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15 results on '"trabeculectomy in young"'

1. Azithromycin, fluoroquinolone and chloramphenicol resistance of non-chlamydia conjunctival bacteria in rural community of Ethiopia

Author

Bayeh Abera and Mulugeta Kibret

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Collagen cross linking, keratoconus, topography guided custom ablation treatment, topography guided photoablation, Azithromycin, chloramphenicol, fluoroquinolone, non-chlamydia conjunctival bacteria, Ethiopia, Ophthalmology, RE1-994
Abstract

Aim: To determine profiles of non-chlamydia conjunctival bacteria and their antimicrobial susceptibility from adults who underwent trachomatous trichiasis surgery in rural areas of Ethiopia. Materials and Methods: A cross-sectional study was conducted in rural districts in West Gojjam administrative zone. Conjunctival swabs were collected during surgery and transported using Stuart transport broth (Oxoid, UK). Antibiotic susceptibility of conjunctival isolates was determined using the Kirby-Bauer disc-diffusion method. Results: Non-chlamydia pathogenic bacteria were recovered from conjunctiva of 438 (31%) participants before treatment. The isolated conjunctival bacteria were Staphylococcus aureus, coagulase-negative Staphylococci, Streptococcus group (A, C, F and G), Enterococci, Streptococcus pneumoniae, Moraxella spp., Escherichia coli, Citrobacter spp., Proteus spp., Klebsiella spp., Pseudomonas spp. and Enterobacter spp. Overall, resistance rates of 57.8% to azithromycin and 68.5% to chloramphenicol were found. However, 86-94.4% sensitivity was demonstrated to ciprofloxacin and norfloxacin. Moderate sensitivity rates (61.8-78.4%) were observed to ceftriaxone, tetracycline and cotrimoxazole. Conclusion: Fluoroquinolones that have activity against the majority of bacterial isolates were potent at in vitro. However, unacceptably high levels of resistance to azithromycin and chloramphenicol in rural community indicated a need for further study and antimicrobial resistance surveillance.

Published
2014
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2. Outcomes of trabeculectomy in juvenile open angle glaucoma

Author

Daizy Pathania, Sirisha Senthil, Harsha L Rao, Anil K Mandal, and Chandra Sekhar Garudadari

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Ophthalmology, RE1-994
Abstract

Purpose: This study was aimed at reporting the outcomes of trabeculectomy in primary juvenile open angle glaucoma (JOAG). Design: This study was a retrospective noncomparative case series. Materials and Methods: We included 60 eyes of 41 JOAG patients who underwent primary trabeculectomy without mitomycin-C (MMC) between 1995 and 2007. The primary outcome was success, defined as complete, if intraocular pressure (IOP) was >5 and ≤21 mmHg without medications or qualified if IOP was >5 and ≤21 mmHg with or without antiglaucoma medications. Secondary outcome measures were mean and percentage IOP reduction, complications, and risk factors for the failure of trabeculectomy. Results: The mean (±standard deviation) age at presentation was 24.1 ± 6.8 years (range, 12-35). Mean follow-up was 67 ± 41 months (range, 12-156). At 1 year, the probability of complete success was 92% (n = 56, 95% CI: 81-96%), at 3 years it was 89% (n = 47, 95% CI: 78-95%), and at the end of 5 years, it was 80% (n = 34, 95% CI: 65-89%). The probability of qualified success was 100% (n = 60) at 1 year, 98% (n = 51, 95% CI: 87-100%) at 3 years, and 96% (n = 36, 95% CI: 84-99%) at the end of 5 years. The mean IOP reduced from 35 ± 10 to 13 ± 2.5 mmHg (P < 0.001) after trabeculectomy. There was no serious postoperative complication. Young age was the only significant risk factor associated with the failure (odds ratio = 0.89, P = 0.03). Conclusion: Primary trabeculectomy without MMC has good success rates in JOAG.

