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Hashmani N, Munaf U, Saleem A, Javed SO, Hashmani S. Comparing SPEED and OSDI Questionnaires in a Non-Clinical Sample. Clin Ophthalmol 2021; 15:4169-4173. [PMID: 34703203 PMCID: PMC8541762 DOI: 10.2147/opth.s332565] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/07/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose To compare the performance of OSDI and SPEED questionnaires in a non-clinical sample in Pakistan. Methods SPEED and OSDI questionnaires were simultaneously administered to a sample of 600 participants in Pakistan with an average age of 31.0 ± 10.1 years. Results Mean SPEED scores were calculated according to the OSDI categories and were found to be 3.33 ± 3.44, 5.45 ± 3.77, 7.86 ± 4.33, and 9.39 ± 4.56 for the normal, mild, moderate, and severe groups, respectively. Using Cronbach’s alpha, the total OSDI and SPEED scores were calculated to be 0.924 and 0.879, respectively. A receiver operating curve was plotted, and the area under the curve (AUC) was estimated to be 0.791. Using this curve, the cutoff score for the SPEED questionnaire was found to be 4.00 (P < 0.001). Conclusion The SPEED questionnaire can be used as an effective alternative to the OSDI.
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Affiliation(s)
- Nauman Hashmani
- Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Sindh, Pakistan
| | - Uzair Munaf
- Civil Hospital, Dow Medical College, Karachi, Sindh, Pakistan
| | - Aqsa Saleem
- Civil Hospital, Dow Medical College, Karachi, Sindh, Pakistan
| | | | - Sharif Hashmani
- Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Sindh, Pakistan
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Hashmani N, Hashmani S. Understanding Ocular Visual Function Beyond the Sphere and Cylinder Using Multimodal Imaging. pak J Ophthalmol 2020. [DOI: 10.36351/pjo.v37i1.1179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We have presented two interesting cases that demonstrate the use of multimodal imaging in refractive surgery cases. The first case demonstrates a simple capsular contraction causing immense problems of light spread in an otherwise normal trifocal implanted patient. The second is a case of a hidden and problematic refractive surgery that again complicated a trifocal lens surgery. We have made many advancements in understanding the eyes optical elements and must use this to our advantage to help our patients.
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Hashmani N, Hashmani M, Hashmani S, Fatima K, Farid N, Zakaria F, Qazi MA. The Influence of Tomographic Corneal Characteristics on Epithelial Thickness Profile. Cureus 2020; 12:e11731. [PMID: 33403163 PMCID: PMC7773304 DOI: 10.7759/cureus.11731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose To understand the influence of tomographic corneal characteristics on the epithelium of normal eyes. Methods We scanned a total of 98 eyes of 98 individuals using anterior segment tomography and a spectral-domain optical coherence tomography (OCT) epithelial mapping tool. Only eyes with no previous pathology were included, with a refractive range of +5 diopters (D) to -6 D, intraocular pressure of < 22 mmHg, and no evidence of dry eye (Schirmer’s test 2 value > 5 mm). Corneal curvature metrics were statistically correlated with regional epithelial thickness parameters. Results The anterior and posterior corneal surface flat and steep axis, the maximum and minimum curvature, corneal topographic astigmatism, astigmatism polar values, and corneal volume had no statistically significant correlation (p>0.05) with the epithelial thickness. Similarly, anterior corneal surface asphericity had no significant correlation. Posterior surface asphericity had a statistically significant moderate correlation with the epithelium in all areas. Similar results were seen in the multivariate analysis. Conclusions None of the front or back surface parameters had any influence on the corneal epithelium except for the posterior surface asphericity. This statistically significant yet clinically insignificant correlation may be enhanced in diseased populations like keratoconus and could indicate epithelial remodeling with early posterior corneal changes.
