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BACKGROUND: Pterygium is very common in India and is usually removed by limbal conjunctival autograft transplantation (LCAT), which, despite being the first-line therapy, is still associated with recurrences of up to 18%. OBJECTIVES: To compare the safety and efficacy of topical cyclosporine A (CsA) and interferon (IFN) alpha-2b in the prevention of postoperative recurrence of pterygium. METHODS: A total of 40 patients with primary pterygium were randomized into two equal groups, Group C and Group I. Both the groups underwent LCAT, with Group C kept on topical cyclosporine 0.05% (CsA) 4 times daily and Group I on topical IFN alpha 2b 0.2 million IU 4 times daily postoperatively for 3 months. Pre- and posttreatment best-corrected visual acuity (BCVA), recurrence, and complications were assessed at day 1, week 1,1 month, and 3 months. RESULTS: The mean preoperative BCVA of 0.51 ± 0.18 and 0.51 ± 0.23 improved to 0.13 ± 0.13 and 0.13 ± 0.13 in Group C and Group I, respectively, after 3 months of treatment (P < 0.0001). Recurrence was seen in 2 cases in Group C and in 1 case in Group I at 3 months. No significant complications occurred in either of the groups. CONCLUSION: Topical CsA and IFN Alpha-2b are newer efficacious adjuvants with LCAT for prevention of postoperative pterygium recurrence. [ABSTRACT FROM AUTHOR]

We report a patient who had earlier penetrating keratoplasty with amniotic membrane transplant and autologous limbal cell transplant for chemical injury who underwent cataract surgery by phacoaspiration. A posterior limbal incision with corneal valve was made superotemporally with extreme caution to avoid damage to the limbal graft. Aspiration flow rates and vacuum were kept low to avoid any turbulence during surgery. A 6.0 mm optic diameter acrylic foldable intraocular lens was inserted in the bag. The patient achieved a best-corrected visual acuity of 6/12 at 10 months′ follow-up with a clear corneal graft. We conclude that caution during wound construction and phacoaspiration can help preserve corneal and limbal graft integrity in patients undergoing cataract surgery after corneal graft and limbal transplantation.

Purpose--Scleral-fixation of intraocular lenses (IOLs) provides an option for eyes that lack sufficient capsular support for in-the-bag IOL placement. The latest techniques for lens fixation include use of a novel suture material, Gore-Tex, and a sutureless method, with flanged intrascleral fixation. The purpose of this pilot study was to compare these methods in terms of anatomic and clinical outcomes. Methods--A total of 35 eyes of patients 18--60 years of age who presented with aphakia, subluxated lens, or ectopia lentis were randomized into two groups. Group A (15 eyes) underwent flanged intrascleral IOL fixation using the Yamane technique; group B (20 eyes) underwent 4-point transscleral fixation of IOL using Gore-Tex suture. The following parameters were compared between groups on day 1, week 3, and month 6 postoperatively: logMAR uncorrected and best-corrected visual acuity, retinoscopy, IOL centration on slit-lamp biomicroscopy, and IOL tilt on ultrasound biomicroscopy. Results--Postoperative visual acuity was better in group B: uncorrected, logMAR 0.89 ± 0.22 versus 0.72 ± 0.24 (P = 0.046); best-corrected, logMAR 0.51 ± 0.18 versus 0.37 ± 0.26 (P = 0.016). No significant difference was found in postoperative retinoscopy and astigmatism between groups. IOL tilt (>100 µm) occurred in 8 cases in group A and in 9 cases in group B; 87% in group A and 100% in group B were well centered. Complications in both groups were minimal. Conclusions--In our small study cohort, both sutureless flanged IOL fixation and Gore-Tex sutured scleral IOL fixation resulted in excellent visual rehabilitation of patients with aphakia and subluxated lenses. Patients who underwent Gore-Tex suture fixation experienced better postoperative visual acuity, IOL centration, and stability. [ABSTRACT FROM AUTHOR]

We report a case of penicillium keratitis in vernal shield ulcer in the absence of corticosteroid use. This report illustrates super-added infection in vernal shield ulcer by an organism which is otherwise innocuous and forms a part of the normal ocular flora.

Background: Direct smears and cell blocks prepared from residual tissue fluids complement each other for establishing a conclusive cytopathologic diagnosis in thyroid lesions. Aim of the Study: Evaluation of the diagnostic utility of fine-needle aspiration cytology (FNAC) alone and in combination with cell blocks in the diagnosis of thyroid lesions. Materials and Methods: A hospital-based prospective longitudinal study was conducted in which 100 thyroid smears were categorized as neoplastic, nonneoplastic and inadequate using FNAC and cell block technique. All specimens were classified using point scoring system modified by Mair et al. Direct smears were compared with cell-block specimens on variables of cellularity, background blood and clot, cellular degeneration and retention of appropriate architecture using Fisher's exact and unpaired t-test. Results: Sixty-two percent of cell block specimens showed a moderate amount of background material (P = 0.01), display of excellent architecture was also significantly more in cell block (20%) technique than direct smears (9%), and degree of cellular degeneration was minimal in significantly more cell blocks (26%) than direct smears (12%), thereby making diagnosis easy as opposed to FNAC which yielded more cellular material than cell blocks (P = 0.02). Four cases showing hemorrhagic material on direct smears were diagnosed on cell block as one case each of colloid goiter and chronic lymphocytic thyroiditis and two cases of adenomatous goiter and two cases showing hemorrhagic material on cell block were diagnosed with chronic lymphocytic thyroiditis on direct smears. Conclusion: FNAC and cell block complement each other and combining both techniques improves the diagnostic yield and facilitates accurate diagnosis. It is advisable to perform cell-block for each case of FNAC of thyroid lesions. [ABSTRACT FROM AUTHOR]