Long term surgical results and safety profile of the novel CM T Flex scleral fixated intraocular lens.

PURPOSE: To report the long term visual outcomes and complications with use of the novel CM-T Flex scleral fixated intraocular lens (CMT-SFIOL). MATERIALS AND METHODS: 116 eyes that underwent CMT-SFIOL were reviewed and 57 eyes with CMT-SFIOL that completed a 2-year follow-up were included. Main outcome measures noted were best-corrected visual acuity (BCVA) and complications. Postoperatively, follow-ups were done at 1 week (1w), 1 month (1 m), 1 year (1y) and 2-year (2y) intervals. RESULTS: 40 (70.17%) of 57 eyes received CMT-SFIOL for surgical aphakia. Mean follow up was 39.77 ± 8.44 months. BCVA for distance & near improved from 1.26 ± 0.84 to 0.76 ± 0.77, 0.50 ± 0.72 and 0.51 ± 0.73 & 1.28 ± 0.58 to 0.98 ± 0.49, 0.92 ± 0.44 and 0.89 ± 0.40 at 1 m, 1y and 2y respectively (p < 0.001 for all). At 1w, 10 eyes (17.54%) had corneal edema (CE) and 8 eyes (14.03%) had anterior chamber (AC) reaction. Two eyes (3.50%) had IOP > 30 mm Hg and 1 eye (1.75%) had vitreous hemorrhage (VH). At 1 m, 3 eyes (5.26%) had CE and 5 eyes (8.77%) had AC reaction. Two eyes (3.50%) had IOP > 30 mm Hg and 1 eye (1.75%) had VH. Cystoid macular edema was noted in 3 eyes (5.26%). At 1y and 2y, 2 eyes (3.5%) and 1 eye (1.75%), had CE. No decentration, dislocation, haptic exposure or retinal detachment was noted. No eyes required resurgery. CONCLUSION: CM-T Flex SFIOL is an effective method to correct aphakia, with reliable and safe long-term results.

Oral leiomyomatous hamartoma: presentation of 3 cases and review of the literature.

Oral leiomyomatous hamartoma (OLH) is a rare lesion, with only 40 cases reported in the literature. It typically presents early in life as a nodule on the anterior maxillary alveolar tissues or the tongue. Its growth potential is limited, with few cases reaching dimensions >2.0 cm, and its microscopic composition includes an intact surface mucosa with an underlying fibrovascular stroma possessing an unencapsulated proliferation of smooth muscle fascicles. Excision is considered the definitive treatment. Here we describe the clinical, microscopic, histochemical, and immunohistochemical features and management of 3 cases of OLH and review the literature. The findings we present here can assist in performing differential diagnosis, particularly in discriminating between OLH and similar yet non-hamartomatous processes and in selecting appropriate management.

Clinical results after binocular implantation of a unique nondiffractive enhanced monofocal intraocular lens designed for enhanced monovision to increase the depth of focus.

PURPOSE: To provide the reports of a pilot study to assess the visual acuity (VA) and contrast sensitivity with RayOne enhanced monovision (EMV), a unique nondiffractive enhanced monofocal intraocular lens (IOL) to increase the range of focus. METHODS: A retrospective case series study was conducted by analyzing 25 patients (50 eyes) who had bilateral implantation of EMV IOL after cataract surgery. Data collected included biometry, spherical equivalent (SE), and VA for near, intermediate, and distance. Patients were reviewed at 1 day, 1 week, and 1 month after surgery. Contrast sensitivity (CS) was checked at 1 month. RESULTS: The study included 14 males (56%). Age of participants was 61.4 ± 7.4 years. Uniocular uncorrected near and distance VA improved from 0.33 ± 0.13 to 0.05 ± 0.07 and from 0.63 ± 0.31 to 0.05 ± 0.10 log of minimum angle of resolution (logMAR) at 1 month (P < 0.001 for both). Binocular uncorrected near and distance VA improved from 0.09 ± 0.18 and 0.14 ± 0.27 to 0.05 ± 0.06 and 0.00 ± 0.09 logMAR, respectively (P < 0.001). SE changed from - 0.23 ± 2.55 to - 0.33 ± 0.46. CS at 3 months was 1.74 ± 0.21. At 1 month, 48 eyes (96%) achieved uncorrected intermediate VA 6/15 (0.4 logMAR) or better. When comparing eyes that had uncorrected intermediate vision of ≥ 0.2 (6/9 or better) to eyes that had < 0.2 logMAR at 1 month, there was no difference between groups with respect to baseline parameters. CONCLUSION: The pilot study shows that the nondiffractive EMV IOL is safe, effective, and stable, providing excellent distance and intermediate vision and good near vision.