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Affiliation(s)
- Nauman Hashmani
- Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, PAK
| | - Maria Hashmani
- Oral and Maxillofacial Surgery, Darul Sehat Hospital, Karachi, PAK
| | - Sharif Hashmani
- Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, PAK
| | - Kiran Fatima
- Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, PAK
| | - Neha Farid
- Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, PAK
| | - Faiza Zakaria
- Ophthalmology, Dow Medical College, Dow University of Health Sciences, Karachi, PAK
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Hashmani N, Mustafa FG, Tariq MA, Ali SF, Bukhari F, Memon AS, Hashmani S. Distribution and Correlation of Ocular Surface Disease Index Scores in a Non-Clinical Population: The Karachi Ocular Surface Disease Study. Cureus 2020; 12:e9193. [PMID: 32821550 PMCID: PMC7429673 DOI: 10.7759/cureus.9193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Introduction There is increasing recognition of dry eye disease (DED) as a significant factor influencing quality of life in seemingly normal individuals. Our goal was to determine the distribution of Ocular Surface Disease Index (OSDI) scores in non-clinical individuals in Karachi, Pakistan. Methods We distributed OSDI questionnaires to subjects aged > 18 years with no active ocular complaint. Examiners were selected from various areas of the city to administer questionnaires to students and the general population. The OSDI score was grouped as per the following: normal (0-12 points), mild (13-22 points), moderate (23-32 points), and severe (33-100 points). Results We surveyed 2433 individuals with a mean age of 30.7±15.6 years. Additionally, the mean OSDI score was 22.4±18.7. To estimate prevalence, we used two OSDI score cutoffs: >13 (64.4%) and >22 points (43.6%). Statistical significance was found using multivariate regression in the following variables: age (p<0.001), contact lens wear (p<0.001), ocular allergies (p<0.001), hypertension (p<0.001), diabetes (p=0.003), and smoking (p=0.047). When graphing mean age against OSDI score, there was a large jump between the third and fourth decades; thereafter, there was a steady increase. Similarly, when plotting smoking, the score was steady until five years and then there was a sharp incline. Conclusion There was a high prevalence of DED in the studied population. Additionally, many systemic and ocular factors were associated with this disease.
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Affiliation(s)
| | | | | | | | - Fakiha Bukhari
- Ophthalmology, Karachi Medical and Dental College, Karachi, PAK
| | | | - Sharif Hashmani
- Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, PAK
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Hashmani N, Hashmani M, Asghar N, Islam M, Hashmani S. Wide Stromal Mapping Using an Anterior Segment Optical Coherence Tomography. Clin Ophthalmol 2020; 14:751-757. [PMID: 32210528 PMCID: PMC7073963 DOI: 10.2147/opth.s242035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/26/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To quantify and assess the reproducibility of the corneal stromal thickness profiles captured by the SD-OCT. Secondly, we correlated the zonal thicknesses to the age, gender and axial length. Methods We included 227 normal eyes of 227 patients with a maximum hypermetropia of +5 and myopia of –6 diopters (D). Subjects with an intraocular pressure exceeding 22 mm Hg, evidence of cataract formation, history of ophthalmic surgery or disease were excluded. Lastly, reproducibility was evaluated in a subset of 50 participants by means of an identical scan protocol repeated by 2 different OCT operators. Results Stromal values were consistently thicker in the peripheral cornea (p<0.001). Age was negatively correlated with approximately every sector of the stroma with notable exceptions of the center (r=0.117, p=0.088) and the superior inner (r=0.057, 0.409), middle (r=0.086, p=0.209) and outer locations (r=0.120, p=0.079). There was no statistical significance in most sectors when looking at the axial length, gender and K1/K2. This method was highly reproducible in terms of both the ICC and COV. Conclusion Corneal stromal mapping is highly reproducible and shows a negative correlation to age. Additionally, the periphery of the stroma is consistently thicker to the center. Other variables like gender and axial length show no relationship to the corneal stroma.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
| | - Maria Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
| | - Noureen Asghar
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
| | - Mahnoor Islam
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
| | - Sharif Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
