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Knowledge and innovation are essential for organizational success. For this reason, organizations are seeking for processes to transform knowledge into better organizational performance. On the other hand, it seems that the relationship between the knowledge management process and performance is more complex than a simple direct relationship, because knowledge must be institutionalized in the organization to improve performance. This institutionalization may be achieved through organizational innovation, which can often facilitate these processes. Therefore, the purpose of this study is to examine the relationship between knowledge management processes, organizational innovation and organizational performance, which has been done in the case of the cement industry. For this purpose, three standard questionnaires of knowledge management (Cronbach's alpha = 0.730), organizational performance (Cronbach's alpha = 0.714) and organizational innovation (Cronbach's alpha = 0.750) were used to collect information from a sample of 385 cement industry employees from six provinces. Data analysis was done using SPSSwin18 and Smart PLS.5 software in the form of descriptive statistics and structural equation model. The results showed the low level of knowledge management and organizational innovation in the studied companies. The findings of the structural equation model showed that knowledge management (β=0.417, P<0.01) and organizational innovation (β=0.427, P<0.01) have a positive and significant effect on organizational performance. In addition, organizational innovation plays a mediating role in the relationship between knowledge management and organizational performance (β=0.331, P<0.01). It is suggested that organizations that have a high ability to manage their knowledge use their resources efficiently and provide more innovation to improve their performance. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis (HD)-associated ocular abnormalities are one of the causes of morbidity among people undergoing HD. This study evaluates the frequency of ocular abnormalities in end-stage renal disease (ESRD) patients undergoing HD and their potential link to HD and demographic parameters. Methods: This cross-sectional study examined 242 eyes of 121 patients with ESRD undergoing regular HD after excluding the ineligible subjects. The study was designed in two parts. Medical histories of each patient including age, gender, family history, medication history, past medical history, and duration of HD collected using a structured check list. All patients underwent complete ophthalmologic examination for evaluation of the best corrected visual acuity (BCVA), intraocular pressure (IOP), and anterior and posterior segments. Results: In total, 121 patients, including 68 (56.2%) males and 53 (43.8%) females, were enrolled in the study. The mean ± SD age of the patients and their mean duration of dialysis were 51.59 ± 16.01 and 3.40 ± 2.75 years, respectively. The most prevalent etiology for HD was diabetes mellitus (39.67%), followed by hypertension (38.84%), and the most common ocular findings included cataract (142 eyes; 58.7%) and ectopic calcification of the conjunctiva and cornea (78 eyes; %32.2). There was at least one abnormal ocular finding in 89.3% of the cases. The BCVA was equal to or less than finger count in 70 eyes (28.92%). There was a significant relationship between conjunctival calcification and the duration of dialysis (P = 0.02). There was significant association between etiology of HD and conjunctival calcification (adjusted odds ratio, 2.44; 95% CI, 1.05-5.67; and P value, 0.03). Such significant associations were present for corneal calcification (P = 0.009), cataract (P = 0.02), and optic atrophy (P = 0.01). Conclusions: Regular ophthalmologic examinations are recommended due to the prevalence of clinical ocular abnormalities in HD patients. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate the results of photorefractive keratectomy (PRK) in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK). Materials and Methods: This prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1) wavefront (WF) scan was undetectable during primary examinations; and/or, (2) WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS) mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT). Results: Thirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. The amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well. Conclusion: PRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction. [ABSTRACT FROM AUTHOR]

Purpose: To report normal interpupillary distance (IPD) values in different age groups of an Iranian population. Methods: This study was performed on 1,500 randomly selected subjects from 3,260 consecutive out-patients with refractive errors referred to Farabi Eye Hospital, Isfahan, Iran over a period of two years (2008 to 2010). Measurement of refractive errors and IPD for far distance were performed using an autorefractometer (RMA-3000 autorefractometer, Topcon, Tokyo, Japan). Results: Mean IPD in adult subjects was 61.1±3.5 mm in women and 63.6±3.9 mm in men (p<0.001). Mean IPD increased 4.8 mm during the second decade, 1.7 mm during the third decade, and 0.6 mm during the fourth and fifth decades of life. Conclusion: The observed increase in IPD after the age of 30 years indicates that factors other than skeletal growth may affect this parameter. [ABSTRACT FROM AUTHOR]

Purpose: To compare two phakic intraocular lenses, Artiflex and STAAR® implantable contact lens (ICL), in high myopia. Setting: Isfahan Ophthalmology Clinic, Iran. Materials and Methods: In a randomized, prospective clinical trial study, 40 eyes of 20 patients who came to Isfahan ophthalmology clinic to correct their refractive error were examined. Artiflex was inserted in 20 eyes and ICL in the other 20 eyes. After 1 year, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity, intraocular pressure (IOP), and specular microscopy of corneal endothelium were assessed in both the groups. Results: In this study, there was no statistical difference between UCVA, BCVA, IOP, cataract incidence, contrast sensitivity, and specular microscopy, 1 year after surgery. 40% of eyes in the Artiflex group developed anterior chamber cell and flare reaction 1 year postoperatively, but no patient in the ICL group developed the same. So, there is obvious difference in the rate of anterior chamber cell and flare reaction between these two groups. Conclusion: These two lenses have similar outcomes except in the incidence rate of anterior chamber cell and flare reaction that is greater in the Artiflex group. So, these two lenses are safe with predictable outcome in treating high myopia. [ABSTRACT FROM AUTHOR]