Published
2014
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3. Aggressive posterior retinopathy of prematurity in infants ≥1500 g birth weight

Author

Gaurav Sanghi, Mangat R Dogra, Deeksha Katoch, and Amod Gupta

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Collagen cross linking, keratoconus, topography guided custom ablation treatment, topography guided photoablation, Azithromycin, chloramphenicol, fluoroquinolone, non-chlamydia conjunctival bacteria, Ethiopia, near vision, prevalence of blindness, visual outcome, Congenital aniridia, descemet stripping endothelial keratoplasty, progressive anterior segment fibrosis syndrome, Early removal, high doses of steroids, mimics microbial keratitis, stingers, Childhood corneal opacity, congenital hereditary endothelial dystrophy, corneal edema, endothelial keratoplasty, pediatric keratoplasty, Aggressive posterior retinopathy of prematurity, APROP, atypical ROP, developing country, heavier infants, neonatal care, oxygen induced retinopathy, retinopathy of prematurity, ROP, zone 1 ROP, Ophthalmology, RE1-994
Abstract

In this retrospective case series, we report the spectrum and outcomes of aggressive posterior retinopathy of prematurity (APROP) in infants ≥1500 g birth weight. Twenty-nine eyes of 15 infants are included. All infants were referred from level I or II nurseries, received supplemental unmonitored oxygen for prolonged duration (>1 week) and had multiple systemic co-morbidities. Of the 29 eyes, 10 (34.5%) had zone 1 and 19 (65.5%) had posterior zone 2 disease. Twenty-five (86.2%) eyes had flat neovascularization and 4 (13.8%) eyes had brush like proliferation. We noticed large vascular loops in 10 (34.5%) eyes. After confluent laser photocoagulation, 22 (75.9%) eyes had a favorable outcome. The study concludes that APROP in heavier (≥1500 g birth weight) premature infants occurs mostly in posterior zone 2 with flat neovascularization and atypical features like large vascular loops. Supplemental unmonitored oxygen for prolonged duration and multiple systemic co-morbidities could be a contributing factor.

Published
2014
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4. Corneal changes following collagen cross linking and simultaneous topography guided photoablation with collagen cross linking for keratoconus

Author

Prema Padmanabhan, Aishwaryah Radhakrishnan, Abinaya Priya Venkataraman, Nidhi Gupta, and Bhaskar Srinivasan

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Collagen cross linking, keratoconus, topography guided custom ablation treatment, topography guided photoablation, Ophthalmology, RE1-994
Abstract

Purpose: To compare the outcome of Collagen cross-linking (CXL) with that following topography-guided customized ablation treatment (T-CAT) with simultaneous CXL in eyes with progressive keratoconus. Materials and Methods: This was a prospective, non-randomized single centre study of 66 eyes with progressive keratoconus. Of these, 40 eyes underwent CXL and 26 eyes underwent T-CAT + CXL. The refractive, topographic, tomographic and aberrometric changes measured at baseline, 1, 3 and 6 months post-operatively were compared between both groups. Results: After a mean follow-up of 7.7 ± 1.3 months, the mean retinoscopic cylinder decreased by 1.02 ± 3.16 D in the CXL group ( P = 0.1) and 2.87 ± 3.22 D in the T-CAT + CXL group ( P = 0.04). The Best corrected visual acuity increased by 2 lines or more in 10% of eyes in the CXL group and in 23.3% of eyes in the T-CAT + CXL group. The mean steepest-K reduced by 0.40 ± 3.71 D ( P = 0.77) in the CXL group and by 2.91 ± 2.01D ( P = 0.03) in the T-CAT + CXL group. The sag factor and surface asymmetry index showed no significant change in the CXL group but reduced by 3.59 ± 5.94 D ( P = 0.01) and 0.72 ± 1.18 ( P = 0.02) respectively in the T-CAT + CXL group. There was a significant increase in the highest posterior corneal elevation in both groups (9.57 ± 14.93 μ in the CXL group and 7.85 ± 9.25 μ in the T-CAT + CXL group, P ≤ 0.001 for both). There was significantly greater reduction of mean coma ( P < 0.001) and mean higher-order aberrations ( P = 0.01) following T-CAT + CXL compared to CXL. Conclusions: CAT + CXL is an effective approach to confer biomechanical stability and to improve the corneal contour in eyes with keratoconus and results in better refractive, topographic and aberrometric outcomes than CXL alone.

