BACKGROUND The prevalence of glaucoma blindness is about 8% of global blindness and in India is about 4.4%. The Intraocular Pressure (IOP) is a single major modifiable risk factor in glaucoma. In order to integrate IOP and CCT as a single risk factor, a new index 'Pressure-to-Cornea Index' (PCI) was proposed. But studies regarding the fact that the increased values of PCI will be a risk factor for glaucoma are limited. This study attempts to describe the role of PCI as a predictive risk factor in clinical POAG. The aims and objectives of this study are to determine the PCI values in POAG, OHT and NTG and to determine whether PCI can be used as a predictive value in clinical Primary Open Angle Glaucoma (POAG). MATERIALS AND METHODS This observational, cross-sectional type of study was conducted over a period of six months, in 478 eyes of patients attending the outpatient at Govt. Rajaji Hospital, Madurai, who satisfied the inclusion-exclusion criteria. IOP estimation by GAT and CCT measurement by Ultrasound Pachymetry was done in all of them. After routine glaucoma evaluation, they were segregated as Group 1: Normotensives (374), Group 2: Ocular Hypertension (29), Group 3: Normal Tension Glaucoma (28) and Group 4: Primary Open Angle Glaucoma (47). Data collected were entered in Master Chart and statistical analysis was done using software IBM SSPS Ver 21.0 (Armonk, NY) by our statistician. The study groups without clinical POAG are Group 1 and Group 2 (mean PCI value of 92 and 117). The study groups with clinical POAG are Group 3 and Group 4 (mean PCI value of 134 and 171). This study demonstrates a significant correlation between PCI levels and glaucomatous changes in eyes. The PCI value may be also useful in the management of glaucoma for setting a target IOP. RESULTS The obtained 'P' value is < 0.001 which is statistically significant says that there is a difference in the IOP measurements and CCT measurements between the 4 groups (Normal, Ocular Hypertension, Normotensive Glaucoma and Primary Open Angle Glaucoma). CONCLUSION The value of PCI is significantly increased in glaucomatous (POAG and NTG) eyes. This emphasises that PCI can be used as a predictive index in development of glaucomatic changes in optic disc in the population.
BACKGROUND Pseudoexfoliation syndrome is an age-related systemic disease manifesting itself primarily in the eyes and is characterised by the accumulation of microscopic granular amyloid-like protein fibres. Pseudoexfoliation is the most commonly seen identifiable cause of secondary glaucoma. The significance is that, it has a more aggressive clinical course with higher IOP readings and is difficult to treat due to poor response to medications. Aim-To find out the distribution of PCI in patients with Pseudoexfoliation (PXF) and to find out whether PCI can be taken as a predictor for clinical open angle glaucoma (OAG) secondary to pseudoexfoliation. MATERIALS AND METHODSOurs was a non-randomised, cross-sectional observational study conducted over a period of 6 months among 112 eyes of patients above 40 years of age with pseudoexfoliation. The eyes were categorised into the following 4 groups: Group 1-Pseudoexfoliation syndrome; Group 2 -Eyes with pseudoexfoliation with normal corrected IOP but with glaucomatous disc and visual field changes; Group 3 -Eyes with pseudoexfoliation with raised IOP, but with normal disc and visual field; Group 4 -Pseudoexfoliative glaucoma. All the statistical analysis was done using statistical software IBM SPSS Ver. 21.0 (Armonk, NY). RESULTS49 eyes PXS as Group 1, 19 eyes in group 2, 16 eyes in group 3 and 28 eyes in Group 4. Kruskal-Wallis test was used to compare the IOP, CCT and PCI measurements between the groups -P value is <0.001 which is statistically significant. The mean, SD and range in non-glaucomatous and glaucomatous eyes were compared using Rank sum, Mann-Whitney U test -P value <0.001 is statistically significant. This study shows that PCI can differentiate between glaucomatous and non-glaucomatous eyes better than the IOP levels in eyes with Pseudoexfoliation. This can be highly helpful in PXS patients with high PCI, to have a close followup schedule and for early diagnosis and treatment of pseudoexfoliative glaucoma, so that further damage to optic nerve head can be prevented. CONCLUSIONIncreased PCI values in PXG patients can more accurately indicate the severity of glaucoma.
AIMS AND OBJECTIVES OF THE STUDY:To study the external DCR with suturing of both anterior and posterior flaps or only anterior flaps in patients with chronic dacryocystitis attending MMC and RI Mysore. MATERIALS
To study the intra-operative complications and their management in patients having cataract with pseudoexfoliation syndrome and assess their post-operative visual outcome. METHODS: Retrospective analysis of 500 eyes of 500patients having significant cataract with PEX undergoing MSICS after complete pre-operative assessment and follow-up on 1 st , 3 rd , 7 th , 15 th , 28 th day and at the end of 6 weeks. All MSICS were done by the same surgeon. RESULTS: Out of 500 cases with cataract and pseudoexfoliation syndrome, 450 (90%) patients got BCVA as 6/6-6/18 postoperatively. The most common complication seen was zonular dehiscence followed by PCR and vitreous loss. CONCLUSION: This study demonstrated an increased incidence of intra operative complications in patients having PEX with cataract undergoing MSICS.
PURPOSE:To study and compare the efficacy of peri bulbar anaesthesia with para bulbar anaesthesia in patients undergoing manual small incision cataract surgery (MSICS). METHODS: Two hundred patients were randomized to peri bulbar and para bulbar groups. All surgeries were performed by same surgeons. Pain during administration of anaesthesia, 1 hour after surgery and 6 hours after surgery was graded on a visual analogue pain scale and compared for both the techniques. The ocular akinesia after anaesthesia was compared for both the techniques. RESULTS:There was no significant difference in pain between both the groups during anaesthesia, 1hour after anaesthesia and 6 hours after anaesthesia. There was no significant difference in the ocular akinesia between both the groups. CONCLUSION: Subtenon's technique for administration of anaesthesia during MSICS is as safe and effective as the peri bulbar technique giving equally good analgesia during and after the surgery. KEYWORDS: Manual small incision cataract surgery, peri bulbar anaesthesia, para bulbar anaesthesia.
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