Publications by authors named "Kourosh Shahraki"

14 Publications

  • Page 1 of 1

Abobotulinum toxin A for periorbital facial rejuvenation: impact on ocular refractive parameters.

Clin Exp Optom 2020 Aug 12. Epub 2020 Aug 12.

School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Clinical Relevance: Botulinum toxin is commonly used for cosmetic facial rejuvenation and can result in pain at the injected site, bruising and ecchymosis, erythema and oedema, headache, diplopia, blurred vision, focal facial weakness. This study evaluates the impact of botulinum toxin on refractive error and binocular vision.

Background: Botulinum toxin (trade name: Dysport) is a neurotoxic protein which is made from a Gram-positive anaerobic bacterium known as Clostridium botulinum. In this study, we aimed to evaluate the impact of Dysport injection on refractive error, near point of accommodation and convergence, and palpebral fissure height.

Methods: Twenty-eight subjects were treated for facial wrinkles, using Dysport. A 500-unit vial of Dysport was diluted with 2.5 ml preserved normal saline, and injected doses were 30 units for crow's feet, six units for lower eyelid wrinkles, 25 to 50 units for glabellar lines (five points), and 20 to 40 for forehead creases on four points. The refractive error, near point of accommodation and convergence and palpebral fissure heights were assessed before and two weeks after injection.

Results: The participants comprised 23 women and five men at a mean age of 53.51 ± 14.1 years. The means of the equivalent sphere before and after injection were -0.07 ± 1.34 and -0.08 ± 1.35 (p = 0.36). The means of near point of accommodation monocularly before and after injection were 29.75 ± 6.16 cm and 26.75 ± 6.00, respectively. The means of near point of convergence before and after injection were 16.03 ± 5.27 cm and 15.55 ± 6.14, respectively (p = 0.30). The means of palpebral fissure height before and after injection were 10.33 ± 1.69 mm and 10.20 ± 1.46 mm, respectively. The changes in equivalent spherical refractive error, binocular near point of accommodation and convergence were not statistically significant.

Conclusion: Dysport injection for the correction of upper face animation lines, if performed at the appropriate sites and the appropriate concentration, has no significant impact on refractive error, near point of accommodation and convergence, and palpebral fissure height.
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http://dx.doi.org/10.1111/cxo.13117DOI Listing
August 2020

Sutureless Femtosecond Laser-Assisted Anterior Lamellar Keratoplasty Using a Bioengineered Cornea as a Viable Alternative to Human Donor Transplantation for Superficial Corneal Opacities.

Cornea 2020 Sep;39(9):1184-1189

Eye Research Center, Eye Department, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Purpose: To evaluate the safety and efficacy of a bioengineered corneal implant using femtosecond laser-assisted anterior lamellar keratoplasty for superficial corneal opacities.

Methods: Six eyes of 6 consecutive patients with superficial corneal stromal opacities involving <220 μm owing to various pathologies were included in the study. Preoperatively, all patients underwent anterior segment optical coherence tomography (Visante; Carl Zeiss Meditec AG) to evaluate the depth of the corneal opacity. All patients underwent sutureless femtosecond laser-assisted anterior lamellar keratoplasty using a bioengineered collagen corneal implant (linkcor). Visual indices, refraction, and keratometry were evaluated preoperatively and 12 months postoperatively.

Results: Corrected distance visual acuity improved significantly in all patients (P = 0.02). A significant decrease was seen in refractive astigmatism postoperatively (P = 0.04). Flat keratometry reduced significantly 12 months after the intervention (P = 0.04). No intraoperative or early postoperative complications were noticed. All implants were fully covered by healthy epithelium within a month after the surgery and remained clear at follow-up visits. The results of this procedure remained stable throughout the follow-up period. In 1 patient, mild inferior collagen melting and epithelial defect formation occurred at 1-year follow-up. Despite frequent topical corticosteroid therapy the melting progressed, the collagen tissue was removed and the patient was treated accordingly with good visual outcomes.