Published
2014
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5. Challenges in pediatric endothelial keratoplasty

Author

Vikas Mittal and Ruchi Mittal

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Collagen cross linking, keratoconus, topography guided custom ablation treatment, topography guided photoablation, Azithromycin, chloramphenicol, fluoroquinolone, non-chlamydia conjunctival bacteria, Ethiopia, near vision, prevalence of blindness, visual outcome, Congenital aniridia, descemet stripping endothelial keratoplasty, progressive anterior segment fibrosis syndrome, Early removal, high doses of steroids, mimics microbial keratitis, stingers, Childhood corneal opacity, congenital hereditary endothelial dystrophy, corneal edema, endothelial keratoplasty, pediatric keratoplasty, Ophthalmology, RE1-994
Abstract

We performed endothelial keratoplasty (EK) in three eyes of two siblings (2.5 years, male and 3.5 years, female) with congenital hereditary endothelial dystrophy (CHED) and report the intraoperative and postoperative difficulties. Repeated iris prolapse, apprehension of crystalline lens touch due to positive vitreous pressure, and need for frequent air injections to attach the graft were intraoperative challenges in all three eyes. These were addressed by use of Sheet′s glide instead of Busin′s glide during graft insertion and suturing of main and side ports before air injection. One eye had graft dislocation on second postoperative day due to eye rubbing by the child. Graft was repositioned with air and a venting incision was created. Postoperative examination required repeated general anesthesia. Corneal edema resolved completely in all three eyes. Present case series highlights the possible intraoperative and postoperative challenges and their solutions in pediatric EK for CHED.

Published
2014
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6. Prevalence, causes of blindness, visual impairment and cataract surgical services in Sindhudurg district on the western coastal strip of India

Author

Shailbala Patil, Parikshit Gogate, Siddharth Vora, Sachin Ainapure, Ramkrishna N Hingane, Anil N Kulkarni, and B R Shammanna

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Collagen cross linking, keratoconus, topography guided custom ablation treatment, topography guided photoablation, Azithromycin, chloramphenicol, fluoroquinolone, non-chlamydia conjunctival bacteria, Ethiopia, near vision, prevalence of blindness, visual outcome, Ophthalmology, RE1-994
Abstract

Background : Konkan coast of India is geographically distinct and its pattern of blindness has never been mapped. Aim : To study the prevalence and causes of blindness and cataract surgical services in Sindhudurg district of West Coast. Subjects : Individual aged > 50 years. Materials and Methods: Rapid assessment of avoidable blindness used to map blindness pattern in the district. Statistical analysis: SPSS version 19. Results: Amongst those examined 1415 (51.7%) had visual acuity (VA) >20/60, 924 (33.8%, confidence interval (C.I) 30.5%-36.8%) had VA 20/200-

Published
2014
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7. Clinical features and management of ocular lesions after stings by hymenopteran insects

Author

K S Siddharthan, Anita Raghavan, and R Revathi

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Collagen cross linking, keratoconus, topography guided custom ablation treatment, topography guided photoablation, Azithromycin, chloramphenicol, fluoroquinolone, non-chlamydia conjunctival bacteria, Ethiopia, near vision, prevalence of blindness, visual outcome, Congenital aniridia, descemet stripping endothelial keratoplasty, progressive anterior segment fibrosis syndrome, Early removal, high doses of steroids, mimics microbial keratitis, stingers, Ophthalmology, RE1-994
Abstract

We describe the ocular alterations and the management after stings from Hymenopteran insects. In all the five patients, the insect was identified as bee. The patients presented with significant corneal edema, which resolved dramatically in three of them after removal of stingers. Among the other two one went for permanent corneal decompensation and the other developed Intumuscent cataract with increased intraocular pressure. Although a rare occurrence, ocular trauma caused by Hymenopteran insects has a potential to cause severe ocular damage in humans. A high level of clinical suspicion and immediate removal of the stingers along with administration of high doses of topical and systemic steroids is a must to prevent chances of permanent corneal damage and intraocular complications.

