BackgroundTo evaluate the effect of three different combinations of tip designs and infusion systems in torsional phacoemulsification (INFINITI and CENTURION) in patients with cataract. According to the manufacturer, two unique improvements in the Centurion are: active fluid dynamic management system and use of an intrepid balanced tip. The study specifically aimed to evaluate the beneficial effects, if any, of change in tip design and infusion system individually and in combination on both per-operative parameters as well as endothelial health over 6 months.MethodsOne hundred and twenty six consenting patients of grade 4.0–6.9 senile cataract were randomized into three groups for phacoemulsification: Group A (n = 42): Gravity fed infusion system and 450 Kelman miniflared ABS phaco tip; Group B (n = 42): intraocular pressure (IOP) based infusion system and 450 Kelman miniflared ABS phaco tip; Group C (n = 42): IOP based infusion system and 450 Intrepid balanced phaco tip. The cumulative dissipated energy (CDE), estimated fluid usage (EFU) and total aspiration time (TAT) were compared peroperatively. The endothelial parameters were followed up postoperatively for six months.ResultsThe three arms were matched for age (p = 0.525), gender (p = 0.96) and grade of cataract (p = 0.177). Group C was associated with significant reductions in CDE (p = 0.001), EFU (p < 0.0005) as well as TAT (p = 0.001) in comparison to the other groups. All three groups had comparable baseline endothelial cell density (p = 0.876) and central corneal thickness (p = 0.561). On post-operative evaluation, although all groups were comparable till 3 months, by 6 months, the percentage losses in endothelial cell density were significantly lower in group C as compared to the other groups.ConclusionsUse of an IOP based phacoemulsification system in association with use of the Intrepid balanced tip reduces the CDE, EFU and TAT in comparison to a gravity fed system with a mini flared tip or IOP based system with a mini flared tip while also providing better endothelial preservation thus favouring the use of an IOP fed system with a balanced tip.Trial registrationTrial registration No.: CTRI/2016/06/007022.

No abstract

Orbital tuberculoma is not uncommon in the developing countries, but intracranial extension of orbital tuberculoma is extremely rare. Our case, a 14-year-old girl, presented with proptosis and progressive painless diminution of vision eventually leading to loss of vision. MRI showed a mass with peripheral enhancement of contrast, separate from the optic nerve and extending into the cranium through the optic foramen. Early decompression and chemotherapy resulted in marked visual recovery. Histopathology of the excised lesion confirmed tuberculosis. The case is reported to highlight both the rare presentation as well as remarkable visual recovery in a patient with orbital tuberculosis.

Introduction: Chalazion is a common inflammatory mass lesion of eyelid. Incision and curettage is a conventional treatment but intralesional steroid is also a safe option for multiple chalazia and chalazion near lacrimal drainage system. So, we conducted an interventional study to compare the treatment outcomes of injection triamcinolone acetonide (TA) versus incision and curettage (I&C) in medium and large sized primary chalazion.Objective: To compare the success rate of intralesional TA versus I&C for the treatment of medium and large sized primary chalazia.Materials and Methods: An interventional study was carried out in 118 patients with primary chalazion. The patients were divided equally into two groups A and B of medium sized (3-7mm) and large sized chalazia (>7mm) respectively. Treatment modality either I&C or TA was decided in each group by randomization Cytological evaluation was done for each case and diagnosis other than chalazion was excluded. Main outcome measure was resolution in size more than 80%. Secondary outcome measure was correlation of cytological features with size, duration, success rate and complications.Conclusion: Intralesional TA was found to be as effective as I&C in both the groups. In cytological analysis, we found that in large sized chalazia I&C is superior to TA in suppurating granuloma.

No abstract

Purpose: Comparison of three ultrasound (US) frequencies for phacoemulsification of hard cataracts to determine a frequency that makes phacoemulsification more efficacious and safer. Methods: A randomized controlled trial was undertaken at a medical college and hospital. In total, 207 patients with grade 5.6–6.9 (LOCS III) senile cataract were randomized into three groups. Group I underwent phacoemulsification with 28-kHz frequency, group II with 42-kHz frequency, and group III with 53-kHz frequency. The effective phacoemulsification time (EPT) and estimated fluid usage (EFU) were compared intraoperatively. The endothelial cell parameters were analyzed for 6 months. Results: The groups were matched for age ( P = 0.467), gender ( P = 0.497), nuclear grade ( P = 0.321), and anterior chamber depth ( P = 0.635). The EPT and EFU were significantly lower in group III, compared to group II and group I, with P < 0.0001 and P < 0.0001, respectively. Postoperatively, the endothelial cell density (ECD) was significantly higher in group III at 1 month ( P < 0.0001), 3 months ( P < 0.0001), and 6 months ( P < 0.0001). The percentages of ECD loss were also significantly lower in group III; the difference was statistically significant ( P < 0.0001) up to 6 months postoperatively Conclusion: Higher frequency ultrasound was associated with a lower EPT and EFU as well as better endothelial preservation than lower frequencies in hard cataracts.

Acromegaly is an endocrine disorder characterized by the excess of growth hormone leading to bony and soft-tissue enlargement. Eye involvement due to extraocular muscle enlargement has been described rarely in these patients. Epiphora has been described only once earlier in a patient with acromegaly. Here, we describe two females with acromegaly who presented with the complaints of watering from the eye and proptosis.

No abstract