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Gabra G, Soliman M, Hamour I, El Tahlawy W, Ghalib H, Bader F, Khalil M, Sabour H, Alsindi F, Hashmani S, Atallah B, El Hajj S, Bajwa G. 188 True or False: Shock Team Approach can Lead to Timely Diagnostic and Therapeutic Interventions to Improve Haemodynamic and Minimize End-Organ Damage. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Hashmani N, Hashmani S, Murad A, Asghar N, Islam M. Effect of Demographic Variables on the Regional Corneal Pachymetry. Asia Pac J Ophthalmol (Phila) 2019; 8:324-329. [PMID: 31356367 PMCID: PMC6727915 DOI: 10.1097/apo.0000000000000252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/20/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The measurement of corneal thickness by corneal pachymetry provides valuable information in the setting of corneal disease; however, spectral-domain optical coherence tomography (SD-OCT)-based assessment of different corneal sectors has been scarce in Pakistan. DESIGN We aimed to obtain a whole-corneal thickness map using SD-OCT and to evaluate its correlation with age, sex, and axial length. METHODS Our study included 214 subjects with healthy corneas; each eye was scanned with an SD-OCT covering a 9-mm diameter, and reproducibility was evaluated in a subset of 50 participants by means of an identical scan protocol repeated by 2 different OCT operators. RESULTS Our analysis revealed corneal thickness to be thinnest inferotemporally whereas thickest in the superior and superonasal quadrants. No statistically significant differences could be detected between male and female participants with respect to corneal thickness, age, intraocular pressure, axial length, and refractive errors. However, we identified a significant negative correlation between age and corneal thickness in all corneal sections, excluding the inner and middle superior, inner superonasal, and inner and middle superotemporal quadrants. Conversely, the correlation between axial length and corneal thickness was found to be positive in the central region (P = 0.03, R = 0.149), the outer inferotemporal quadrant (P = 0.012, R = 0.171), throughout the temporal quadrant (P = 0.024, R = 0.154 for inner; P = 0.025, R = 0.153 for middle; P = 0.006, R = 0.186 for outer), and in the inner superotemporal quadrant (P = 0.018, R = 0.162). CONCLUSIONS Different corneal sectors may interact heterogeneously with patient-related characteristics. This may provide incentive to evaluate whole-corneal thickness as a distinct parameter for clinical identification of disease processes.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
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Hashmani N, Hashmani S, Murad A, Baig N. Macular vascular density at the superficial capillary plexus using the optical coherence tomography angiography. Clin Ophthalmol 2019; 13:295-302. [PMID: 30799915 PMCID: PMC6371924 DOI: 10.2147/opth.s189515] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose The aim of this study was to assess the effects of age, gender, axial length and retinal thickness on the vascular density in a normal population using the Optovue optical coherence tomography angiography (OCT-A). Methods A total of 209 eyes of 209 healthy subjects were scanned using the OCT-A on an outpatient basis. Patients were 20–75 years of age. The built-in software covered a 3×3 mm circle centered at the macula. The circle was divided into five sectors: a 1 mm central foveal circle and an upper, lower, nasal and temporal sector each spanning 1–3 mm away from the central circle. The vascular density (VD) at the superficial capillary plexus was measured, which spanned from the inner limiting membrane to the inner plexiform layer. Results The fovea was the least dense area (32.5%±5.9%), and the temporal area was the densest (52.4%± 4.4%). Similarly, the fovea was the thinnest part of the retina (237.8±20.7 µm); however, the nasal sector was the thickest (308.5±15.1 µm). We found a correlation of the retinal thickness (r=0.541, P<0.001) with VD only at the fovea. Similarly, males had a greater density at the fovea (P=0.002). All regions significantly and negatively correlated with age even after adjusting for axial length. The age sees a decline in the density after the fifth decade where the variability also seems to increase. Conclusion This study provides normative data for the Pakistani population. Additionally, it demonstrates that VD is affected by the retinal thickness at the fovea and the density begins to decline after the fifth decade.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
| | - Sharif Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
| | - Asif Murad
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
| | - Natasha Baig
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
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Abstract
