue engineering. The process of sheep colon decellularization was done in four stages which included scaffold preparation, histologic examination and microscopic investigations to reveal the remaining cellular deposits, biomechanical evaluation and collagen quantification studies by measurement of hydroxyproline content of normal and decellularized sheep colon. Decellularized colon scaffold revealed complete cell removal under a light microscope while 4',6-diamidino-2-phenylindole, di-hydrochloride (DAPI) staining confirmed no deoxyribonucleic acid (DNA) residues. Decellularized colon displayed preserved ultrastructure, comparable biophysical properties (resistance to unidirectional stretch forces) and higher hydroxyproline content. The results of biomechanical tests proved that the decellularized matrix did not bear any unexpected damages or structural changes which would make it unable to tolerate in vivo forces and stretches. The microscopic images captured after staining the tissue with Picro-sirius red also showed that the collagen in extracellular matrix is well preserved; this was confirmed by scanning electron microscopy. This implies that the scaffold prepared by this method is suitable for tissue augmentation or transplantation.
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http://dx.doi.org/10.1016/j.jbiosc.2013.07.006DOI Listing
February 2014
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