Conclusions: Femtosecond laser-assisted anterior lamellar keratoplasty with bioengineered corneal (linkcor) implantation is an effective treatment for improving vision quality in anterior stromal opacities. This procedure reduces the need for human donor tissue and avoids human donor-related and suturing complications.
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http://dx.doi.org/10.1097/ICO.0000000000002394DOI Listing
September 2020

Treatment of Persistent Chemosis after Upper Lid Blepharoplasty by Hand-Held Fine-Tip Cautery: Report of a Case.

Middle East Afr J Ophthalmol 2019 Apr-Jun;26(2):120-122. Epub 2019 Aug 26.

Ocular Tissue Engineering Research Center, Tehran, Iran.

Persistent chemosis is an uncommon complication of blepharoplasty, and its treatment is challenging. Herein, the authors report a case of persistent chemosis after a cosmetic upper lid blepharoplasty and present a simple, noninvasive, inexpensive, and successful method of treatment that uses hand-held cautery.
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http://dx.doi.org/10.4103/meajo.MEAJO_218_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737782PMC
November 2019

Optic Disc Deformation and Orbital Bone Erosion Secondary to a Huge Neglected Orbital Cavernous Hemangioma.

J Craniofac Surg 2018 Nov;29(8):e790-e792

Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences.

Cavernous hemangioma (CH) is the most common benign tumor of the orbit which can expand the bony orbit by gradual growth of a large tumor. In this article, the authors report a 28-year-old man presented with a longstanding unilateral proptosis secondary to a huge orbital CH which also caused optic disc deformation and bone erosions in the adjacent orbital walls. The optic disc deformities resolved after the tumor removal.
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http://dx.doi.org/10.1097/SCS.0000000000004777DOI Listing
November 2018

Effects of intracameral cefuroxime on corneal endothelial cell counts and its morphology after cataract surgery.

Interv Med Appl Sci 2017 Jun;9(2):100-104

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

Background: Endophthalmitis is one of the most important complications after cataract surgery and in case event can cause many symptoms, such as severe decrease in eyesight and/or even the loss of vision. Employing methods to reduce this problem is very important. The aim of this study was to evaluate the effect of intracameral cefuroxime after cataract surgery on corneal endothelial cell counts and its morphology.

Methods: In this study, 32 eyes of 30 patients underwent endothelial cell count and morphology assessment by ConfoScan III device before and 1 month after cataract surgery. All patients undertaken cataract surgery by one surgeon and by one method. Intracameral cefuroxime (1 mg/0.1 ml) was used as prophylaxis of postoperative endophthalmitis at the end of operation.

Results: In this study, the rate of corneal endothelial cell loss 1 month after cataract surgery was 8.4%, and the rate of endothelial cells polymegathism before and after cataract surgery did not differ statistically. During the follow-up period, there were no cases of endophthalmitis or other complications.

Conclusion: With regard to the importance of the intracameral cefuroxime in a reduction in the rate of endophthalmitis after cataract surgery and that harmful effects on the endothelial cells were not seen, this method can be considered as a suitable method for endophthalmitis prophylaxis.
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http://dx.doi.org/10.1556/1646.9.2017.2.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598127PMC
June 2017

Frequency of Bacterial Samples from Patients with Chronic Acquired Nasolacrimal Duct Obstruction.

Med Arch 2016 Dec;70(6):433-436

Department of Ophthalmology, AJA University of Medical Sciences, Tehran, Iran.

Introduction: Dacryocystitis is an infection of lacremical sac due to obstruction of nasolacrimal duct which has primary or secondary causes. Idiopathic inflammatory obstruction is the primary cause. Trauma, infection, inflammation, neoplasia, and mechanical obstruction are secondary one.

Aim: The objective of this study is determination of bacterial samples from patients with chronic acquired nasolacrimal duct obstruction.

