The organic effects of varicocele on testicular histology were studied in bilateral testicular biopsies obtained from 30 infertile men during varicocele repair and 3 to 6 months post-operatively, using light microscopy. Before surgery and at follow-up, semen analyses were performed. The results showed a substantial improvement in semen quality in 22 cases post-operatively. Pre-operative biopsies showed depressed spermatogenesis with a predominant picture of maturation arrest, sloughing of spermatogenic epithelium, an increase in Leydig cells, thickening of tubular basement membranes and interstitial blood vessel walls with narrowing of their lumina, and increased deposition of interstitial fibrous tissue. Post-operatively, spermatogenesis improved in 22 cases, with increased mean tubular scores together with diminution in epithelial cell sloughing. The increased prominence of Leydig cells reverted to normal in 18 cases. The changes in tubular basement membranes, interstitium and interstitial blood vessels were unaffected.

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The differences between unilateral and bilateral inferior oblique graded recession-anteriorization are insignificant. Unilateral surgery has a higher tendency for the subsequent development of antielevation syndrome. Bilateral surgery may still become complicated by antielevation syndrome, although at a lower rate. In addition, bilateral surgery had a higher rate of undercorrection. Further studies on a larger sample are encouraged.

Purpose: To compare the effect of daily occlusion of the sound eye for two hours, without and with near vision exercises, versus six hours without near vision exercises, for the management of strabismic amblyopia and to determine the different factors affecting compliance to each treatment regimen. Methods: Forty fi ve children having unilateral strabismic amblyopia were divided equally into 3 groups. Group A received 2-hour daily occlusion. Group B received 2-hour occlusion combined with near vision exercises. Group C received 6-hour occlusion therapy. Patients were followed up for 6 months. Results: The mean logMAR improvement was-1.03+/-0.57,-0.63+/-0.66 and-0.65+/-0.66, for groups A, B and C, respectively. The difference in mean logMAR improvement was signifi cant (P < .001) in groups A versus B and A versus C, but was insignifi cant (P = .748) in group B versus C. Factors affecting compliance to each occlusion regimen were related to age, socioeconomic status, life pattern and season of the year. Conclusion: The best outcome was achieved when 2-hour daily patching was combined with near vision activities. Higher compliance to two-hour occlusion with near vision exercises was attained in older, educated children. Six-hour occlusion was more suitable in younger and in uneducated children.