Clinicopathological Profile of Nodular Hidradenoma: A ten year Study in a Tertiary Care Center.

Nodular hidradenoma is a rare skin adnexal tumor of eccrine differentiation with predominant site being scalp and axillae. Due to its variable locations and unusual clinical presentation and no definite radiological criteria, histopathology seems to be the mainstay in diagnosing these tumors. Most of the lesions present as a cystic swelling and was clinically thought to be a sebaceous cyst/metastasis/carcinoma/sarcoma. In our study, we have included 37 cases and compared its varied clinical and radiological presentation.

Nanocubic copper cobaltite for methyl orange degradation through photocatalytic process.

In this study, cubic spinel structured CuCo2O4 (Copper cobaltite) nanospheres were fabricated by thermal decomposition method. The visible light degradation of organic contaminant methyl orange (MO) was focused in this study using the synthesized pure CuO, Co3O4 and CuCo2O4 with different weight ratios of raw materials (90:10, 75:25 and 50:50). It could be well realized that after the characterization techniques, the synthesized CuCo2O4 materials resembled cubic spinel structure as confirmed by X-ray diffraction (XRD) investigation. Meanwhile, all the synthesized materials through transmission electron microscopy (TEM) have showed cubic shaped particles and among the CuCo2O4 materials, CuCo2O4 (50:50) expressed not as much of crystallinity due to the agglomerated nanospheres. On the other hand, well crystalline CuCo2O4 (75:25) displayed higher surface area than the other materials when analysed through Brunauer-Emmett-Teller (BET) method. The Fourier transform infra-red (FTIR) spectrum has evinced the formation of CuCo2O4 nanostructures. In addition, the cubic spinel structured CuCo2O4 provided positive results over visible light irradiation. Finally, the CuCo2O4 (75:25) sample has scored high as much of 85% MO degradation compared with others. This sample was progressed with repetitive recycling tests and presented the best photocatalytic degradation efficiency. The upgraded results of CuCo2O4 sample have been linked with the developed synergistic effects during the formation of binary metal oxides. Also, the interfacial electron-hole formation leads to the migration and hindering of charge carriers for visible light activity.

Bilateral choroidal effusion following vaccination against SARS-CoV-2 virus.

An 80-year-old systemically stable female presented with sudden blurring of vision post the first dose of CovishieldTM, a non-replicating viral vector vaccine. On examination, she was found to have bilateral serous choroidal effusions. A thorough systemic and ocular workup was performed to rule out other causes of choroidal effusion. The effusions resolved with tapering doses of oral and systemic steroids. To the best of our knowledge, at the time of submission, this is the first case of choroidal effusion being reported after the coronavirus disease 2019 (COVID-19) vaccine.

The influence of heterostructured TiO2/ZnO nanomaterials for the removal of azo dye pollutant.

In recent times, there has been an inspired research on combining semiconducting metal oxides for improved industrial applications. Significantly, wastewater removal is concerned and the researchers are finding new methodologies for removing azo dyes that possess a high level of carcinogenic effects. In this connection, this work investigates the photocatalytic activity of synthesized TiO2/ZnO nanocomposite irradiated under UV and visible light. The application of the work involves the removal of methylene blue (MB) dye solution. Initial work begins with the novel synthesis of TiO2/ZnO coupled system by integrated sol-gel and thermal decomposition methods. Then, various characterization techniques brought out the existing properties of the prepared TiO2/ZnO catalyst. The X-ray diffraction measurements showed the assorted tetragonal and hexagonal structures. The spherical shape mixed with hexagonal shaped particles were perceived via transmission electron microscopy (TEM). Besides, from photoluminescence spectrum (PL) results, the TiO2/ZnO coupled system displayed slowing down of charge recombination, because of the intermediate states that helps in intensifying the photocatalytic activity. The dual absorption bands corresponding to UV region were deep-rooted from UV-vis spectroscopy. Further, the valuable application of the catalyst in removing methylene blue (MB) dye under both UV and visible light was carried out. The catalyst had displayed 90% of degradation within 40 min under UV light conditions. The other hand, visible light illumination of the catalyst provides divergent results as it possess lesser light absorption. Therefore, this catalyst was unable to yield visible light photocatalytic activity. Hence, this captivating research would bring the wastewater treatment progression using UV light.