Published
2014
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8. Recurrent progressive anterior segment fibrosis syndrome following a descemet-stripping endothelial keratoplasty in an infant with congenital aniridia

Author

Mihir Kothari, Kavita Rao, and Samita Moolani

Subjects
Blindness, cataract, eye lens, risk factors, treatment of cataract, Low vision care, multiple disabilities and visual impairment, reading performance, Accommodation, presbyopia, supraciliary segment implants, Amblyopia, citicoline, patching, Corneal endothelium, human corneal endothelial precursor cells, in vitro expansion, sphere forming assay, thermo-reversible gelation polymer, transportation, Endophthalmitis, explantation, fungal, intraocular lens, postoperative, recurrent, Colour perception, learning disabilities, school children, stereo acuity, testability, visual acuity, Contracted socket, dermis fat graft, porous orbital implant, reconstruction, Glucose, in vitro anticataract, lens, Moringa oliefera, ′BARC I-125 Ocu-Prosta seeds′, choroidal melanoma, ciliary body melanoma, Episcleral plaque brachytherapy, retinal angioma, retinoblastoma, vasoproliferative tumor, Congenital glaucoma, gonioscopy, Retcam, Acoustic features, A-scan, B-scan, choroidal mass, ultrasound biomicroscopy, Cataract surgery, education, informed consent, multimedia, rural health, Lagophthalmos, silicone sling, temporalis muscle, Contrast sensitivity function, disability, function peak, multiple sclerosis, spatial frequency, Congenital cataract, developmental cataract, outcome, vision function, Bacterial, extracellular enzymes, keratitis, toxins, Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition, Descemet′s stripping endothelial keratoplasty, complications, donor dislocation, endothelial cell loss, graft failure, management, Glaucoma, glaucoma experimental, parapapillary atrophy, Juvenile open angle glaucoma, juvenile glaucoma, primary trabeculectomy, trabeculectomy in young, Collagen cross linking, keratoconus, topography guided custom ablation treatment, topography guided photoablation, Azithromycin, chloramphenicol, fluoroquinolone, non-chlamydia conjunctival bacteria, Ethiopia, near vision, prevalence of blindness, visual outcome, Congenital aniridia, descemet stripping endothelial keratoplasty, progressive anterior segment fibrosis syndrome, Ophthalmology, RE1-994
Abstract

Progressive anterior segment fibrosis syndrome (ASFS), after intraocular surgery in older children (≥9 years) and adults with congenital aniridia, is described in the literature. In this report, we describe an unique case of ASFS in an infant with congenital aniridia following a combined trabeculotomy-ectomy and its recurrence after a descemet stripping endothelial keratoplasty. The ophthalmologists should be well aware of this entity and warn the parents about its possibilities. Use of immunomodulators or prolonged anti-inflammatory therapy may be considered to prevent its occurrence.

Published
2014
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9. Outcomes of trabeculectomy in juvenile open angle glaucoma.

Author

Pathania, Daizy, Senthil, Sirisha, Rao, Harsha L., Mandal, Anil K., and Garudadari, Chandra Sekhar

Subjects
*CONGENITAL glaucoma, *MITOMYCINS, *INTRAOCULAR pressure, *GLAUCOMA treatment, GLAUCOMA surgery
Abstract