Purpose: To compare keratometric measurements using a Javal type manual keratometer with IOLMaster in eyes undergoing photorefractive keratectomy (PRK) for myopia. Methods: In this comparative case series, we studied patients aged 21 to 27 years scheduled for myopic PRK. Keratometry was performed preoperatively and three months after the procedure using a Javal type manual keratometer and the IOLMaster. We compared postoperative measurements obtained by both instruments with the clinical history method (CHM). Results: Seventy eyes of 35 patients with mean age of 23.45±1.55 years were studied. Mean preoperative spherical equivalent was -4.53±1.3 D. Average preoperative IOLMaster and manual keratometric readings were 45.95±1.23 D and 46.32±1.18 D, respectively. Postoperatively, mean IOLMaster measurements was 38.03±0.68 D and that of manual keratometry was 43.15±1.1 D. Compared to CHM measurements, the 95% limits of agreement were .5.95 to -0.85 for the IOLMaster and -1.44 to 4.04 for manual keratometry. Conclusion: Keratometric measurements with the IOLMaster and a Javal type manual device are comparable after PRK; both are largely deviant from the CHM and can yield misleading results. [ABSTRACT FROM AUTHOR]

Background: To evaluate refractive, visual, topographic, and wavefront outcome of photorefractive keratectomy (PRK) for treatment of myopia and myopic astigmatism with two different excimer laser systems: Technolas 217z and Lasersight LSX excimer lasers. Methods: 183 eyes of 95 patients enrolled in this clinical trial. Patients underwent PRK in a Sadra refractive surgery center with Technolas or Lasersight system by a single surgeon between 2007 and 2011. For PRK we used Technolas 217z in one group and Lasersight LSX excimer laser in another group. Subjects examined before and 24 months after surgery evaluating vision, refraction, Orbscan topography, and Wavefront analysis. Data collected, analyzed with SPSS 16. We used Student t-test for statistical data analysis. Findings: 83 eyes were in the Lasersight group and 100 eyes in the Technolas group. Pre-op spherical equivalent refraction was not different in two groops. After surgery it was -0.93 ± 0.73 in Technolas and -0.19 ± 0.40 in Lasersight group, the difference was statistically significant (P < 0.001). Post-op difference vector of astigmatic correction was 0.44 ± 0.58 in Technolas and 0.41 ± 0.26 diopters in Lasersight group (P = 0.04). Post-op LogMAR Acuity was 0.015 ± 0.027 in Technolas and 0.0005 ± 0.005 in Lasersight group (P < 0.001). Post-op Q value of asphericity was 0.24 ± 0.33 in Technolas and 0.46 ± 0.37 in Lasersight group (P < 0.001). Conclusion: Post-op spherical equivalent refractive outcome, best corrected distance visual acuity and satisfaction were better in Lasersight group. We did not find any difference regarding post-op wavefront analysis between groups. [ABSTRACT FROM AUTHOR]

Background: Photorefractive keratectomy or PRK is a good way to correct mild, moderate and severe myopia and astigmatism. Because of several reports about the sight threatening of Hyperopic PRK, it's effectiveness is less known. This study was done to characterize the refractive changes after excimer laser PRK for correction of hyperopia > 3 diopters and to assess refractive state and changes in astigmatism after 1year. Methods: In an interventional study, thirty eyes of nineteen patients were participated. Their mean refractive error was +5.45 diopters and mean astigmatism was -1.42D. All of the patients were treated by Technolas 217-z excimer laser. Post operative SE (sphere equivalent), UNCVA (uncorrected visual acuity), BCVA (best corrected visual acuity) and all of the complications examined at 12 months later. Findings: The mean post operative refraction was +1.00D (range-2.00 to +5.00), the mean SE was 0.55D and mean astigmatism was -0.95D (range -0.25 to-2.00D). Mean BCVA was unchanged or improved in 83.4% of cases (pre op log MAR = 0.10 and post op log MAR = 0.11) but five eyes (16.6%) lost 1 or 2 lines of snellen BCVA. In 46.6% refraction was within +/-1.00D and 80% was within +/-2.00 from target refraction. The grade corneal haze in eighteen eyes (66%) was 0 or 0.5 and in one eye was 3 and neither developed to grade 4. Conclusion: Hyperopic PRK has a low predictability for high hyperopia but it is effective for low hyperopia. We do not recomended PRK in highly hyperopic-astigmatic eyes. [ABSTRACT FROM AUTHOR]