The Significance of Topoisomerase II Alpha in Invasive Breast Carcinoma.

Background Topoisomerase II alpha (Top 2 A) protein has been shown to be a proliferation marker associated with tumour grade. The current study evaluated the prognostic impact of Top 2 A protein on luminal breast cancer and its utility as an independent prognostic marker. Immunohistochemical expression of Top 2 A in breast cancer and its correlation with the tumour type, size, lymph node metastases, grade and ER/PR positivity. Methodology Ethics committee approval was taken and 65 cases of Invasive breast carcinoma presenting to the Department of Pathology at a tertiary care centre in South India were studied. Patient details including age, tumour type, tumour size, tumour grading, estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor receptor 2 (HER2/neu) status and pathologic stage was studied. Immunohistochemistry (IHC) work-up for Top 2 A expression was done and evaluated. Results Of the 65 histological sections of breast cancers, 29/65 showed nuclear positivity for Top 2 A. Node positive tumours 17/65 stained positive for Top 2 A. Stage I tumours 2/65, stage II tumours 12/65 and stage III 14/65 stained positive for Top 2 A. Among the HER2/neu-positive tumours, 22/65 stained for Top 2 A and among ER/PR-positive 9/65 cases were positive for Top 2 A. Triple-negative tumours 5/65 stained for Top 2 A. Conclusion Higher Top 2 A expression was seen in higher stage tumours. HER2/neu-positive tumours significantly showed a correlation with Top 2 A positivity. Therefore, Top 2 A expression can be considered an individual prognostic factor in breast carcinoma.

Hyperreflective foci as biomarkers for inflammation in diabetic macular edema: Retrospective analysis of treatment naïve eyes from south India.

Purpose: The aim of this study was to analyze the factors associated with hyperreflective foci (HRF) in diabetic macular edema (DME) in treatment naïve eyes. Methods: This retrospective observational study included 131 eyes of 91 treatment naïve patients with DME. Details of ophthalmological examination with duration of vision loss and systemic parameters were noted. The spectral-domain optical coherence tomography (SD-OCT) images were analyzed for number and location of HRF and the associated imaging biomarkers. Results: Inner retinal (IR) HRF were seen in 88 eyes (67%), outer retinal (OR) in 28 (21%), and subretinal (SR) in 12 (9%). The IR had (7.1 ± 7) HRF, the OR (6.5 ± 4.8), and SR (3.9 ± 2.9). A greater proportion of eyes with HRF also had subretinal fluid (SRF), significantly higher blood pressure and lower serum triglycerides. Univariate linear regression analysis showed women (3 HRF greater vs. men, P = 0.04), eyes with cystoid spaces (2.95 more HRF vs. no cystoid spaces, P = 0.02), and SRF (2.96 more HRF vs. no SRF, P = 0.007) had more HRF, whereas higher triglycerides (1 HRF lesser per 50 mg lower TGL, P = 0.03) had lesser. Conclusion: Our study highlights the importance of HRF as an imaging biomarker in DME suggesting an inflammatory origin. Long-term observations of large cohorts with automated analysis can give more insights.

Outcomes of sutureless and sutured scleral fixated intraocular lens in paediatric population.

PURPOSE: To analyse the outcomes of sutureless and sutured scleral fixated intraocular lenses (SFIOL) in paediatric population. SETTING: Vitreoretina department of a tertiary eye care institute in Southern India. DESIGN: Retrospective case series. METHODS: Data were collected from January 2010 to December 2018 for children less than 18 years of age, based on the following parameters: demographics, pre-operative characteristics, duration between aphakia and surgery, previous amblyopia treatment, the uncorrected (UCVA) and the best corrected visual acuity (BCVA) at baseline and, 1,6 and 12 months or final visit. Early and late post-operative complications along with details of any resurgery was recorded. RESULTS: The study included 45 eyes of 43 patients. The mean age when children became aphakic was 8.8±3.6 years and the mean age at SFIOL implantation 10.1 ± 3.9 years. Sutureless SFIOL was performed for 36 (80%) eyes. The improvement in UCVA was statistically significant at 1-month follow up. Transient hypotony (n = 3), vitreous hemorrhage (n = 7) and raised IOP (n = 4) were the most observed early post-operative complications, while haptic exposure or disinsertion (n = 4, 9%) was a delayed postoperative complication. The mean spherical equivalent at the last follow up was 1.96 ± 0.83D and mean postoperative cylinder 2.32 ± 1.3D. The children were followed up for a mean duration of 20 ± 21.7 months. History of previous vitrectomy was found to be associated with two line reduction in UCVA (95% CI = 0.03-0.5 logMAR, p = 0.008). CONCLUSION: SFIOLs- sutured and sutureless; both were suitable for the rehabilitation of paediatric aphakia. Sutureless scleral fixation is a safe alternative for children but prospective studies with longer follow-up are needed.

