Sodium bicarbonate versus sodium hyaluronidase in ocular regional anaesthesia--a comparative study.

It has been reported that alkalinisation of an anaesthetic medication enhances the rate of onset of regional anaesthesia. The purpose of this study therefore was to find out whether alkalinisation really hastened peribulbar anaesthesia as given prior to routine cataract surgery. Two hundred and forty otherwise healthy patients with bilateral cataracts were selected for this study irrespective of their demographic attributes. The first eye (group FE) received a routine peribulbar block with a standard solution of 6 ml of 2% lignocaine mixed with 15 IU/l units of sodium hyaluronidase at a pH of 4.6. The second eye (group SE) was taken up for surgery after one week and received a peribulbar block with 6 ml lignocaine 2% mixed with 7.5% sodium bicarbonate at a pH 7.4. The time taken for onset of akinesia in both the situations was measured to the last minute with the aid of a stop watch by an independent observer. Thirty-five per cent of patients in group FE had complete akinesia at the end of 5 minutes, another 60% at the end of 7 minutes and remaining 6% at 10 minutes. Sixty-eight per cent of patients in group SE had complete akinesia at the end of 5 minutes and 100% at the end of 7 minutes. No anaesthesia related ocular or systemic complications were seen in any group. Sodium bicarbonate buffered peribulbar block is faster than routine hyaluronidase augmented block with a reduced time of onset of akinesia.

Managing post acute congestive phase by combined manual small incision cataract surgery and trabeculectomy: a prospective study.

The purpose of the study was to evaluate the therapeutic efficacy of manual small incision cataract surgery (SICS) and trabeculectomy as management option for acute angle closure glaucoma. The first 6 cases of 14 cases of acute angle closure glaucoma seen over a period of 18 months underwent surgical peripheral buttonhole iridectomy (PBHI) after their intra-ocular pressure (IOP) was controlled medically. Subsequently 8 cases underwent manual SICS+trabeculectomy as an alternative procedure after their IOP control who needed further surgery and overall patients' comfort. The results showed sustained visual acuity remained 6/9 or better in all the patients of SICS + trabeculectomy group, compared 6/12 or worse in the PBHI group. Mean non-contact tonometry reading at the end of 6 weeks was 10.2 mm Hg in the second group compared to 14.6 in the first group. None of the patients in the second group ever needed surgery in a 4-month follow-up, whereas 3 patients in the first group had to be operated again for cataract or uncomplicated IOP. Manual SICS+ trabeculectomy offers a good, economical and rational therapeutic alternative to traditional PBHI in the postcongestive phase.

Tissue adhesive in ophthalmology.

Tissue adhesive in ophthalmology is commonly used for corneal wound and restricted for superficial closure. Only synthetic adhesive available is butyl-2-cyanoacrylate. However, if it gets between the wound margins it inhibits healing by forming impervious barrier.

Xerophthalmia: a study among malnourished children of West Mednipur District.

To study the correlation of stages of xerophthalmia in different grades of malnutrition, having 200 children clinically diagnosed having malnutrition as per criteria laid down by the Indian Academy of Pediatrics (IAP) were examined to detect the dinical stages of xerophthalmia as proposed by World Health Organisation (WHO). Out of 200 cases with different grades of malnutrition 81 (40.5%), 78 (39.0%), 22 (11.0%) and 19 (9.5%) were found malnourished in grades I, II, III, and IV respectively. Night blindness was earliest feature and seen in 97 cases (48.5%). All the 97 cases of night blindness fell in group of X(N) in which one case had corneal scar and falls in the group of X(S) in clinical staging of xerophthalmia. Thirty-nine (40.2%), 35 (36.1%), 19 (19.6%), 3 (3.1%) and (1.1%) were in clinical stages of xerophthalmia of X(1A), X(1B), X2, X(3A), X(3B)respectively. Severity of xerophthalmia was found directly proportional to severity of malnutrition.