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.