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.

A rare case of bilateral optic neuritis post-Covishield (ChAdOx1-S [recombinant]) vaccination.

Multiple adverse effects have been reported in people receiving the COVID-19 vaccinations including few reports of optic neuritis. However, there is no report till date, of bilateral optic neuritis post-ChAdOx1-S (recombinant) vaccination. We report here, for the first time, such a case in a previously healthy woman. Although a direct causal relationship cannot be proven, there was a temporal association between the vaccination and the onset of optic neuritis. Some vaccine adjuvants inciting disproportionate systemic inflammation, molecular mimicry, and the hypercoagulable state seen after COVID-19 vaccination could be the possible causes for the development of optic neuritis. Clinicians should be aware of this adverse effect apart from various other adverse effects of COVID-19 vaccination.

Multisystem Inflammatory Syndrome in Children (MIS-C) Related to SARS-CoV-2 and 1-Year Follow-up.

OBJECTIVE: To study the demographics, clinical profile, management, outcome and 1-y follow-up of children with multisystem inflammatory syndrome in children (MIS-C). METHODS: This was a retrospective observational study of 54 Children satisfying the WHO MIS-C criteria admitted during the study period. RESULTS: Fifty-four children were included in the study, median age was 5.5 (IQR 8.75), 68.5% were males. PICU admissions were 77%. Most involved organ was gastrointestinal (92%), followed by cardiovascular 85%, central nervous system (CNS) 74%, respiratory 72%, mucocutaneous 59%, and renal 31%, and hypotension was the presenting symptom in 43%. Coronary artery dilatation was seen in 1 (1.8%) child. All patients presented with more than three organs involvement. Raised procalcitonin was seen in 100%, raised BNP in 31.5%, low ejection fraction in 83.3%, and abnormal radiograph in 59%. All children were positive for anti-SARS-CoV-2 antibodies and negative for cultures. Methylprednisolone or intravenous immunoglobulin (IVIg) was used in 77%, mechanical ventilation in 18.5%, and inotropic support in 77%. Aspirin was used in 48% and low molecular weight heparin (LMWH) in 54%. The median stay in hospital was 7 d (IQR 2). There was 1 mortality (1.8%). On 7-d follow-up, 98% children had a normal echocardiography; on 6 mo and 1-y follow-up, all children had normal echocardiography. CONCLUSION: MIS-C is an important complication of COVID-19 infection. Cardiac involvement resolves completely. Coronary artery involvement is not common.

Outcomes of a simplified, fixed surgical dosage calculation for uncomplicated, horizontal, concomitant strabismus in adults.

Purpose: The aim of this study was to evaluate the outcomes of a simplified, fixed surgical dosage calculation for uncomplicated, horizontal, concomitant strabismus in adults. Methods: Outcomes analysis of a fixed-dose calculation method for uncomplicated, horizontal, concomitant strabismus in adults (≥18 years) wherein 1-mm recession/resection equals 2 PD for lateral rectus and 3 PD for medial rectus. This was a retrospective case series. Results: The mean age of the patients was 28.50 ± 8.43 years, the mean amount of preoperative deviation was 35.16 ± 9.97 PD, the mean expected correction was 36.26 ± 9.49 PD, and the mean correction achieved was 35.92 ± 10.74 PD. There were 22 monocular exotropias, six monocular esotropias, eight alternate divergent squints, and two alternate convergent squints. There were 20 cases of sensory strabismus (54.28%). There was no statistically significant difference between the expected correction and correction achieved (P = 0.519), meaning that our fixed-dose calculation method was effective. Thirty-five out of 38 patients had successful outcomes as per our criteria of less than 10-PD deviations from straight in primary position. Therefore, the success rate achieved by this procedure was 92.10%. There was no statistically significant correlation between age and the amount of deviation (P = 0.611). Conclusion: Our case series had a high postoperative success rate in terms of motor alignment. It is hoped that this simplified, fixed-dosage calculation method would help the numerous novice strabismus surgeons, make their starting steps easier and give them the confidence to do strabismus surgeries. They can modify the dosages later as per their own experiences.