No abstract

Purpose:This study aimed to propose the role of amniotic membrane transplantation (AMT) as an additional modulator in primary Mitomycin C (MMC)-augmented trabeculectomy.Methods:This was a randomized prospective interventional study. Forty eyes of 39 adult patients with uncontrolled primary glaucoma were randomly divided into two equal groups. Control group underwent trabeculectomy augmented with MMC while the study group underwent additional AMT. Patients were followed up for 12 months and outcomes measured were intraocular pressure (IOP), need for additional intervention, and bleb morphology.Results:Complete success (defined as IOP <16 mmHg on no medication) could be achieved in 85% eyes in study group while it was 60% in control group (P = 0.04). IOP reduced by 71.1% in study group from 41.9 ± 10.6 to 12.1 ± 2.7 mmHg and from 40.5 ± 8.5 to 12.8 ± 4.5 mmHg in control group, a decline of 68.29%. Blebs in AMT group showed better bleb morphology in terms of significantly better extent (E3) on day 1 (P = 0.03) and better height (H2 and H3) (P = 0.04), according to the Indiana Bleb Appearance Grading Scale, at all follow-up visits along with normal vascularity. The study group required significantly lesser (P = 0.03) bleb needlings as compared to control group.Conclusion:Amnion enhanced the efficacy of MMC-modulated trabeculectomy in terms of eyes with complete success and lesser interventions such as bleb needling. This reiterates the role of amnion as a safe and effective bleb modulator. A diffusely elevated bleb with healthier conjunctiva can go a long way in predicting better health and longevity of the bleb.

AimTo report a case of bilateral phacomatosis pigmentovascularis (PPV), in a young male,presenting with developmental glaucoma and high myopia along with systemic features of klippel trenanauy weber (KTW) syndrome.BackgroundThe co-existence of oculodermal melanocytosis (ODM)and port-wine stain was termed PPV by Ota. Port-wine stain presents as part of Sturge-Weber syndrome (SWS). KTW presents with varicose veins and tissue hypertrophy alongwith port-wine stain.Case DescriptionA 22-year-old male presented with decreased vision owing to high myopia and advanced glaucoma. Incidental findings noted were pigmentary naevi along with facial port-wine stain, which collectively comprises PPV. Also noted were bilateral varicose veins which are usually seen in association with KTW. In view of advanced visual field damage and inability to control intraocular pressures (IOP) on topical medications, he underwent Glaucoma filtration surgery in both eyes. Intra-operatively care was taken to avoid sudden decompression by controlled anterior chamber paracentesis, and scleral flap closure with releasable sutures was done to prevent hypotony related complications in the immediate postoperative period. Such precautions lead to an uneventful postoperative recovery, and even at 3 years’ follow-up, the patient is maintaining IOP in early teens along with a stable visual acuity and visual fields.ConclusionThis case highlights the overlapping features of congenital conditions like oculodermal melanocystosis (ODM), SWS, KTW; presenting in a young male. Systemic features reported less frequently with PPV, included palatal pigmentation and palatal vascular malformations.Clinical SignificanceThis case re-emphasizes a common origin of these entities, PPV and KTW, from the neural crest cells. Early recognition of the systemic features and timely surgical intervention under appropriate precautions, can be vision salvaging in such cases of developmental glaucoma.How to cite this article: Singh K, Dangda S, Mutreja A, Bhattacharyya M, Jaisingh K. Bilateral Phacomatosis Pigmentovascularis in a Young Male with Developmental Glaucoma and Varicose Veins. J Curr Glaucoma Pract 2018;12(2):94-98.