Purpose To map the corneal epithelium using a map measuring 9 mm in diameter and view the effects of age, sex, and axial length. Additionally, we wanted to demonstrate the reproducibility of this technique. Methods We calculated the epithelial thickness in 220 individuals using an SD-OCT machine with the newly released commercially available algorithm. We included normal eyes with refractive errors between +5 and -6 diopters (D). We excluded patients with an intraocular pressure of >22 mm Hg, history of cataract, previous ocular surgery, or disease and those with corneal pathology. Additionally, we excluded patients with evidence of systemic disease or pregnancy. Lastly, reproducibility was measured in 50 individuals. Results We found the center of the corneal epithelium to be thicker than the peripheral in all zones except the nasal (P = 0.124). The superior quadrant was found to be the thinnest while the inferior was the thickest. Males had a thicker epithelium in all locations except the superior outer section (P = 0.123). Three zones had a weak correlation with age: outer superior (P = 0.039, R = -0.152); outer temporal (P = 0.042, R = -0.150); and outer superior temporal (P = 0.011, R = -0.187). There was no significant relationship with the axial length. We found good to excellent reproducibility when using this technique in the central as well as the peripheral cornea. Conclusions We provide a comprehensive study in healthy, normal eyes using a novel algorithm to map the corneal epithelium with a wide diameter. This study can be used as a reference for future research.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
| | - Sharif Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
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Hashmani N, Hashmani S, Murad A, Mahmood Shah SM, Hashmani M. Assessing reproducibility and the effects of demographic variables on the normal macular layers using the Spectralis SD-OCT. Clin Ophthalmol 2018; 12:1433-1440. [PMID: 30147295 PMCID: PMC6095115 DOI: 10.2147/opth.s172109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose To quantify and view the possible influence of demographic variables on normal macular layers. Additionally, we wanted to assess the reproducibility using the Spectralis SD-OCT. Methods A Spectralis SD-OCT machine using a commercially available algorithm was used to scan 242 healthy subjects in an outpatient setting. We examined retinal thicknesses in seven layers: retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL) and retinal pigment epithelium (RPE). Combined retinal thicknesses were expressed as inner retinal layer (IRL), photoreceptor layer (PL) and total retinal thickness (TRT). Measurements were taken from each of the nine sectors defined by the Early Treatment Diabetic Retinopathy Study; the center was the fovea, the inner circle (IC) was 1–3 mm away, and the outer circle (OC) was 3–6 mm away. Results The TRT was thickest inferiorly in the IC, and superiorly in the OC. The RNFL (P=0.030), GCL (P=0.006), IPL (P=0.006), IRL (P=0.030), PL (P<0.001) and TRT (P=0.001) were found to be thicker in males. The GCL (r=0.078, P=0.001), IPL (r=0.079, P=0.001), IRL (r=0.072, P=0.002), PL (r=0.076, P=0.001) and TRT (r=0.090, P<0.001) were found to decrease with age. The INL (r=0.060, P=0.010), ONL (r=0.078, P=0.001), and RPE (r=0.066, P=0.004) were inversely related to axial length. Excellent reproducibility was observed in all layers. Conclusion Our study shows differences in various retinal layers according to age, gender, and axial length. Additionally, we demonstrate excellent reproducibility of this algorithm using the Spectralis SD-OCT.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
| | - Sharif Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
| | - Asif Murad
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
| | | | - Maria Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan,
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Abstract
Introduction We wanted to assess the efficacy, predictability, and stability of topography-guided, laser-assisted in situ keratomileusis (TGL) on normal untreated eyes with a preoperative best corrected visual acuity (BCVA) of 20/20. Methods This was a retrospective, non-randomized, and single arm study evaluating the outcomes of TGL in eyes with a preoperative BCVA of 20/20. We included 50 eyes of 50 patients who presented to the Hashmanis Hospital, Pakistan and were followed for six months postoperatively. All eyes underwent treatment using the Alcon Wavelight Allegro Topolyzer (Alcon Laboratories, Inc., TX, USA). Results The mean preoperative sphere, cylinder, and spherical equivalent (SE) values were -4.3 ± 1.6 dioptres (D), -1.0 ± 0.8 D, and -4.8 ± 1.8 D. On day one these values were 0.2 ± 0.8 D, -0.5 ± 0.3, and 0.3 ± 0.8, respectively, and on month six they were -0.1 ± 0.6, -0.5 ± 0.3, and -0.4 ± 0.6 D, respectively. On postoperative day one and month six, 86% and 94% of eyes had a UCVA of 20/20 or better, respectively. Two eyes (4%) had an SE change of greater than 0.5 D from three to six months. Conclusion Our study demonstrates good efficacy, predictability, and stability of eyes undergoing TGL with a follow-up of six months.