Innovative intraocular lens design to manage surgical aphakia in an eye with a filtering bleb.

An innovative intraocular lens (IOL), the CM-T Flex IOL, was used to correct surgical aphakia without disturbing a functioning filtering bleb. A 66-year-old man presented with aphakia in the left eye. Cataract extraction and trabeculectomy was performed in the left eye 2 years previously elsewhere. Corrected distance visual acuity (CDVA) in the left eye was 6/18, and, on examination, it showed a filtering bleb that encroached on the limbus and superior cornea. The cornea was clear with a deep anterior chamber. Retinal examination was normal. Disc cupping was noted with a cup-to-disc ratio of 0.8. Refractive correction was performed by implanting the CM-T Flex IOL. This IOL has a unique design that eliminates the need for maneuvering the IOL haptics extraocularly. It entails a simple grasp, exteriorize, and release technique that anchors the IOL firmly to the scleral bed. At 6 months, CDVA in the left eye was 6/9 with a stable, centered IOL.

The use of air from the infusion line to confirm infusion tip positioning in vitreous surgery for eyes with media opacities.

PURPOSE: To demonstrate the use of an air bubble in infusion to ascertain infusion tip (IT) positioning before commencing vitreoretinal surgery (VRS) in eyes with media opacities. METHODS: Twenty-four eyes were studied. An air bubble was introduced into the IT by manually expelling fluid from the distal end of the IT. Passage of this air bubble into the vitreous cavity immediately on opening the infusion line confirmed IT position and VRS was commenced only after this event. RESULTS: The air bubble was seen within the eye in 18/24 eyes immediately on opening the infusion line. In 6 eyes, the air bubble did not exit the infusion line, and VRS was commenced only after IT position was confirmed by other methods. In all 24 eyes, no untoward effect attributable to the air bubble was noticed during subsequent VRS. CONCLUSIONS: An air bubble introduced into the IT helps to quickly confirm IT position when direct visualization of the IT is difficult. There were no untoward events in eyes where the air bubble could not enter the vitreous cavity.

Refractive outcomes of a single-step and a two-step approach for silicone oil removal and cataract surgery.

Purpose: To compare the intermediate-term refractive outcomes of a single-step and a two-step approach for silicone oil removal (SOR) and cataract surgery. Methods: Case records of patients who had SOR and phacoemulsification (PE) from 2011 to 2013 at a tertiary center in South India were retrospectively analyzed. A total of 135 eyes that underwent ultrasound biometry (UB) were studied. Eighty-seven eyes had SOR and PE at a single surgery (Group A), where as UB was done in a silicone oil (SO) filled eye. Forty-eight eyes had SOR followed by PE later (Group B), where UB was done in a fluid-filled eye. The refractive error (RE) and best-corrected visual acuity (BCVA) at postoperative day 45 (D45) and postoperative month 3 (M3) were compared. Results: Baseline axial length, intraocular lens (IOL) power, and RE in both groups were comparable. A myopic shift (4.18 ± 5.47 diopters [D]) was noted in 92% eyes at M3. Forty-nine percent eyes had a RE of ≤±1.5D at M3. RE at D45 and at M3 was significantly lesser in Group B (-1.73 ± 2.04 vs. -0.64 ± 1.75; P, 0.002). BCVA was significantly lesser in Group A at baseline, at D45, and at M3 (P < 0.01 for all). There was no difference in other baseline characteristics of eyes that had RE ≤±1.5D and those that had RE >±1.5D at M3. Conclusion: SO-filled eyes had a myopic shift in refraction after SOR and PE. When UB is used for IOL power calculation, better refractive outcomes are obtained when SOR and PE are performed in a two-step approach.