Introduction : In the ocular surface there is a well- coordinated system of enzymes that can produce urea independent of external urea supply. Urea locally formed from ocular tissues is important for the composition of the tear fluid. In eyes with dry syndromes this production is affected. Estimation of urea levels in the lacrimal fluid may prompt a newer treatment for dry eyes utilising urea. This study was done to evaluate the correlation between serum urea levels and pathophysiology of dry eye syndromes. Materials and methods: A prospective, observational, single-centre study. 50 patients of dry eye disease were included in the subjects and 50 controls were included in the study based on schirmer’s test. Tear film urea was estimated wih semi autoanalyser erba chem 5. When sample volume was not sufficient it was diluted with sterile water and urea was estimated after calculating for dilution factor. Blood urea was estimated with Erba Chem EM 360 working on similar principle Results: In the test group, the urea level in tear film ranged from 14.01 mg % to 39 mg % with a mean of 26.78 +/- 5.70 mg %. In the controls the levels of urea in the tear film ranged from 21.06 mg% to 56.00 mg% with a mean of 41.72±6.86 mg%. Conclusions: Levels of urea in tear film in normal individuals without dry eyes is similar to urea levels in the blood. Tear film urea levels were significantly lower in patients with dry eye diagnosed with Schirmer’s Test. Decreased tear film urea level in dry eyes is unrelated to blood urea levels and may play a role in the pathophysiology of dry eyes. This needs further investigation.
BackgroundElevated serum ceruloplasmin is a biomarker for oxidative stress. Diabetes mellitus (DM) is known to be a state of oxidative stress which causes complications of DM including diabetic retinopathy (DR). The role of ceruloplasmin in DR is still unclear. MethodsNinety patients of DM were included as cases and after evaluation sub-grouped as those with no DR, nonproliferative DR (NPDR) and proliferative DR (PDR). Serum ceruloplasmin levels were tested in all cases as well as in equal numbers of age and sex-matched controls without DM. Statistical analysis was done with p<0.05 taken as significant. ResultsSerum ceruloplasmin was significantly higher among cases as compared to controls (1222.82±306.15 IU/L versus 868.38±198.80 IU/L, p<0.01). There was no statistical difference between serum ceruloplasmin values in No DR, NPDR and PDR. On receiver operator characteristic curve (ROC) analysis for serum ceruloplasmin as a test for discriminating various parameters, it was seen that serum ceruloplasmin was a good test for discriminating DM from no DM (area under receiver operator characteristic {AUROC}=0.814, 95% CI=0.749-0.868, p<0.0001) with a cut point of >1093 IU/L yielding a sensitivity of 63.33% and specificity of 87.78%.
Objectives: A study to see if scleral tunnel based sutureless extracapsular cataract extraction with superior quadrant approach can correct pre-existing corneal astigmatism in soft cataracts of non-structural protein 1 (NS1) grade nuclear sclerosis in patients of younger age profile having “with-the-rule” pattern of corneal astigmatism. Material and Methods: 47 eyes of 41 patients who underwent scleral tunnel based sutureless extracapsular cataract extraction were taken as the study group and a second group of 44 eyes of 38 patients who underwent clear corneal incision based phacoemulsification surgery formed the control group. Soft cataracts of NS1 grade nucleus having “with-the-rule” corneal astigmatism were included in the study. Keratometry measurements were done preoperatively and at 6 weeks post-operative follow-up by Zeiss IOLMaster. Results: Sutureless scleral tunnel based extracapsular cataract extraction was found to neutralize pre-existing corneal astigmatism if it was in range of 1.0–1.5 D. It was also found to change the pattern of astigmatism from “with-the-rule” to “against-the-rule” if the pre-operative astigmatism was in the range of 0.5–1.0 D with little change in the absolute value of the astigmatism. Conclusion: Patients with pre-existing with-the-rule corneal astigmatism undergoing scleral tunnel based sutureless extracapsular cataract extraction had reduced corneal astigmatism. Phacoemulsification, on the other hand, was found to be an astigmatically neutral surgery.
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