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Papers by KAZEM AMANZADEH

Research paper thumbnail of Long-term results of an accelerated corneal cross-linking protocol 18mW/cm2 for the treatment of progressive keratoconus

American Journal of Ophthalmology, 2015

To compare the long-term outcomes of accelerated and standard corneal cross-linking protocols in ... more To compare the long-term outcomes of accelerated and standard corneal cross-linking protocols in the treatment of progressive keratoconus. Prospective randomized clinical trial. Thirty-one eyes with keratoconus were treated with an accelerated protocol (18 mW/cm(2), 5 min) and all contralateral eyes were treated with the standard method (3 mW/cm(2), 30 min) using the same overall fluence of 5.4 J/cm(2). At 18 months after the procedure, the standard group showed significant improvement in spherical equivalent (P < .05), K-readings (P < .05), Q value (P < .05), index of surface variance (P < .05), and keratoconus index (P = .008) and decline in central corneal thickness (P < .05), but no significant change in visual acuity, corneal hysteresis, corneal resistance factor, P2 area, or endothelial cell density. In the accelerated group, central corneal thickness was the only parameter with statistically significant change. However, neither of these parameters showed significant differences between the standard and the 18 mW/cm(2) accelerated protocol, except K-reading (P = .059) and index surface variance (P = .034). An accelerated cross-linking protocol, using 18 mW/cm(2) for 5 minutes, shows a comparable outcome and safety profile when compared to the standard protocol, but better corneal flattening is achieved with the standard method than the accelerated method. Overall, both methods stop the disease progression similarly. This study will continue to examine more long-term results.

Research paper thumbnail of Descemet stripping automated endothelial keratoplasty performed by cornea fellows

Cornea, 2012

To evaluate the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in 78 e... more To evaluate the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in 78 eyes with corneal endothelial dysfunction performed by cornea fellows under the supervision of experienced faculty members in an academic hospital. In this interventional case series, 78 eyes of 73 patients with corneal endothelial dysfunction of different underlying etiologies were enrolled for DSAEK. Healthy donor corneas with more than 2000 endothelial cells per square millimeter were requested. Intraoperative and postoperative complications were recorded. Best-corrected visual acuity, postoperative refraction, central corneal thickness, and endothelial cell density at 6 months after surgery were also registered and analyzed. Among 78 eyes of 73 patients with corneal endothelial dysfunction, DSAEK was performed on 55 eyes (70.5%) due to pseudophakic bullous keratopathy, which was the most common indication. Other indications included aphakic bullous keratopathy in 6 (7.7%), Fuchs endot...

Research paper thumbnail of Short-term comparison of accelerated and standard methods of corneal collagen crosslinking

Journal of Cataract & Refractive Surgery, 2015

To compare the 6-month results of accelerated and standard collagen crosslinking (CXL) treatment ... more To compare the 6-month results of accelerated and standard collagen crosslinking (CXL) treatment of progressive keratoconus. Noor Eye Hospital, Tehran, Iran. Prospective randomized clinical trial. Two groups of eyes (intervention and control) received corneal collagen crosslinking (CXL) treatment. The intervention group received accelerated CXL (18 mW/cm(2), 5 minutes), and the control group received standard CXL (3 mW/cm(2), 30 minutes). The eyes were evaluated for changes in the visual indices, refraction, and topography preoperatively and 1, 3, and 6 months postoperatively and regarding corneal rigidity indices and the endothelial cell count (ECC) preoperatively and at 6 months. The study evaluated 62 eyes (31 patient) in 2 groups. The mean changes in uncorrected (P = .733) and corrected (P = .646) distance visual acuities and manifest refraction spherical equivalent (P = .598) did not differ statistically significantly between the 2 groups. The central corneal thickness was higher in the standard group than the accelerated group (P = .025). The mean decrease in the maximum keratometry (K) (P = .865) and mean K (P = .974) and the mean changes in the asphericity (P = .272) were not statistically significantly different between the 2 groups. The mean changes in corneal hysteresis (CH) (P = .548) and the corneal resistance factor (CRF) (P = 1.000), CH-CRF (P = .282), and the area under the peak 2 (P = .260) were similar in both groups. The mean decrease in the ECC was not statistically significantly different between the 2 groups (P = .218). Based on 6-month results, accelerated and standard corneal CXL arrested the progression of keratoconus similarly. No author has a financial or proprietary interest in any material or method mentioned.

Research paper thumbnail of Single-segment and double-segment INTACS for post-LASIK ectasia

Acta medica Iranica, 2014

The objective of the present study was to compare single segment and double segment INTACS rings ... more The objective of the present study was to compare single segment and double segment INTACS rings in the treatment of post-LASIK ectasia. In this interventional study, 26 eyes with post-LASIK ectasia were assessed. Ectasia was defined as progressive myopia regardless of astigmatism, along with topographic evidence of inferior steepening of the cornea after LASIK. We excluded those with a history of intraocular surgery, certain eye conditions, and immune disorders, as well as monocular, pregnant and lactating patients. A total of 11 eyes had double ring and 15 eyes had single ring implantation. Visual and refractive outcomes were compared with preoperative values based on the number of implanted INTACS rings. Pre and postoperative spherical equivalent were -3.92 and -2.29 diopter (P=0.007). The spherical equivalent decreased by 1 ± 3.2 diopter in the single-segment group and 2.56 ± 1.58 diopter in the double-segment group (P=0.165). Mean preoperative astigmatism was 2.38 ± 1.93 diopte...

