Delayed closure of a full-thickness macular hole following pars plana vitrectomy with ILM flap.

PURPOSE: Our aim is to describe a patient with delayed closure of a stage 3 full thickness macular hole after pars plana vitrectomy. METHODS: A retrospective case report. Details of the case were obtained from the electronic patient record system, Medisoft. RESULTS: A 65-year-old male was referred with a left stage 3 full thickness macular hole measuring 720 microns and visual acuity of 6/36. He underwent phaco-vitrectomy, ILM peel with an inverted ILM flap and C3F8 gas tamponade. 7 weeks after surgery, the macular hole was smaller at 196 microns but remained open. The patient was listed for repeat surgery, however another 13 weeks later the full thickness macular hole demonstrated type 2 closure without further intervention. DISCUSSION/CONCLUSION: Delayed macular hole closure after pars plana vitrectomy is rare. In cases where there has been a substantial decrease in the size of a full thickness macular hole after surgery without full closure, a short period of observation to allow for further closure may be appropriate before reconsidering surgery.

An In Vitro Stereomicroscopic Evaluation of Bioactivity between Neo MTA Plus, Pro Root MTA, BIODENTINE & Glass Ionomer Cement Using Dye Penetration Method.

The ideal root end filling material should form a tight seal in the root canal by adhering to the cavity walls. Several materials have been used for root end filling. The present study aims to find out and compare the bioactivity of Neo MTA Plus, Pro Root MTA White, BIODENTINE & glass ionomer cement as root end filling materials using 1% methylene blue as tracer. MATERIALS AND METHODS: 80 extracted human permanent maxillary anterior teeth were used in the study. They were divided into four groups. Specimens were sectioned transversely in the cervical area to separate the crown from the root. The root canal was obturated with gutta percha and zinc oxide eugenol sealers. Thereafter, each sample was resected apically by removing 3 mm of the apex and filled with different materials. Samples were kept in buffering solution at 37 °C until the recommended evaluation periods. The specimens were then suspended in 1% methylene blue for 24 h, prior to the analysis. The teeth were then sectioned, and dye penetration was examined, photographed, and evaluated under a stereomicroscope. RESULTS: Vertical dye penetration showed significant differences across different groups. The minimum dye penetration was seen in Neo MTA plus followed by BIODENTINE, Pro Root MTA and maximum in GIC. There was no significant difference in dye penetration between Neo MTA plus and BIODENTINE both at fifteen days and one-month intervals. CONCLUSION: The present study suggests Neo MTA plus and BIODENTINE should be the preferred material for root end filling.

Assessment of Antimicrobial Effectiveness of Neem and Clove Extract Against Streptococcus mutans and Candida albicans: An In vitro Study.

BACKGROUND: There is increasing interest to develop antimicrobial aids from alternative sources such as medicinal plants for the treatment of infectious diseases. Neem and clove are known to have antimicrobial properties. AIM: The study aimed at detecting the antibacterial and antifungal activity of neem and clove extract against Streptococcus mutans and Candida albicans. MATERIALS AND METHODS: Strains of S. mutans and C. albicans and selective media for growing micro-organisms were procured. Antimicrobial activity was assessed using two methods, by determining the minimum inhibitory concentration (MIC) using the broth dilution method and determining the zone of inhibition using well diffusion method on mitis salivarius bacitracin selective for S. mutans and Saboraud's dextrose agar plates for C. albicans. One way ANOVA with post hoc analysis was done to compare the antimicrobial activity of extracts and 0.2% chlorhexidine. RESULTS: MIC of neem extract was found to be 4.2 mg/ml and 5.0 mg/ml against S. mutans and C. albicans, respectively. While for cloves, it was 5.5 mg/ml for both. Neem had the highest antibacterial activity with a mean zone of inhibition of 11.4 mm followed by chlorhexidine and cloves whereas antifungal activity was highest for chlorhexidine (14.4 mm) followed by neem and clove. CONCLUSION: The result of the study established that both plant extracts possess antimicrobial activity against common microbes present in the oral cavity.

Surgical outcomes and complications of sutured scleral fixated intraocular lenses in pediatric eyes.

OBJECTIVE: To study the outcome and complications of sutured scleral fixated intraocular lenses (SSFIOL) in children. DESIGN: Retrospective study. SUBJECTS: A total of 279 eyes of 230 children who underwent SSFIOL at ≤18 years of age in a tertiary eye care centre in India. METHODS: Treatment-naive children having traumatic cataract or subluxated lens underwent a single-sitting lensectomy and pars plana vitrectomy (PPV), along with SSFIOL insertion. Children with aphakia underwent PPV with SSFIOL, and vitrectomized eyes underwent only SSFIOL implantation. Fixation of SSFIOL was done by the 4-point ab externo fixation technique using 10-0 prolene suture. MAIN OUTCOME MEASURES: Preoperative and postoperative visual acuity, as well as intraoperative and postoperative complications. RESULTS: The mean age at which SSFIOL was performed was 10.8 ± 4.22 years. The most common indication of SSFIOL in our study was traumatic subluxation of lens (47.63%; n = 133 patients), followed by congenital subluxation in 38.7% (n = 108). Best-corrected visual acuity was maintained or improved from the preoperative visual acuity in 93.19% of eyes. The complications included choroidal detachment in 2.86% (n = 8), dispersed vitreous hemorrhage in 2.86% (n = 8), endophthalmitis in 0.72% (n = 2), raised intraocular pressure in 12.54% (n = 35), diplopia in 0.72% (n = 2), retinal detachment in 5.73% (n = 16), and dislocation of the SSFIOL in 4.6% (n = 13). The mean follow-up after SSFIOL implantation was 39.68 months. CONCLUSIONS: SSFIOLs are effective in correcting aphakia in children; long-term follow-up of these children is, however, necessary.

Nodular syphilitic scleritis masquerading as an ocular tumor.

BACKGROUND: Scleritis may be the initial or only presenting feature of systemic, autoimmune, or infectious disorders. Corticosteroids are the mainstay of treatment for immune-mediated scleritis. However, steroids could prove detrimental when used to treat infectious scleritis. Hence, infectious causes of scleritis should be ruled out. FINDINGS: A 47-year-old male from central India presented with swelling, pain, and redness in the left eye since 2 months. The patient was diagnosed elsewhere as having an extraocular extension of intraocular tumor and advised radiation brachytherapy for the same. Clinical examination revealed nodular scleritis in the left eye. The patient did not have any systemic illness or complaints suggestive of connective tissue disease. Laboratory investigations ruled out the same. However, Venereal Disease Research Laboratory (VDRL) test was positive. Rapid plasma reagin (RPR) test and Treponema pallidum hemagglutination assay (TPHA) were also positive, confirming the diagnosis of syphilis. Ultrabiomicroscopy (UBM) and ultrasound scan of the eye ruled out intraocular tumor. Treatment was initiated with benzathine penicillin 2.4 million units per week for 3 weeks to which the patient responded remarkably well. CONCLUSIONS: Although rare, syphilis can present as nodular scleritis masquerading as ocular tumor. Syphilis must be considered in the list of etiological diagnoses in patients presenting with nodular scleritis, and testing for this disease should be a part of routine investigation in patients with scleritis.