Purpose: This study was aimed at reporting the outcomes of trabeculectomy in primary juvenile open angle glaucoma (JOAG). Design: This study was a retrospective noncomparative case series. Materials and Methods: We included 60 eyes of 41 JOAG patients who underwent primary trabeculectomy without mitomycin-C (MMC) between 1995 and 2007. The primary outcome was success, defined as complete, if intraocular pressure (IOP) was >5 and =21 mmHg without medications or qualified if IOP was >5 and =21 mmHg with or without antiglaucoma medications. Secondary outcome measures were mean and percentage IOP reduction, complications, and risk factors for the failure of trabeculectomy. Results: The mean (±standard deviation) age at presentation was 24.1 ± 6.8 years (range, 12-35). Mean follow-up was 67 ± 41 months (range, 12-156). At 1 year, the probability of complete success was 92% (n = 56, 95% CI: 81-96%), at 3 years it was 89% (n = 47, 95% CI: 78-95%), and at the end of 5 years, it was 80% (n = 34, 95% CI: 65-89%). The probability of qualified success was 100% (n = 60) at 1 year, 98% (n = 51, 95% CI: 87-100%) at 3 years, and 96% (n = 36, 95% CI: 84-99%) at the end of 5 years. The mean IOP reduced from 35 ± 10 to 13 ± 2.5 mmHg (P < 0.001) after trabeculectomy. There was no serious postoperative complication. Young age was the only significant risk factor associated with the failure (odds ratio = 0.89, P = 0.03). Conclusion: Primary trabeculectomy without MMC has good success rates in JOAG. [ABSTRACT FROM AUTHOR]

Published
2014
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10. Outcomes of trabeculectomy in juvenile open angle glaucoma

Author

Chandra Sekhar Garudadari, Harsha L. Rao, Sirisha Senthil, Anil K Mandal, and Daizy Pathania

Subjects
Male, medicine.medical_treatment, Visual Acuity, Blindness, Low vision care, Cataract surgery, ′BARC I-125 Ocu-Prosta seeds′, lcsh:Ophthalmology, human corneal endothelial precursor cells, B-scan, Trabeculectomy, Young adult, Lagophthalmos, Child, A-scan, Endophthalmitis, multimedia, patching, school children, informed consent, Bacterial, Colour perception, retinal angioma, keratitis, silicone sling, parapapillary atrophy, dermis fat graft, explantation, glaucoma experimental, eye lens, vision function, Glaucoma, Open-Angle, medicine.medical_specialty, Accommodation, reconstruction, complications, Amblyopia, recurrent, treatment of cataract, developmental cataract, vertical rectus transposition, Humans, stereo acuity, choroidal melanoma, choroidal mass, primary trabeculectomy, trabeculectomy in young, Intraocular Pressure, Retrospective Studies, testability, Glaucoma, Odds ratio, donor dislocation, medicine.disease, Ophthalmology, Glucose, Acoustic features, disability, lcsh:RE1-994, in vitro anticataract, sphere forming assay, Juvenile open angle glaucoma, Retcam, Intraocular pressure, Visual acuity, Time Factors, Moringa oliefera, ciliary body melanoma, intraocular lens, in vitro expansion, multiple sclerosis, supraciliary segment implants, function peak, gonioscopy, risk factors, postoperative, rural health, Congenital glaucoma, periosteal fixation, education, Episcleral plaque brachytherapy, endothelial cell loss, toxins, Exotropic Duane retraction syndrome, spatial frequency, reading performance, Descemet′s stripping endothelial keratoplasty, Treatment Outcome, thermo-reversible gelation polymer, cataract, fungal, outcome, Original Article, Female, vasoproliferative tumor, medicine.symptom, management, Adult, temporalis muscle, lens, Adolescent, Corneal endothelium, graft failure, strabismus surgery, retinoblastoma, Tonometry, Ocular, Young Adult, medicine, learning disabilities, multiple disabilities and visual impairment, porous orbital implant, Congenital cataract, transportation, Contrast sensitivity function, business.industry, Postoperative complication, Retrospective cohort study, Contracted socket, extracellular enzymes, citicoline, Surgery, presbyopia, business, juvenile glaucoma, ultrasound biomicroscopy, Follow-Up Studies
Abstract