Research paper thumbnail of Long-term results of an accelerated corneal cross-linking protocol 18mW/cm2 for the treatment of progressive keratoconus

American Journal of Ophthalmology, 2015

To compare the long-term outcomes of accelerated and standard corneal cross-linking protocols in ... more To compare the long-term outcomes of accelerated and standard corneal cross-linking protocols in the treatment of progressive keratoconus. Prospective randomized clinical trial. Thirty-one eyes with keratoconus were treated with an accelerated protocol (18 mW/cm(2), 5 min) and all contralateral eyes were treated with the standard method (3 mW/cm(2), 30 min) using the same overall fluence of 5.4 J/cm(2). At 18 months after the procedure, the standard group showed significant improvement in spherical equivalent (P < .05), K-readings (P < .05), Q value (P < .05), index of surface variance (P < .05), and keratoconus index (P = .008) and decline in central corneal thickness (P < .05), but no significant change in visual acuity, corneal hysteresis, corneal resistance factor, P2 area, or endothelial cell density. In the accelerated group, central corneal thickness was the only parameter with statistically significant change. However, neither of these parameters showed significant differences between the standard and the 18 mW/cm(2) accelerated protocol, except K-reading (P = .059) and index surface variance (P = .034). An accelerated cross-linking protocol, using 18 mW/cm(2) for 5 minutes, shows a comparable outcome and safety profile when compared to the standard protocol, but better corneal flattening is achieved with the standard method than the accelerated method. Overall, both methods stop the disease progression similarly. This study will continue to examine more long-term results.

Research paper thumbnail of Descemet stripping automated endothelial keratoplasty performed by cornea fellows

Cornea, 2012

To evaluate the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in 78 e... more To evaluate the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in 78 eyes with corneal endothelial dysfunction performed by cornea fellows under the supervision of experienced faculty members in an academic hospital. In this interventional case series, 78 eyes of 73 patients with corneal endothelial dysfunction of different underlying etiologies were enrolled for DSAEK. Healthy donor corneas with more than 2000 endothelial cells per square millimeter were requested. Intraoperative and postoperative complications were recorded. Best-corrected visual acuity, postoperative refraction, central corneal thickness, and endothelial cell density at 6 months after surgery were also registered and analyzed. Among 78 eyes of 73 patients with corneal endothelial dysfunction, DSAEK was performed on 55 eyes (70.5%) due to pseudophakic bullous keratopathy, which was the most common indication. Other indications included aphakic bullous keratopathy in 6 (7.7%), Fuchs endot...

Research paper thumbnail of Short-term comparison of accelerated and standard methods of corneal collagen crosslinking

Journal of Cataract & Refractive Surgery, 2015

To compare the 6-month results of accelerated and standard collagen crosslinking (CXL) treatment ... more To compare the 6-month results of accelerated and standard collagen crosslinking (CXL) treatment of progressive keratoconus. Noor Eye Hospital, Tehran, Iran. Prospective randomized clinical trial. Two groups of eyes (intervention and control) received corneal collagen crosslinking (CXL) treatment. The intervention group received accelerated CXL (18 mW/cm(2), 5 minutes), and the control group received standard CXL (3 mW/cm(2), 30 minutes). The eyes were evaluated for changes in the visual indices, refraction, and topography preoperatively and 1, 3, and 6 months postoperatively and regarding corneal rigidity indices and the endothelial cell count (ECC) preoperatively and at 6 months. The study evaluated 62 eyes (31 patient) in 2 groups. The mean changes in uncorrected (P = .733) and corrected (P = .646) distance visual acuities and manifest refraction spherical equivalent (P = .598) did not differ statistically significantly between the 2 groups. The central corneal thickness was higher in the standard group than the accelerated group (P = .025). The mean decrease in the maximum keratometry (K) (P = .865) and mean K (P = .974) and the mean changes in the asphericity (P = .272) were not statistically significantly different between the 2 groups. The mean changes in corneal hysteresis (CH) (P = .548) and the corneal resistance factor (CRF) (P = 1.000), CH-CRF (P = .282), and the area under the peak 2 (P = .260) were similar in both groups. The mean decrease in the ECC was not statistically significantly different between the 2 groups (P = .218). Based on 6-month results, accelerated and standard corneal CXL arrested the progression of keratoconus similarly. No author has a financial or proprietary interest in any material or method mentioned.

Research paper thumbnail of Single-segment and double-segment INTACS for post-LASIK ectasia

Acta medica Iranica, 2014

The objective of the present study was to compare single segment and double segment INTACS rings ... more The objective of the present study was to compare single segment and double segment INTACS rings in the treatment of post-LASIK ectasia. In this interventional study, 26 eyes with post-LASIK ectasia were assessed. Ectasia was defined as progressive myopia regardless of astigmatism, along with topographic evidence of inferior steepening of the cornea after LASIK. We excluded those with a history of intraocular surgery, certain eye conditions, and immune disorders, as well as monocular, pregnant and lactating patients. A total of 11 eyes had double ring and 15 eyes had single ring implantation. Visual and refractive outcomes were compared with preoperative values based on the number of implanted INTACS rings. Pre and postoperative spherical equivalent were -3.92 and -2.29 diopter (P=0.007). The spherical equivalent decreased by 1 ± 3.2 diopter in the single-segment group and 2.56 ± 1.58 diopter in the double-segment group (P=0.165). Mean preoperative astigmatism was 2.38 ± 1.93 diopte...