Comparison of Hill-RBF 3.0 with Barrett Universal II, SRK/T, Hoffer Q, Haigis, and Holladay 1 to predict the accuracy of post-cataract surgery refractive outcomes in Indian eyes.

PURPOSE: To compare Hill-RBF 3.0 with Barrett Universal II (BU II), SRK/T, Hoffer Q, Haigis, and Holladay 1 in predicting the accuracy of post-cataract surgery refractive outcomes in Indian eyes. METHODS: In this prospective, comparative, observational study, consecutive patients with uncomplicated age-related cataracts undergoing uneventful phacoemulsification with posterior chamber intraocular lens (IOL) implantation were included. The mean absolute errors (MAEs) and median absolute errors were used to determine the accuracy of predicted postoperative target refractions. RESULTS: A total of 219 eyes of 173 patients were enrolled. Based on the axial lengths (AL), the patients were classified into: AL <22 mm (short), 22-24.5 mm (normal), and >24.5 mm (long). BU II exhibited the lowest MAE for normal ALs (0.2683 ± 0.2790 D) as well as for the entire population (0.2764 ± 0.2764 D). For the short ALs, Hill RBF 3.0 exhibited the lowest MAE (0.3268 ± 0.3268 D), while for the long ALs, SRK/T showed the lowest MAE (0.2823 ± 0.2642 D). BU II exhibited the highest percentage of eyes of 57.5%, 95.4%, and 98.6% within ±0.25, ±0.75, and ±1.0 D of postoperative target refractions respectively, whereas Hill RBF 3.0 had the highest percentages of eyes (88.1%) within ±0.5 D of postoperative target refraction. CONCLUSION: Hill-RBF 3.0 exhibited the least MAE for patients with short ALs, while BU II showed the least MAE for normal ALs as well as for the entire population and SRK/T for long ALs. This study is likely to aid surgeons in selecting the most appropriate IOL power formula, which thereby improves the refractive outcomes with utmost accuracy.

Ocular biometry characteristics and corneal astigmatisms in cataract surgery candidates at a tertiary care center in North-East India.

Purpose: The purpose of this study is to determine the ocular biometry characteristics and corneal astigmatisms using partial coherence laser interferometry in patients aged 40 years or above undergoing cataract surgery in a medical college in North-East India. Methods: In a hospital-based cross-sectional study, ocular biometry characteristics such as axial length (AL), anterior chamber depth (ACD), white-to-white (WTW) diameter, corneal power (K), and corneal astigmatisms (D) of consecutive eligible cataract patients in a medical college in North-East India between January 2015 and December 2017 were determined using the intraocular lens (IOL) master. Height and weight were also measured. Results: A cross-sectional study evaluated ocular biometry characteristics of 641 eyes in 641 eligible patients. The mean age was 64.04 ± 10.81 years. The mean AL, ACD, WTW, corneal power, IOL power, and body mass index (BMI) were 23.34 ± 1.12 mm, 3.12 ± 0.39 mm, 11.92 ± 0.54 mm, 44.41 ± 1.50 diopter (D), 20.53 ± 2.79 D, and 26.12 ± 4.32, respectively. Against-the-rule, with-the-rule, and oblique astigmatisms were 48.4%, 33.2%, and 18.4%, respectively. Corneal astigmatism of ≥1 D was found in 292 eyes (45.55%) and >1.5 D in 182 eyes (28.39%). AL had statistically significant correlation with ACD, WTW, K, IOL power, height and weight but not with age. By multivariate analysis, AL was found to be associated with ACD, WTW, K and IOL power (P ≤ 0.05). The mean AL was negatively correlated with the mean K (R-square 0.138). Conclusion: This study is likely to provide the initial normative data for ocular biometry values in Indian adults 40 years or above, because such data is lacking in Indians using the IOL master. This will also help ophthalmologists in planning and improving the quality of surgical outcomes in phacoemulsification and phacorefractive surgeries by choosing the appropriate IOL and incision location.

A challenging case of a large intraorbital foreign body perforating the nasal septum in a child.

A 5 year old boy with a history of fall from a height of about 4 feet, presented after one week with swelling, watering and discharge of the right eye. He had severe conjunctival chemosis with superior displacement of the globe. Computed Tomography (CT) showed a linear low attenuation tract in the right orbit extending from the inferolateral wall up to the left uncinate process of the ethmoid bone with increasing Hounsfield unit after 10 days. The parents did not agree for early exploration. After 10 days an exploration was done and a large linear and irregular wooden foreign body (FB) measuring 4.5 x 1.5 cm2 was removed from the right orbit and a smaller one from the nasal cavity. Four weeks post surgery, his vision was 6/9 in the right eye with the eyeball in the normal position. This case was challenging because of the late presentation, parents not agreeing for early exploration, difficulty in diagnosing by CT and a large and very deep penetrating FB.

Sutureless, Glue-less Conjunctival Autograft versus Conjunctival Autograft with Sutures for Primary, Advanced Pterygia: An Interventional Pilot study.