Methods: This cross-sectional study was contained 90 patients with dacryocystitis from 2010 to 2011, in Besat hospital. Convenience sampling in sterile condition sampling was performed by sterile swab from the pus out of the lacrimal sac. Blood agar, EMB, chocolate agar, and thioglycolate broth were used for bacterial cultivation. Various antibiotics were used for antibiotic resistance study. Finally, statistical analysis was done by SPSS ver. 15.

Results: In this study, the mean age of participants was 49.36 ± 12.18 years. Number of male and female patients was equal and Sampling was performed in 53.3% of patients from the right eye. The most frequent bacteria were Staphylococcus, E. coli, and Enterobacteriaceae, respectively. Also, our results show most of bacteria obtained from patients eye pus are sensitive to chloramphenicol and the most antibiotic resistance was for co-trimoxazole.

Conclusion: Our results illustrated gram-positive bacteria have an important role in dacryocystitis which is confirm previous studies. Although our results indicated chloramphenicol is the best choice for treatment process, but it is notable due to the variety of bacteria which can cause this disease, identification of bacterial contamination can be a great help to choose the best treatment process.
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http://dx.doi.org/10.5455/medarh.2016.70.433-436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292220PMC
December 2016

Comparison of Manual Refraction Versus Autorefraction in 60 Diabetic Retinopathy Patients.

Med Arch 2016 Jul;70(4):280-283

Department of Ophthalmology, AJA University of Medical Sciences, Tehran, Iran.

Aim: The purpose of the study was to evaluate the comparison of manual refraction versus autorefraction in diabetic retinopathy patients.

Material And Methods: The study was conducted at the Be'sat Army Hospital from 2013-2015. In the present study differences between two common refractometry methods (manual refractometry and Auto refractometry) in diagnosis and follow up of retinopathy in patients affected with diabetes is investigated.

Results: Our results showed that there is a significant difference in visual acuity score of patients between manual and auto refractometry. Despite this fact, spherical equivalent scores of two methods of refractometry did not show a significant statistical difference in the patients.

Conclusion: Although use of manual refraction is comparable with autorefraction in evaluating spherical equivalent scores in diabetic patients affected with retinopathy, but in the case of visual acuity results from these two methods are not comparable.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034982PMC
http://dx.doi.org/10.5455/medarh.2016.70.280-283DOI Listing
July 2016

Prognostic Investigations of Expression Level of Two Genes FasL and Ki-67 as Independent Prognostic Markers of Human Retinoblastoma.

Oncol Res 2017 Apr 12;25(4):471-478. Epub 2016 Sep 12.

Department of Anesthesia, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran.

In this study, expression of FasL and Ki-67 messenger RNA (FasL and Ki-67 mRNA) in human retinoblastoma (HRB) was examined by the immunohistochemistry method and quantitative real-time PCR. Positive expression of Ki-67 in tumor cells was detected in 16 of 30 patients (53.33%), and only 9 (30%) of the tissues from patients with retinoblastoma showed positive staining for FasL. Our results revealed that FasL expression was significantly higher in tumor tissue with invasion compared with the noninvasion form (p = 0.033). Ki-67 expression was markedly increased in tumor tissues with invasion compared with the noninvasion group (p = 0.04), but no significant correlation was found between FasL expression and differentiation (p > 0.05). In addition, Ki-67 expression was strongly linked to differentiation (p < 0.002). Expression of these FasL was correlated with shorter overall survival of patients, but its expression was not significantly associated with overall survival (p = 0.15). The impact of Ki-67 expression on survival in patients was also evaluated. Ki-67 expression level was not found to be significantly associated with shorter survival (Kaplan-Meier; p = 0.09). Univariate analysis revealed that massive choroidal invasion was correlated with poor prognosis. Taken together, the data suggest that massive choroidal invasion is also an important indicator of poor prognosis for HRB.
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http://dx.doi.org/10.3727/096504016X14721217330657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841034PMC
April 2017

Investigation of serum levels and tissue expression of two genes IGFBP-2 and IGFBP-3 act as potential biomarker for predicting the progression and survival in patients with glioblastoma multiforme.