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Affiliation(s)
- Sharif Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital
| | - Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital
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Abstract
Purpose To map and view the effects of age, gender, and axial length on seven individual retinal layers around the optic nerve head (ONH). Methods We scanned 242 healthy patients using the Spectralis spectral domain optical coherence tomography in an outpatient setting. The layers were observed on the Early Treatment Diabetic Retinopathy Study sectors using the standard Spectralis Family Acquisition Module 6.0.11.0. The center was the ONH, the inner circle (IC) was 1-3 mm away, and the outer circle (OC) was 3-6 mm away. The seven layers were retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), and retinal pigment epithelium (RPE). Additionally, we calculated the mean thickness of two combined layers: inner retinal layer (IRL) and photoreceptor layer (PL). Finally, we measured the mean of the total retinal thickness (TRT). Results The TRT was highest at the inferior end in the IC and at the nasal end in the OC. The RPE (p<0.001) and PL (p<0.001) were thicker in males; however, the IRL (p=0.015) was thicker in females. We found that the RNFL (p<0.001, r=0.139), GCL (p<0.001, r=0.116), IPL (p=0.016, r=0.059), INL (p<0.001, r=0.104), OPL (p=0.009, r=0.064), ONL (p<0.001, r=0.157), RPE (p=0.001, r=0.079), IRL (p<0.001, r=0.190), PL (p=0.030, r=0.053), and TRT (p<0.001, r=0.191) correlated negatively with age. The axial length significantly and negatively correlated at the GCL (p=0.003, r=0.093), IPL (p=0.020, r=0.072), INL (p=0.018, r=0.073), ONL (p<0.001, r=0.110), IRL (p=0.003, r=0.092), and TRT (p=0.003, r=0.094). We found poor reproducibility in the IC; however, this was excellent in the OC. Conclusion We found significant differences in layers according to age, gender, and axial length. Additionally, reproducibility can be improved by altering the algorithm to account for the ONH parameters.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
| | - Sharif Hashmani
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
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Hashmani S, Hashmani N, Memon RS. Corneal Collagen Cross-Linking Combined with an Artiflex Iris-Fixated Anterior Chamber Phakic Intraocular Lens Implantation in a Patient with Progressive Keratoconus. Case Rep Ophthalmol 2017; 8:482-488. [PMID: 29118708 PMCID: PMC5662956 DOI: 10.1159/000480728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 08/28/2017] [Indexed: 01/04/2023] Open
Abstract
We present here the case of a 24-year-old male who experienced progressive keratoconus and vision loss which adversely affected his ability to carry out everyday tasks. This landed him in the Hashmanis Hospital for consultation. He had a preoperative best corrected visual acuity of 6/12. He underwent multiple Oculus Pentacam examinations, which showed progressive keratoconus. Corneal collagen cross-linking (CXL) was performed to stabilize his cornea and, subsequently, an Artiflex anterior chamber iris-fixated phakic intraocular lens (ACIF-PIOL) was implanted to alleviate his refractive errors. The patient achieved a postoperative uncorrected visual acuity of 6/12. This report shows that CXL combined with ACIF-PIOL can be safe and effective in those with progressive keratoconus.