Introduction: Phacoemulsification is a new and modern cataract surgery; although surgically induced astigmatism is an unavoidable complication. The site of incision is an important factor in complication. The horizontal incision is a safer method of surgery; but in practice, surgeons prefer to make easier oblique incision. So we compared surgically induced astigmatism after these incisions. Methods: In a randomized prospective clinical study, 66 patients with = 1 diopter (D) astigmatism were evaluated. Horizontal and oblique clear corneal incisions were performed. Topography values were evaluated and changes in surgically induced astigmatism were calculated by vector analysis; independent t-test was used to compare mean values. Finding: The mean surgically induced astigmatism was 0.95 ± 0.57 diopters (D) in the oblique incision group and 0.83 ± 0.56 (D) in horizontal incision group. The difference in surgical induced astigmatism between two incision types was not statistically significant (P = 0.73) Conclusion: There is not any statistically significant difference in surgical induced astigmatism between oblique and horizontal incision groups. [ABSTRACT FROM AUTHOR]

Purpose: To customize clinical practice guidelines (CPGs) for management of diabetic retinopathy (DR) in the Iranian population., Methods: Three DR CPGs (The Royal College of Ophthalmologists 2013, American Academy of Ophthalmology [Preferred Practice Pattern 2012], and Australian Diabetes Society 2008) were selected from the literature using the AGREE tool. Clinical questions were designed and summarized into four tables by the customization team. The components of the clinical questions along with pertinent recommendations extracted from the above-mentioned CPGs; details of the supporting articles and their levels of evidence; clinical recommendations considering clinical benefits, cost and side effects; and revised recommendations based on customization capability (applicability, acceptability, external validity) were recorded in 4 tables, respectively. Customized recommendations were sent to the faculty members of all universities across the country to score the recommendations from 1 to 9., Results: Agreed recommendations were accepted as the final recommendations while the non-agreed ones were approved after revision. Eventually, 29 customized recommendations under three major categories consisting of screening, diagnosis and treatment of DR were developed along with their sources and levels of evidence., Conclusion: This customized CPGs for management of DR can be used to standardize the referral pathway, diagnosis and treatment of patients with diabetic retinopathy., Competing Interests: There are no conflicts of interest.

Background: This study performed to assess the safety of cataract extraction with phacoemulsification and intraocular lens (IOL) implantation in patients with high axial length compared with patients with normal axial length., Materials and Methods: A total of 866 eyes were enrolled in this study; all subjects underwent phacoemulsification and IOL implantation for treatment of cataract. Seven hundred and nine eyes fell in the normal group with axial lengths ranging between 21 and 24.5 mm, and 157 eyes were considered myopic with axial length equal or greater than 26 mm. The two groups were compared regarding intraoperative surgical complications, such as vitreous loss, posterior capsular rupture, nucleolus drop, and undesirable implantation of IOL in the anterior chamber., Results: Age was a risk factor in both groups, with each year increase of age, the chance of incidence of intraoperative complications increased 1.04-folds (P = 0.03). And with 1 mm increase in axial length, the incidence of complications raised 1.22-folds (P = 0.007). There was no significant correlation between axial length and incidence of vitreous loss, although the incidence of posterior capsular rupture and nucleus fragment drops increased with increment in the axial length. Sex of the patients and side of the left or right eye were not found to be significant risk factors., Conclusions: As the results illustrate, in this survey, age and high axial length were statistically significant risk factors for incidence of intraoperative complications of cataract surgery with phacoemulsification technique. Anticipation of these complications and also preparation and prophylactic measures may decrease incidence of these complications.

Purpose: To report the efficacy, safety, predictability and complications of photorefractive keratectomy (PRK) with intraoperative application of mitomycin-C (MMC)., Methods: This historical cohort study was performed on 1,250 eyes of 625 patients who underwent PRK using the Technolas 217 excimer laser machine by a single surgeon with intraoperative use of MMC 0.02% up to 2 minutes, depending on depth of ablation. A complete ophthalmologic examination was performed which included refraction uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and slitlamp biomicroscopy. Outcomes were analyzed after one year of follow-up., Results: The mean preoperative spherical equivalent refractive error was -4.85±2.27 (range, -2.50 to -13.5) diopters (D). Mean depth of ablation was 89±22 microns and mean time to reepithelialization was 4.5±1.7 days. At final follow-up, UCVA of 20/20 and 20/40 or more was achieved in 92.1% and 99.2% of eyes, respectively. One year postoperatively, 69.4% and 91% of eyes were within ±0.50 D and ±1.00 D of emmetropia.Overall, 62 eyes (4.9%) developed one or two lines of decrease in BCVA, and 50 eyes (4%) developed corneal haze which was grade 1 or 2 in most cases; grade 3 and 4 corneal haze was found in 4 and 2 eyes, respectively. No other adverse event was noted during the study period., Conclusion: PRK with intraoperative application of MMC provides excellent visual outcomes with acceptable safety and predictability, and entails minimal side effects.