INTRODUCTION: Conjunctival Autograft (CAG) in pterygium surgery can be attached by sutures or fibrin glue or autologous in situ blood coagulum. Recurrence rate and other parameters related to pterygium surgery between CAG with sutures and autologous in situ blood coagulum have not been compared uniformly in advanced pterygia alone. AIM: To compare and evaluate the outcome of sutureless, glue-less CAG with autologous in situ blood coagulum versus CAG with sutures for primary, advanced pterygium. MATERIALS AND METHODS: Thirty eyes of 30 patients with primary, nasal, advanced, Grade 3 pterygia (as per Tan et al's., classification) were randomized into Group 1 (n=15) (sutureless, glue-less CAG with autologous in situ blood coagulum) and Group 2 (n=15) (conjunctival autograft with 8-0 vicryl sutures) as a pilot study. The outcome parameters evaluated were graft stability and symptoms of pain, foreign body sensation and watering at day 1, day 7, day 14, one month, three months and six months and recurrence at six months. RESULTS: The mean age in the study was 44.77±13.74 years. Overall, Group 1 had better scores in symptom parameters than Group 2 (p<0.05). Graft stability was better in Group 2 (p<0.05). In Group 1, 3 (20%) patients had one side displacement and 3 (20%) patients had full displacement of graft. At six months, 4 (26.6%) patients in Group 1 had recurrence whereas in Group 2, 5 patients (33.3%) had recurrence (p=0.446). CONCLUSION: In primary, advanced pterygia, sutureless, glue-less pterygium surgery with autologous in situ blood coagulum was better in symptom scores but graft stability was better in the suture group. Sutureless, glue-less pterygium surgery with autologous in situ blood coagulum was unpredictable in graft stability. There was no statistically significant difference in the recurrence rate between the two groups.

Comparative Study of Efficacy and Safety of Ferric Carboxymaltose Versus Iron Sucrose in Post-partum Anaemia.

BACKGROUND: The incidence of post-partum anaemia (PPA) is 14-24%. Treatment of PPA with injectable iron replenishes the iron store. Ferric carboxymaltose complex (FCM) is a non-dextran containing intravenous iron agent, having a very low immunogenic potential, designed to be administered in large doses in a short period of time. OBJECTIVE: To compare the efficacy and safety of intravenous FCM and iron sucrose (IS) in post-partum iron-deficiency anaemia. MATERIAL AND METHOD: In this prospective, comparative study, 120 post-partum women with iron-deficiency anaemia (Hb < 10 g%) were divided into two groups. A fixed dose of 1000 mg of FCM or IS was given within 10 days of delivery. Hb and serum ferritin were repeated 14 days post-transfusion. RESULT: There is a mean increase in Hb (P value 0.000, 0.000) and ferritin (P value 0.000, 0.000) in both the groups. For intergroup comparison, independent Student's t test was performed which showed FCM was superior to IS (P value 0.000 and 0.000). CONCLUSION: In our study, FCM was very effective in improving Hb concentration as well as in early replenishment of iron stores in patients with PPA. Large doses given in a short period of time not only save hospital resources but also improve patient satisfaction. It has significant benefit for use in the outpatient department. From this study, we can recommend its use in post-partum women with iron-deficiency anaemia.

A Comparative Study of Single Incision versus Conventional Four Ports Laparoscopic Cholecystectomy.

INTRODUCTION: Cholelithiasis is one of the most common disorders of the digestive tract encountered by general surgeons worldwide. Conventional or open cholecystectomy was the mainstay of treatment for a long time for this disease. In the 1980s laparoscopic surgery revolutionized the management of biliary tract diseases. It brought about a revolutionary change in the basic concepts of surgical principles and minimal access surgery gradually started to be acknowledged as a safe means of carrying out surgeries. AIM: To investigate the technical feasibility, safety and benefit of Single Incision Laparoscopic Cholecystectomy (SILC) versus Conventional Four Port Laparoscopic Cholecystectomy (C4PLC). MATERIALS AND METHODS: This prospective randomized control trial was conducted to compare the advantages if any between the SILC and C4PLC. Thirty two patients underwent SILC procedure and C4PLC, each. The age of the patients ranged from 16-60years. Other demographic data and indications for cholecystectomy were comparable in both the groups. Simple comparative statistical analysis was carried out in the present study. Results on continuous variables are shown in Mean ± SD; whereas results on categorical variables are shown in percentage (%) by keeping the level of significance at 5%. Intergroup analysis of the various study parameters was done by using Fisher exact test. SPSS version 22 was used for statistical analysis. RESULTS: The mean operating time was higher in the SILC group (69 ± 4.00 mins vs. 38.53 ± 4.00 mins) which was of statistical significance (p=<0.05). Furthermore, the patients of the SILC group had less post-operative pain, with lesser analgesic requirements (p=<0.05), shorter hospital stay and earlier return to normal activity. CONCLUSION: SILC is feasible and safe in trained hands. It did not compromise the procedural safety, or lead to any complication. The operating time was longer otherwise it has almost similar clinical outcomes to those of C4PLC.