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Hashmani N, Hashmani S, Ramesh P, Rajani H, Ahmed J, Kumar J, Kumar A, Jamali M. A Comparison of Visual Outcomes and Patient Satisfaction Between Photorefractive Keratectomy and Femtosecond Laser-Assisted In Situ Keratomileusis. Cureus 2017; 9:e1641. [PMID: 29119072 PMCID: PMC5665689 DOI: 10.7759/cureus.1641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose To compare visual outcomes and satisfaction among patients of photorefractive keratectomy (PRK; Wavelight EX 500, Alcon, Ft Worth, TX, USA) and femtosecond laser-assisted in situ keratomileusis (FAL; Wavelight FS 200 laser and Wavelight EX 500, Alcon, Ft Worth, TX, USA). Methods We performed a retrospective study of 409 eyes in 207 patients that underwent either PRK (n=90) or FAL (n=117) at the two centers of Hashmanis Hospital, Karachi, Pakistan. The included refractive outcomes were sphere diopters (D), cylinder D, and spherical equivalent D. Additionally, visual acuities were included. All of these were assessed preoperatively and at the one-month postoperative check-up. Patient satisfaction was gauged at the time of chart review by contacting the patient. Results When looking at the postoperative outcomes, we found all values to be statistically significant (p<0.001) with superior outcomes in the FAL cohort. Additionally, 90% and 15% of eyes achieved a postoperative uncorrected visual acuity (UCVA) of 20/20 in FAL and PRK, respectively. Furthermore, the efficacy indexes of the FAL and PRK arms were 1.00 and 0.82, respectively. The predictability of the procedures were 92.1% and 64.9%, respectively. Lastly, 93.3% of patients were satisfied with FAL and 95.7% with PRK. Conclusion Our study shows superior visual outcomes in patients undergoing FAL. However, we found a higher satisfaction rate in those that underwent PRK, perhaps due to the higher cost of FAL.
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Affiliation(s)
| | | | | | - Hina Rajani
- Student, Dow Medical College, Karachi, Pakistan
| | - Junaid Ahmed
- Dow University of Health Sciences, Civil hospital karachi
| | - Jaish Kumar
- Student, Dow Medical College, Karachi, Pakistan
| | - Arun Kumar
- Student, Dow Medical College, Karachi, Pakistan
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Hashmani N, Saleem M, Rajani H, Hashmani S. Traumatic dislocation of phakic anterior chamber iris-claw intraocular lens: A case report. J PAK MED ASSOC 2017; 67:1124-1126. [PMID: 28770904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We are presenting a traumatic dislocation of a Phakic intraocular lens (PIOL) secondary to a blunt trauma to the right eye. The patient presented with a sudden blurring of vision with no other associated injury. His slit lamp examination showed disenclavation of the temporal clip and pre-operatively his best spectacle-corrected visual acuity (BSCVA) was 6/36. The patient was brought to the operating room where his lens was repositioned and re-enclaved. He had a complete restoration of vision with a BSCVA of 6/9 and an endothelial cell count of 2786/mm2. We conclude that a traumatic dislocation of an iris-claw PIOL can be successfully corrected without immediate postoperative complications and endothelial cell count loss.
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Hashmani N, Hashmani S, Hanfi AN, Ayub M, Saad CM, Rajani H, Muhammad MG, Aziz M. Effect of age, sex, and refractive errors on central corneal thickness measured by Oculus Pentacam ®. Clin Ophthalmol 2017; 11:1233-1238. [PMID: 28721008 PMCID: PMC5501622 DOI: 10.2147/opth.s141313] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Central corneal thickness (CCT) can be used to assess the corneal physiological condition as well as the pathological changes associated with ocular diseases. It has an influence on the measurement of intraocular pressure and is being used as a screening tool for refractive surgery candidates. The aim of this study was to determine the median CCT among normal Pakistani population and to correlate CCT with age, sex, and refractive errors. METHODS We conducted a retrospective analysis of 5,171 healthy eyes in 2,598 patients who came to Hashmanis Hospital, Karachi, Pakistan. The age of the patients ranged from 6 to 70 years. The refractive error was gauged by an auto-refractometer, and CCT was measured using Oculus Pentacam®. RESULTS The median CCT of our study was 541.0 μm with an interquartile range (IQR) of 44.0 μm. The median age was 26.0 years (IQR: 8.0). Median spherical equivalent (SE) of the patients was -4.3 D (IQR: 3.3) with the median sphere value as -4.0 D (IQR: 3.8). Lastly, the median cylinder was -1.0 D (IQR: 1.3). Age has a weak negative correlation with CCT (r=-0.058) and shows statistical significance (P<0.001). Additionally, males had thinner CCT readings than females (P=0.001). The cylinder values, on the other hand, had a significant (P=0.004) and positive correlation (r=0.154). Three values showed no significant correlation: sphere (P=0.100), SE (P=0.782), and the left or right eye (P=0.151). CONCLUSION Among the Pakistani population, CCT was significantly affected by three variables: sex, age, and cylinder. No relationship of CCT was observed with the left or right eye, sphere, and SE.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