J Neurol Sci 2016 Jul 14;366:202-206. Epub 2016 May 14.

Department of Neurosurgery, AJA University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Identification of genetic copy number changes in glial tumors is of importance in the context of improved/refined diagnostic, prognostic procedures and therapeutic decision-making. Blood-derived biomarkers, therefore, would be useful as minimally invasive markers that could support diagnosis and enable monitoring of tumour growth and response to treatment.

Objective: The aim of this study was to evaluate the clinical significance of IGFBP-2/3 in glioblastoma multiforme (GBM) and their value as predictors of survival.

Methods: We examined the plasma levels of IGFBP-2 and IGFBP-3 using ELISA in patient suffering from GBM and controls groups. Furthermore, immunohistochemistry method was used to evaluate the expression levels of these markers.

Results: Preoperative plasma levels of IGFBP-2 and IGFBP-3 were markedly higher in glioblastoma patients (mean±SD: 521.5±164.2ng/ml; 402.4±126ng/ml) when compared with healthy controls (301.28±73.12; 244±89.5ng/ml; p<0.001). Immunohistochemical results indicated that the median H score for glioblastoma tissues was higher when compared with normal tissues. The mean scores for IGFBP-2 expression in glioblastoma was higher than normal tissues (p<0.001). Our result showed that the median H score for glioblastoma tissues was higher when compared with normal tissue for IGFBP-3 expression. The mean scores for glioblastoma tissues was higher than normal tissues (p<0.001). We also evaluated whether plasma IGFBP-2 and IGFBP-3 levels were related to clinical features. The plasma IGFBP-2 level was strongly linked to the patient's age (R=0.769, P=0.001) that were strongly increased in patients with older age (>65), (mean±SD: 594.36±33.3ng/ml). On the other hand, plasma IGFBP-3 level was not correlated with age (P=0.462), sex (P=0.532), and tumor size (P=0.245). Our findings indicated that the tissue IGFBP-2 level was also markedly correlated with the patient's age (R=0.612, P=0.015). On the other hand, tissue IGFBP-3 expression level was not correlated with age (P=0.472), sex (P=0.512), and tumor size (P=0.241). Kaplan-Meier survival and log-rank analysis suggested that patients with high plasma level of IGFBP-2 and tissue expression of IGFBP-2 had shorter overall survival than those with low levels (log-rank test P=0.027; P<0.001). Kaplan-Meier survival and log-rank analysis suggested that patients with high plasma level of IGFBP-3 and tissue expression of IGFBP-3 had shorter overall survival than those with low levels groups (log-rank test P=0.018; P<0.001).

Conclusion: These data suggest that plasma levels and tissue levels of IGFBP-2 and IGFBP-3 may be as potential biomarkers for predicting the progression and survival in patients with GBM.
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http://dx.doi.org/10.1016/j.jns.2016.05.018DOI Listing
July 2016

Effects of Topical 1% Sodium Hyaluronate and Hydroxypropyl Methylcellulose in Treatment of Corneal Epithelial Defects.

Med Hypothesis Discov Innov Ophthalmol 2016 ;5(4):136-144

Department of Ophthalmology, Alzahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.

We aimed to compare the therapeutic effects of topical 1% sodium hyaluronate (Healon) or hydroxypropyl methylcellulose (HPMC) for the treatment of alkali-induced epithelial corneal defects. An alkali burn was produced in 30 corneas of 30 New Zealand White rabbits, using a 7.5-mm-diameter trephine. The rabbits were randomly divided into three groups. Four times a day, one group was treated with 1% sodium hyaluronate, one with HPMC, and one (the control group) with physiologic saline. During the treatment period, the size of the epithelial defect was observed every day, up to day 17, using a slit-lamp biomicroscope (with fluorescein). Sodium hyaluronate significantly accelerated the wound healing process compared with saline and increased the healing rate to an even greater extent compared with HPMC. Sodium hyaluronate, but not HPMC, is an effective wound-healing adjuvant for alkali-induced corneal epithelial defects.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346304PMC
January 2016

Surgical treatments in inferior oblique muscle overaction.

