Slit-beam retro-illumination assisted phacoemulsification for cataract with coexisting corneal opacity.

INTRODUCTION: We describe a novel surgical technique of slit-beam retro-illumination assisted phacoemulsification for cataract with coexisting corneal opacity. CASES: We present two cases with cataract and coexisting opacity, who underwent slitbeam retro-illumination assisted phacoemulsification and further application of same process in 12 patients. CONCLUSION: This technique is safe and provides excellent visualization during cataract surgery in patients with corneal opacities.

Long-Term Visual Outcome in Surgical Management of Cataract Coexistent With Corneal Opacity in One-Eyed Patients.

PURPOSE: To determine the visual outcome and safety of cataract surgery alone and compare with the long-term visual outcome of triple procedure in one-eyed patients. DESIGN: Retrospective study. METHODS: This study reviewed 44 one-eyed patients with cataract coexistent with corneal opacity. The patients who underwent cataract surgery alone (group A, n = 25) were compared with patients managed by triple procedure (group B, n = 19). Outcome measures were the improvement of best corrected visual acuity (BCVA) and period of maintained ambulatory vision. Institutional ethics committee approval was obtained. RESULTS: The most common etiology of corneal opacity was fungal and the commonest cause of permanent visual loss in other eye was phthisis bulbi. Mean age was 61.2 ±â€Š8.1 years and 62.5 ±â€Š6.9 years in groups A and B, respectively. At each follow-up, the mean postoperative BCVA was found significantly better than the preoperative vision in both groups and at the end of 3 years, mean postoperative vision of group A was better than that of group B (P = 0.012). Group A had longer (33.36 ±â€Š11.97 months) mean period of maintained ambulatory vision than that of group B (26.5 ±â€Š13.5 months) (P = 0.245) and showed less risk of losing ambulatory vision. Limited visual outcome was due to continuing presence of corneal opacity in group A, and graft infection and graft rejection in group B. CONCLUSIONS: Cataract surgery with intraocular lens (IOL) implantation alone can be considered as an alternative or temporary option to provide stable ambulatory vision in one-eyed patients.

Causes of visual impairment in applications for blindness certificates in a tertiary center of Bihar and its role in health planning.

PURPOSE: To analyze applications for blindness certificates to find causes of visual impairment (VI), handicap, and blindness in a tertiary hospital of Bihar. METHODS: Applications for blindness certificates were analyzed over a two-year period. The main cause of blindness, visual handicap, and VI in these applications was ascertained by age group and etiology. VI disability percentages and definitions proposed by Governmen of India (category 0-4; 20-100%) were used to categorize and give percentage to all applicants. Results were compared with data from studies on blindness certificates and population based studies. RESULTS: In total, 203 applicants were reviewed. Mean age was 23.5 ± 7.9 years. Overall, most common cause of visual handicap (40-100% impairment) and blindness (75-100% impairment) was macular pathology (P <.05), while most common cause of overall VI (20-100% impairment) was amblyopia. In age group 0-15 years, most common causes of blindness/visual handicap were congenital globe and hereditary retinal or optic nerve disorders (P = 0.016). In age group 16-30 years, macular pathology was the most common cause of visual handicap [P = 0.007], while amblyopia was the most common cause of VI [P = 0.00]. Between 31 and 45 years of age group, corneal scar in one eye was the most common cause of VI, while macular scar in both eyes was the most common cause of visual handicap. Glaucoma and diabetic retinopathy were the most common causes of blindness/visual handicap between 46 and 65 years and above 65 years of age, respectively. Data about causes of VI such as amblyopia, complicated cataract surgery, and one eyed blindness could not be ascertained by analyzing blindness certificate alone. CONCLUSION: Data from applications for blindness certificates provide valuable information regarding different causes of VI that might otherwise not be eligible for blindness certification and provide an insight into the overall trends in disease profile and service delivery.

Safety and efficacy of fibrin glue versus infinity suture in SICS with extended scleral flap.

Purpose: To study the safety and efficacy of biologic fibrin glue (FG) in comparison with infinity suture in SICS with compromised scleral flap. Methods: A retrospective comparative study of patients who were treated with FG (Group A) with 10-0 nylon (Group B) as sealing agent for intraoperative compromised tunnels in SICS. Parameters noted were postoperative inflammation, wound integrity, anterior chamber (AC) depth, intraocular pressure (IOP), and surgically induced astigmatism (SIA) at postoperative day 1, 4 weeks, 6 weeks, and 6 months, respectively. Epi Info 7 software and SIA calculator, Version 2.1 were used to analyze the result. Results: We reviewed the two groups of 18 patients each and noted that there was no statistically significant difference in postoperative inflammation (P > 0.05), AC depth (P > 0.05), and IOP (P > 0.05) between both groups at each postoperative visit. One patient in Group A showed postoperative shallow AC and subconjunctival bleb. Exposed sutures causing foreign body sensation had to be removed in five patients in Group B. At the end of 6-month postoperative period, no statistically significant difference was found in SIA (P = 0.92) between the two groups. Conclusion: Biologic FG can be safely used in securing the compromised scleral incisions in SICS. It also avoids suture-related complications.

Why Should Viral Markers Be Mandatory in Ocular Surgeries: A Hospital Based Retrospective Study.

INTRODUCTION: Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus I, II (HIV-I,II) are serious global and public health problem. Knowledge of the seroprevalence would enable early diagnosis, treatment of patients and also help in prevention of horizontal spread of infection by application of universal infection control measures. AIM: To determine the seroprevalence of HBV, HCV and HIV I, II infection in patients undergoing ocular surgery. MATERIALS AND METHODS: A retrospective review of 560 patients who had undergone ocular surgery between Dec 2014 to June 2015 at Regional Institute of Ophthalmology, Patna, India, was done. Blood samples of patients were tested for the presence of Hepatitis B Surface Antigen (HBsAg) and anti-HCV antibodies by Enzyme Linked Immunosorbent Assay (ELISA) method, while HIV I, II was tested by ELISA and Western Blot as per National AIDS Control Organization (NACO), India guidelines. The number of patients with positive viral serology, age, sex ratio and nature of surgery were analysed. RESULTS: Out of 560 patients, 27 (4.8%) patients were found to be positive for viral serology. HBsAg was positive in 22 patients (3.92%). Out of these 14 patients (2.5%) were male while 8(1.4%) were females. Anti- HCV was positive in 3 (0.53%) patients. Out of these 2(.35%) were male and 1 (.17%) was female. HIV was positive in 2 patients (0.35%), both of whom were males. CONCLUSION: Keeping in view the number of cases of seropositivity in our study and various studies showing the presence of these viruses in aqueous and tears, we suggest that screening for viral markers should be made mandatory before ocular surgery so that early detection and treatment of patients can be done and risk of horizontal spread is minimized.