| | - Sharif Hashmani
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
| | - Azfar N Hanfi
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
| | | | | | | | | | - Misbahul Aziz
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
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Hashmani S, Hashmani N, Kumar S, Kumar S, Dhomeja V, Razak S, Rajani H, Hanfi AN, Adhi I. Reasons for Refusing Laser-Assisted in Situ Keratomileusis in a Pakistani Population. Cureus 2017; 9:e1391. [PMID: 28775931 PMCID: PMC5526700 DOI: 10.7759/cureus.1391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To study and analyze the reasons for not performing laser-assisted in-situ keratomileusis (LASIK) surgery in Pakistan. Methods This is a retrospective observational review of the patients who presented for LASIK surgery during January 2014 to September 2016 at the Hashmanis Hospital refractive surgery facility in Karachi, Pakistan. Results A total of 6005 eyes in 3512 patients presented for LASIK surgery. Out of these, a total of 1795 eyes (29.9%) of 899 patients (25.6%) were rejected. The most common cause for not performing LASIK surgery was found to be increased risk of postoperative ectasia seen in 534 (29.75%) eyes. In 275 (15.32%) eyes, the surgery could not be performed because of affordability of procedure or unscientific apprehensions of the patient. Keratoconus was seen in 268 (14.93%) eyes. Conclusion The patients presenting for LASIK surgery need extensive screening as the large proportion of patients may have corneal structural for not performing this procedure. The cost of the procedure plays its role as does the unscientific beliefs amongst the patients.
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Affiliation(s)
| | | | - Sham Kumar
- Dow Medical College, Civil hospital karachi
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Hashmani S, Hashmani N, Rajani H, Ramesh P, Soomro JA, Hussain Shah SR, Kumar J, Mahmood Shah SM. Comparison of visual acuity, refractive outcomes, and satisfaction between LASIK performed with a microkeratome and a femto laser. Clin Ophthalmol 2017; 11:1009-1014. [PMID: 28579752 PMCID: PMC5449167 DOI: 10.2147/opth.s137451] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare refractive outcomes, visual acuities, and satisfaction of patients between those treated with laser-assisted in situ keratomileusis (LASIK) using a Hansatome microkeratome (HM) and femto-assisted laser (FAL). Methods This was a retrospective analysis of 1,366 eyes in 687 patients who underwent LASIK with an HM (n=1,137) and an FAL (n=229) at the two centers of Hashmanis Hospital, Karachi, Pakistan. Refractive outcomes, including sphere, cylinder, and spherical equivalent in diopters (D), and visual acuities were assessed both preoperatively and at 1 month follow-up. Patient satisfaction was gauged by contacting the patient at the time of chart review. Results The postoperative median sphere, cylinder, and spherical equivalent values for those treated with FAL were 0.3±0.7 (−5.5–1.8), −0.5±0.6 (−5.0–1.0), and 0.0±0.7 (−6.0–1.6), respectively. For the HM arm, they were 0.0±1.28 (−10.8–6.8), −0.5±0.5 (−4.5–1.5), and −0.3±1.3 (−11.6–6.8), respectively. All preoperative values were statistically insignificant between the groups, while postoperative values were significant with P-values <0.001. Predictability and efficacy index was higher for the FAL (92.1%, 1.00) than the HM group (82.2%, 0.84). Similarly, patient satisfaction was slightly higher for those treated with FAL (93.3%) than HM (91.4%). Conclusion Our large retrospective analysis of eyes that have undergone LASIK using HM and FAL shows superior refractive outcomes in the latter, with special regard to procedural efficacy and predictability.
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Affiliation(s)
- Sharif Hashmani
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
| | - Nauman Hashmani
- Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan
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Hasan KS, Rabbani G, Hashmani S, Hasan MM. Trabeculectomy--a short term follow-up. J PAK MED ASSOC 1981; 31:193-6. [PMID: 6798238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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