Context:Precise intraocular pressure (IOP) measurement is important in glaucoma practise. Various instruments are available today to accurately measure IOP. Thus, the question arises about which instrument to use and whether all of them can be used interchangeably.Aims:To assess the agreement between noncontact tonometer (NCT), rebound tonometer (RBT), Goldmann applanation tonometer (GAT), and dynamic contour tonometer (DCT) in measuring IOP.Subjects and Methods:499 eyes of 250 patients were evaluated during a period of 24 months from September 2010 to August 2012 and measurement of IOP by NCT, RBT, GAT, and DCT was done in the given sequence. The agreement was assessed by use of the Bland–Altman plot keeping GAT as a gold standard technique.Results:The mean IOP value of NCT, RBT, GAT, and DCT was 15.9 ± 5.5, 15.9 ± 5.8, 15.9 ± 4.9, and 16.0 ± 4.7 mm of Hg, respectively. The limits of agreement of GAT with DCT, NCT, and RBT were found to be +5.4 to −5.2, −4.7 to +4.6, and −5.2 to +5.1 mm of Hg, respectively.Conclusions:A positive and strong correlation was found between newer tonometers and GAT, but the limit of agreement was clinically unacceptable. The use of a single tonometer should be practised at a glaucoma clinic for a patient at each follow-up.
Background:Cytomegalovirus (CMV) retinitis remains the most common ocular opportunistic infection in patients with acquired immunodeficiency syndrome even in the era of highly active antiretroviral therapy (HAART). Increased survival of patients on HAART has increased incidence of blindness, which will further increase in the future. The objective of this study was to determine the incidence of CMV retinitis and the effect of HAART on the natural history of CMV retinitis in patients referred from ART center.Materials and Methods:Patients with baseline/current CD4 counts <150 cells/µl were evaluated for CMV retinitis. Complete ophthalmological evaluation was carried out and records of CD4 counts, HAART regime, presence of any form of CMV retinitis and response to HAART were noted.Results:Out of 800 patients registered with CD4 <150 cells/µl in ART center, 100 patients reached us. Among these, CMV retinitis was observed in 15% patients, with median CD4 count at the time of examination being 56 cells/µl (range: 24-306 cells/µl). 66.67% patients were HAART non-responders and 63.6% eyes were economically blind.Conclusion:CMV retinitis occurs even in patients with higher CD4 counts. Timely diagnosis and intervention of this treatable condition can reduce the number of blinding years in these young patients who otherwise live longer as a result of HAART.
: The aim of this study was to analyze the surgically induced astigmatism in comparison to site of incision superior and temporal in commonly performed SICS technique of cataract surgery. : A prospective interventional study was done on 30 patients who underwent manual small incision cataract surgery (MSICS) divided into two groups namely sics superior group and sics tempral group based on incision-site. The two techniques were compared with respect uncorrected visual acuity, surgically induced astigmatism and type of astigmatism drift. In our study, There was significant difference between techniques regarding best uncorrected visual acuity on 40 post operative day. Greater proportion of patients had good outcomes in both the groups as regards to final visual acuity. Superior incision induced post operative ATR drift (75%) and temporal incision induced WTR astigmatism (70%). : Incision on steep axis is an economical and effective way of reducing pre-existing astigmatism in high-volume and low-cost cataract surgery.
Aims: To evaluate donor cornea by using eye bank specular microscope and evaluate outcome of keratolplasty according to the graft condition. Materials and Methods: This was a prospective study of 30 patients who undergone keratoplasty. Donor cornea was evaluated by slit lamp biomicroscopy and after preservation in MK media, evaluated using eye bank specular microscope. Final decision of transplantation was made on grading of specular microscopy. All patients undergone penetrating keratoplasty and post-operative outcome was measured. Results: In our study majority of donors were in age group of 21-40 years. Endothelial cell count of >3000 cells/mm 2 was observed in 60% cases, while 2500-3000 cells/mm 2 in 26.67% cases. The reason for penetrating keratoplasty were corneal opacity or scarring (40%), PBK (23.33%), acute infective keratitis (13.33%), regraft due to graft failure (10%), ABK (10%) and corneal dystrophy (3.33%). Postoperative clear graft was seen in 60% cases while cloudy in 20% and opaque in 20% cases. It was observed that large number of recipients (46.66%) had post-operative visual acuity more than 6/60. Conclusions: Though tissue utilization can be optimized with the use of eye bank specular analyzer, final outcome depends on multiple factors. Few tissues of older age can be utilized if having good endothelial count.
Cataract is the major cause of treatable blindness in India (62.6%). Quality cataract surgery is basic need of the cataract blind patient. Phacoemulsification and SICS are routine surgery performed for cataract in developing countries. Continuous Curvilinear Capsulorhexis is the most important pre-requisite for successful outcome of cataract surgery.To evaluate early outcome of assisted capsulorhexis versus manual capsulorhexis in cataract surgery. This descriptive observational study was carried out during January 2017 to October 2018 with purposive sampling of 100 cases.Mean age of the study population was 60±9.1 in which 84% patients had immature cataract, while 16% patients had mature cataract. The cases operated by phacoemulsification surgery using manual technique 76% had regular shape of CCC and with assisted technique 84% had regular shape of CCC. Among patients operated with SICS using manual technique, 16% cases had regular shape of CCC and with use of assisted capsulorhexis device, 80% had regular shaped CCC. A statistically significant association was found between assisted technique and centration of the CCC (p=0.00001). The assisted capsulorhexis device (VERUS) was found to be effective in achieving optimal size, circularity and centration of CCC during cataract surgery.
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