J Ophthalmic Vis Res 2014 Jul-Sep;9(3):291-5

Brain and Spinal Injury Repair Research Center, Tehran University of Medical Sciences, Tehran, Iran ; Department of Ophthalmology, Eye Hospital, Hannover Medical School, Hannover, Germany.

Purpose: To compare the outcomes of surgical procedures in the treatment of inferior oblique muscle overaction (IOOA) as a common disorder of ocular motility.

Methods: This retrospective study was performed on patients with primary and secondary IOOA who underwent three surgical treatment procedures including disinsertion, myectomy and anterior transposition, between 2001 and 2011. Type of strabismus, ocular alignment, presence of pre-and post-operative dissociated vertical deviation (DVD), pre- and post-operative degree of IOOA were obtained using specified checklist.

Results: A total of 122 eyes of 74 patients with mean age of 13 ± 11.7 (range, 1-51) years were included in this study. Disinsertion was performed on 12 eyes (9.8%), myectomy in 91 eyes (74.6%) and anterior transposition in 19 (15.6%). Preoperative V-pattern and DVD existed in 67 and 17 eyes; after surgery they remained in only 10 and 8 eyes, respectively. The success rate (IOOA <+1), in disinsertion, myectomy and anterior transposition groups were 91.7%, 97.8%, and 89.5%, respectively and these measures did not change after 6 months. Overall, 53.3% (n = 65) and 38.5% (n = 47) of eyes had preoperative esotropia and exotropia. Preoperative hypertropia and hypotropia were observed in 16.4% (n = 20) and 3.3% (n = 4) of eyes, respectively. After surgery there were no cases of additional strabismus. However, residual hypertropia was seen in 9 eyes, while preoperative hypotropia increased in one patient who underwent anterior transposition surgery. Esotropia and exotropia were not observed in any surgical treatment groups postoperatively.

Conclusion: We conclude that all these three procedures are effective for treatment of primary or secondary IOOA with minimum side-effects.
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http://dx.doi.org/10.4103/2008-322X.143355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307652PMC
February 2015

Spontaneous closure of traumatic macular holes.

Can J Ophthalmol 2014 Aug 23;49(4):395-8. Epub 2014 Jul 23.

Department of Ophthalmology, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Objective: To present a series of cases with spontaneous closure of traumatic macular hole.

Design: Case series.

Participants: Six eyes of 6 patients with traumatic macular hole.

Methods: The characteristics of eyes with macular hole secondary to blunt trauma in which the macular hole closed spontaneously without surgical manipulation were reviewed.

Results: Patient age range was 13 to 55 years. There were 4 full-thickness and 2 lamellar macular holes. Spontaneous closure occurred after 1 to 6 months of observation. Best corrected visual acuity improved in 5 eyes and remained unchanged in the other eye.

Conclusions: Spontaneous closure of traumatic macular holes may occur within 6 months after initial presentation.
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http://dx.doi.org/10.1016/j.jcjo.2014.04.017DOI Listing
August 2014

Central retinal artery occlusion in Crohn disease.

J AAPOS 2012 Aug 21;16(4):392-3. Epub 2012 Jul 21.

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

Crohn disease is an inflammatory bowel disease frequently associated with extraintestinal manifestations. Ocular manifestations are uncommon but may cause significant morbidity, including blindness. We report the first case of a 9-year-old boy with biopsy-proven Crohn disease who developed a cilioretinal artery-sparing central retinal artery occlusion. After 2 months of follow-up, the patient developed optic atrophy with no change in visual acuity.
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http://dx.doi.org/10.1016/j.jaapos.2012.03.004DOI Listing
August 2012