Amniotic membrane transplantation (AMT) without the use of sutures/fibrin glue.

INTRODUCTION: Amniotic membrane transplantation (AMT) has been used for a wide variety of ocular surface problems. Current techniques for the AMT involve suturing of the graft or patch over the ocular surface or use of fibrin glue. OBJECTIVE: To describe a new sutureless technique of amniotic membrane transplantation (AMT) without the use of sutures/fibrin glue. MATERIALS AND METHODS: Amniotic membrane transplantation as overlay or patch was done in fourteen eyes of eight patients with severe dry eye due to Stevens Johnson syndrome for ocular surface reconstruction, promotion of epithelization, reduction of inflammation and symptomatic relief from dry eye. In this new technique of amniotic membrane transplantation, we mount the amniotic membrane with its epithelial side up on a conformer and place it on the ocular surface without applying any sutures. CONCLUSION: In all the fourteen eyes of eight patients operated at our centre, the amniotic membrane take up was satisfactory, with significant reduction of inflammation and symptomatic relief from dry eye. This is a simple, fast effective technique with surgical outcomes comparable to amniotic membrane transplantation using sutures/ fibrin glue.

Long-term change in intraocular pressure after extracapsular cataract extraction with posterior chamber intraocular lens implantation versus phacoemulsification with posterior chamber intraocular lens implantation in Indians.

PURPOSE: The purpose of the study is to evaluate the long-term changes in intraocular pressure (IOP) after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. MATERIALS AND METHODS: The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation (ECCE group) and 31 patients were selected for phacoemulsification with PCIOL implantation (Phaco group). IOP was measured pre-operatively and post-operatively, from the 1(st) month to the 12(th) month. Statistical significance was indicated by P > 0.05. RESULTS: There was a mean fall in IOP of 2.70 mm Hg (19.74%) in the ECCE group and 2.74 mm Hg (20.57%) in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant (P > 0.01) at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups (P < 0.05, all post-operative visits). After 4(th) monthpost-operatively, the IOP was mostly stable, but it was significantly lower than the pre-operative IOP. CONCLUSION: Significant IOP reduction may be expected after cataract surgery with either ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4(th) month.

Corneal stromal pseudohypopyon in a pseudophakic patient.

BACKGROUND: Corneal stromal pseudohypopyon is a rare entity. CASE: A 65-year-old female developed a suture abscess in her pseudophakic right eye, three years after conventional extra-capsular cataract extraction with posterior chamber intraocular lens implantation. Pusfrom the suture abscess tracked down the corneal stromal layers and formed a pus level leading to the appearance of a corneal intra-stromal pseudo-hypopyon. CONCLUSION: This case is unique due to its unusual clinical presentation and highlights the fact that corneal pseudo hypopyon may occur without any associated anterior chamber hypopyon or Descemet's detachment.

The predictive value of the relative lens position in primary angle-closure glaucoma.

The relative lens position has been considered to be an important determinant in primary angle-closure glaucoma, but its predictive value needs to be assessed. Therefore, in this tertiary-care center-based case-control study, 70 cases and an equal number of controls were investigated to analyze this association. It was found that, after controlling for age, sex, and refractive error, the relative lens position and anterior chamber depth had a strong association with the disease in separate logit models (P < .01). The predictability of the separate logit models with the relative lens position and anterior chamber depth was found to be statistically significant (-2 x maximized logarithmic likelihood, 93.94 and 19.39, respectively, P < .01). Because the relative lens position represents a composite measure from a set of variables, it can be used as a significant predictive alternative to anterior chamber depth in the genesis of this disease.

Anterior chamber depth and lens thickness in primary angle-closure glaucoma: a case-control study.

Anterior chamber depth and lens thickness have been considered as important biometric determinants in primary angle-closure glaucoma (PACG). In a tertiary care centre-based case-control study, 70 patients and equal number of controls were investigated to analyse the strength of association and predictability of anterior chamber depth (ACD) and lens thickness (LT) in the disease. Mean (+/- S.D.) ACD and LT in the cases and the controls were found to be 2.28 +/- 0.19, 2.87 +/- 0.10; 4.57 +/- 0.34 and 4.13 +/- 0.19 mm respectively. Two sample t test demonstrated statistically significant difference in the ACD and LT between the cases and the controls (Difference being -0.59, 0.44; 95% confidence interval of the difference: -0.64, -0.53 and 0.34, 0.53 respectively, P < 0.01). Logistic regression analysis demonstrated statistically significant protective effect of ACD over PACG (P < 0.01). The odds ratio corresponding to an increase of 0.01 mm in ACD and LT were computed as 0.83 and 1.11 respectively.

Pattern of paediatric ocular problems in north India.

In this study, 3,490 children were examined to know the pattern of ocular problems in children in this part of the country. It showed that heritable diseases were quite prevalent, i.e., 41.49%. In this group refractive error, nasolacrimal duct block, and primary squint were most common, while in the non-heritable group various types of conjunctivitis, trauma, foreign bodies, blepharitis and nutritional diseases were most prevalent.

Alteration in glutathione metabolism during cataract progression.

Human cataractous lenses obtained from eye relief camp showed decreased levels of sulphydryl and glutathione. Significant depletion in activities of glutathione reductase, glutathione peroxidase and glucose-6-phosphate dehydrogenase was also encountered. These findings indicated an impairment in glutathione metabolism of the mature cataractous lenses as compared to immature lenses, and oxidative stress could be considered as a primary event in this process.