IntroductionWith the advent of newer microsurgical techniques, the results for cataract surgery have become quite promising. An accurate intraocular lens (IOL) power calculation is one of the most important factors in optimizing the results. The aim of this study was to evaluate the accuracy of four IOL power calculation formulas, namely, Barrett Universal II, Holladay 1, SRK/T and Hoffer Q, using optical biometry in children undergoing cataract surgery with primary IOL implantation. MethodsThis was a cross-sectional study. A total of 60 eyes of 42 children aged 5-16 years with congenital cataract and having undergone uneventful cataract surgery with IOL implantation were included in the study. Eyes were divided into three groups based on the axial length (AL): short (AL <22.00 mm), medium (AL 22-24.50 mm) and medium long (AL 24.50-26.00 mm). Optical biometry was used and the IOL power was calculated using the Barrett Universal II formula. The predicted postoperative refraction with the other three formulas, namely, SRK/T, Holladay 1 and Hoffer Q, using the same IOL power was estimated. This was compared with the actual postoperative refraction (spherical equivalent at 12 weeks) to give the absolute prediction error. The mean of all absolute prediction errors gave the mean absolute prediction error (MAE) values for each formula that were then compared.

PURPOPSE: This study aims to evaluate the ocular surface response after strabismus surgery, using two different materials for conjunctival closure. METHODS: Randomized prospective comparative study was done. After performing strabismus surgery, conjunctival flap was apposed with fibrin sealant in Group 1 and 8-0 vicryl suture with buried knots in Group 2. Preoperative and postoperative measurement of tear film break up time and Schirmer test for tear secretion was done in both the groups of 30 patients each at regular follow-up visit up to 2 months. Postoperatively, both the groups were also compared for the resolution of discomfort and redness. RESULTS: Conjunctival recession was not seen in any group. Mean period was 5.8 days for resolution of discomfort (pain, lacrimation, and irritation) and 7.2 days for redness in Group 1 compared to 12 and 16 days in Group 2 ( P < 0.05). During the study, we noticed significant decrease in tear film stability and increase in tear secretion in both the groups. However, in Group 2, the parameters were significantly more altered and even changes persisted for longer duration. CONCLUSION: Early rehabilitation of ocular surface might be related to unaltered healing process with the use of a biological substance (fibrin sealant) as compared to suture.

Introduction: This study aims to evaluate retinochoroidal optical coherence tomography angiography (OCTA) parameters in patients recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Methods: This study was an observational study that included 80 subjects being discharged after having negative reports on the reverse transcription-polymerase chain reaction (RT-PCR) test for SARS-CoV-2 to evaluate OCTA parameters of the retina. The subjects underwent an ophthalmic evaluation that included best-corrected visual acuity (BCVA), intraocular pressure (IOP), color vision (CV), contrast sensitivity (CS), and optical coherence tomography (OCT) parameters. OCTA was done for all patients and was evaluated for foveal avascular zone (FAZ) area, perimeter, and circularity index, and vessel density (VD) in superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina (OR), outer retina chorio-capillaries (ORCC), chorio-capillaries (CC), and choroid (C) using 3 x 3 mm scans. The OCTA parameters were compared with normative data of the Indian population for various parameters in question.Results: The subjects included 54/80 (67.5%) males and 26/80 (32.5%) females having a mean age of 52.40 ± 15.71 (18-60) years. The systemic evaluation revealed 38.75% of subjects had hypertension, 30% had diabetes, 20% had kidney disease, 5% had tuberculosis, and 3.75% had coronary artery disease. The mean distance BCVA was logarithm of the minimum angle of resolution (LogMAR) (1.17 ± 0.22), mean IOP was 17.0 ± 4.0 mmHg, mean CS was 2.13 ± 0.36, 50.62% of subjects had normal CV on Farnsworth test while 47% had tritanopia, and none of the subjects had red-green CV defect on Ishihara plates. The OCT scan was normal in 90% of eyes while the posterior vitreous detachment was seen in 4% of eyes, broad vitreomacular adhesion in 2.5% of eyes, and the globally adherent epiretinal membrane was seen in 2.5% of eyes. The mean central macular thickness (CMT) measured 245.14 ± 28.41 micrometers. The mean FAZ area measured 0.37 ± 0.15 mm 2 , the perimeter was 3.28 ± 1.08 mm, and the circularity index measured 0.41 ± 0.10. The average VD in SCP measured 16.

No abstract

Aim:The aim of this article is to report a case of chronic localized intravascular coagulation in widespread sporadic multifocal venous malformations (VMs) associated with phleboliths, presenting with pathological femur fracture with very high D-dimer level and deranged coagulation profile hampering the surgical management of the patient.