The effectiveness of most SD-OCT parameters in detecting glaucoma significantly decreased when evaluated against a clinically relevant control group with suspicious-looking optic nerves compared with that against a control group consisting of normal subjects with no findings suspicious for glaucoma.

Objectives: To compare visual outcomes and clinical performance of diffractive trifocal and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods: This prospective, consecutive, nonrandomized, comparative study of 6-month duration included assessment of 160 eyes of 80 patients (40 patients in each group). The patients had bilateral cataract surgery with implantation of a trifocal (FineVision Micro F; PhysIOL SA, Liège, Belgium) or EDOF IOL (TECNIS Symfony; Abbott Medical Optics, Inc., Abbott Park, IL) in both eyes. Ophthalmological evaluation included measurement of monocular uncorrected distance visual acuity (UDVA) and corrected distance VA (CDVA), uncorrected intermediate VA (UIVA) and distance-corrected intermediate VA (DCIVA), uncorrected near VA (UNVA) and distance-corrected near VA (DCNVA). Analysis of point-spread function and modulation transfer function was also performed postoperatively, and quality of vision and spectacle-dependence questionnaires were assessed. Results: There was no statistically significant difference between groups in monocular UDVA (P=0.65), CDVA (P=0.82), and binocular UDVA (P=0.81). The monocular UIVA, monocular DCIVA, and binocular UIVA were also comparable among the two groups (P=0.70, 0.74, and 0.81, respectively). Monocular UNVA, DCNVA, and binocular UNVA were statistically and significantly better for the trifocal group than for the EDOF (P=0.01, P=0.009, and P=0.001, respectively). There were no differences in visual symptoms and quality among groups. Conclusions: Trifocal IOL had a clear advantage over EDOF IOLs in near VA, while both IOLs showed excellent performance in distance and intermediate VA. Both IOLs provided high percentage of spectacle independence and patient satisfaction with minimal level of disturbing photic phenomena.

We report a rare case of bilateral keratoglobus with hypermature intumescent cataract in a 55-year-old woman. Clinical examination and corneal topography confirmed generalized corneal bulging and global corneal thinning. A Pentacam® (Oculus Optikgerate, Wetzlar, Germany) demonstrated bilateral diffuse corneal thinning (368 μm in the right eye and 371 μm in the left eye). Phacoemulsification was performed in the right eye after thorough workup and modification of the surgical technique. This case report helps in better understanding of the challenges of cataract surgery and intraocular lens selection in a keratoglobus patient, and stresses the need for both thorough preoperative planning and intraoperative surgical modifications.

This study was conducted to determine the risk factors and feto-maternal outcomes in uterine rupture at a tertiary care centre, with the goal to assess the delays or gaps in management, in order to avert associated morbidity and mortality. Material and methodsThis study was conducted from June 2018 to May 2020 in Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, wherein all women diagnosed with uterine rupture, either at the time of admission or during the course of hospital stay, were included after taking written informed consent. The primary outcome measured was the incidence of uterine rupture, whereas the secondary outcomes assessed were clinical features, risk factors, per-operative findings, management, and feto-maternal outcomes. ResultsThe total number of deliveries during the study period was 67005. Out of these, 12985 women underwent LSCS, whereas others delivered vaginally. A total of 61 cases of uterine rupture occurred among them. The majority of these women were unbooked (62.29%), having a gestation age >37 weeks (65.57%). The most common risk factor identified was a history of previous LSCS (91.80%). Around 80.33% of women had rupture of the lower segment of the uterus. Maximum cases were managed by repair with ligation (63.93%), while 26.22% underwent hysterectomies. Bladder injury occurred in 11.48% of women. While most of the women required blood transfusion (93.44%), only three maternal deaths occurred. ConclusionRupture of a gravid uterus can be a lethal surgical catastrophe with potentially grave feto-maternal consequences. Alacrity in diagnosis and referral to a tertiary centre, along with facility-level preparedness to respond to this emergency, apart from optimal care around birth, are critical determinants for feto-maternal survival.

To examine and improve outcomes of resident-performed manual small incision cataract surgery (MSICS) cases via analysis of visual recovery, intraoperative adverse events, and early postoperative course. Particular focus was directed toward mature cataracts extracted by MSICS. A retrospective review was performed to identify MSICS cases performed by resident surgeons unfamiliar with the technique (initial ten cases) in an academic setting. Preoperative history, intraoperative adverse events, and postoperative course were reviewed. Of 30 cases identified, mean preoperative acuity was 1.8 ± 0.9 logMAR units (Snellen equivalent = 20/1262) improving to 0.20 ± 0.35 logMAR units (20/31) at final follow-up (p < 0.0001). Mean follow-up was 22.1 ± 19.0 days. The most frequent intraoperative adverse events were wound leak requiring intraoperative suturing (33 %), vitreous loss (6.7 %), and capsulorhexis radialization (6.7 %). Transient cornea edema was the most frequent (56.7 %) early postoperative minor complication. Two major complications occurred that required wound revision in one eye and iridoplasty in one eye. Of the 30 eyes undergoing surgery, 19 were noted to have mature cataracts. In this subset, mean acuity was 2.25 ± 0.64 logMAR units (20/3557) improving to 0.28 ± 0.42 logMAR (20/38) at final follow-up (p < 0.0001). Complications were similar in nature and frequency to the entire population in this subgroup. Supervised resident MSICS cataract surgery can result in excellent anatomic and visual outcomes. Appropriate wound construction is a frequently encountered difficulty, so particular attention should be directed to this step by both trainers and trainees.