RE-INVENTING CYANOACRYLATE RETINOPEXY IN THE 21ST CENTURY: LITERATURE REVIEW AND CASE SERIES.

PURPOSE: We report use of cyanoacrylate (N-butyl-Cyanoacrylate) in previously failed retinal reattachment surgeries for chorio-retinal colobomas. We report the surgical technique, its challenges, and long-term outcomes in three patients who underwent the surgery. METHODS: A chart review of patients with chorio-retinal colobomas and retinal detachment repair with cyanoacrylate at a tertiary eye care center in Nepal. Cyanoacrylate was used to seal colobomatous retinal breaks in eyes which had undergone multiple retinal surgeries with failed outcome. RESULTS: Three eyes that were operated using cyanoacrylate were included. All three patients had attached retina and none of the patients required a long-term tamponading agent. None of the patients underwent head positioning following the surgery. All of the patients had a visual acuity gain of 3/60 or more at the end of 8 months. No adverse or inflammatory reactions were noted. CONCLUSION: We demonstrate that cyanoacrylate is safe and less resource-demanding without a requirement of second surgery to remove a tamponading agent. It could be helpful in eyes with persistent retinal detachment in colobomatous eyes. Because we were able to achieve favorable outcomes without head positioning, we believe it may also be helpful in patients who are not suitable for positioning because of bodily or bony deformities and in retinal detachment with other coexisting trauma.

Eye-glasses wear compliance following school-based visual acuity screening in Nepal: a comparative study.

INTRODUCTION: Eye-glasses wear compliance is found to be low among children in school-based eye screening programs who are provided spectacles free of charge. METHODS: Thirty-six schools from school visual acuity screening program in Nepal were randomly selected to receive no follow-up (standard) or follow-up by an optometry team at 3 months. In the intervention group (that received the follow-up), ophthalmic personal made unannounced visits to the schools at 3 months to determine spectacle compliance .Direct examination to determine compliance with spectacle wear 6 months was done. The primary reason for noncompliance from a list of possibilities was identified using a questionnaire. RESULTS: Among 297 (145 control and 152 intervention) students that received glasses in the 36 schools, 128/152 (84%) were available for examination at 3 months in the intervention group. A total of 216/297 (73%) students were available for examination at 6 months (73 % and 72% of the control and intervention groups, respectively). Within the intervention group, 51% of children at 3 months and 57% at 6 months were wearing glasses during the unannounced visits. The main source of refractive error was myopia. Out of 66 children with astigmatism, 24 (36%) were wearing glasses. There was no statistically significant difference in compliance (p=0.85) between private and public schools, but compliance correlated better with the educational status of careers. CONCLUSION: A follow-up visit to the school by eye care personnel did not improve spectacle wear compliance among children .Other factors may also be responsible for poor compliance.