Purpose: This study was aimed at reporting the outcomes of trabeculectomy in primary juvenile open angle glaucoma (JOAG). Design: This study was a retrospective noncomparative case series. Materials and Methods: We included 60 eyes of 41 JOAG patients who underwent primary trabeculectomy without mitomycin-C (MMC) between 1995 and 2007. The primary outcome was success, defined as complete, if intraocular pressure (IOP) was >5 and ≤21 mmHg without medications or qualified if IOP was >5 and ≤21 mmHg with or without antiglaucoma medications. Secondary outcome measures were mean and percentage IOP reduction, complications, and risk factors for the failure of trabeculectomy. Results: The mean (±standard deviation) age at presentation was 24.1 ± 6.8 years (range, 12-35). Mean follow-up was 67 ± 41 months (range, 12-156). At 1 year, the probability of complete success was 92% (n = 56, 95% CI: 81-96%), at 3 years it was 89% (n = 47, 95% CI: 78-95%), and at the end of 5 years, it was 80% (n = 34, 95% CI: 65-89%). The probability of qualified success was 100% (n = 60) at 1 year, 98% (n = 51, 95% CI: 87-100%) at 3 years, and 96% (n = 36, 95% CI: 84-99%) at the end of 5 years. The mean IOP reduced from 35 ± 10 to 13 ± 2.5 mmHg (P < 0.001) after trabeculectomy. There was no serious postoperative complication. Young age was the only significant risk factor associated with the failure (odds ratio = 0.89, P = 0.03). Conclusion: Primary trabeculectomy without MMC has good success rates in JOAG.

Published
2014

11. Aggressive posterior retinopathy of prematurity in infants ≥1500 g birth weight

Author

Deeksha Katoch, Mangat R Dogra, Gaurav Sanghi, and Amod Gupta

Subjects
Male, visual acuity, medicine.medical_treatment, Azithromycin, Blindness, Low vision care, Cataract surgery, ′BARC I-125 Ocu-Prosta seeds′, lcsh:Ophthalmology, human corneal endothelial precursor cells, B-scan, heavier infants, Birth Weight, mimics microbial keratitis, Favorable outcome, Lagophthalmos, Childhood corneal opacity, neonatal care, A-scan, Endophthalmitis, multimedia, descemet stripping endothelial keratoplasty, Laser Coagulation, patching, school children, informed consent, Bacterial, Retinopathy of prematurity, Colour perception, ROP, retinal angioma, keratitis, silicone sling, parapapillary atrophy, Aggressive posterior retinopathy of prematurity, dermis fat graft, visual outcome, high doses of steroids, explantation, glaucoma experimental, endothelial keratoplasty, eye lens, vision function, near vision, Infant, Premature, topography guided custom ablation treatment, Accommodation, medicine.medical_specialty, reconstruction, zone 1 ROP, complications, Amblyopia, recurrent, treatment of cataract, developmental cataract, vertical rectus transposition, Humans, stereo acuity, choroidal melanoma, choroidal mass, APROP, oxygen induced retinopathy, primary trabeculectomy, trabeculectomy in young, Retrospective Studies, testability, Glaucoma, donor dislocation, medicine.disease, eye diseases, Ophthalmology, Glucose, Acoustic features, disability, lcsh:RE1-994, in vitro anticataract, Ethiopia, sphere forming assay, Juvenile open angle glaucoma, Retcam, chloramphenicol, Pediatrics, genetic structures, Moringa oliefera, ciliary body melanoma, intraocular lens, non-chlamydia conjunctival bacteria, in vitro expansion, multiple sclerosis, supraciliary segment implants, Neovascularization, function peak, gonioscopy, risk factors, postoperative, retinopathy of prematurity, rural health, pediatric keratoplasty, Congenital glaucoma, topography guided photoablation, periosteal fixation, education, Early removal, Episcleral plaque brachytherapy, endothelial cell loss, toxins, Gestational age, Exotropic Duane retraction syndrome, spatial frequency, reading performance, Vascular loops, Descemet′s stripping endothelial keratoplasty, Treatment Outcome, thermo-reversible gelation polymer, cataract, congenital hereditary endothelial dystrophy, fungal, outcome, Female, vasoproliferative tumor, corneal edema, medicine.symptom, Laser coagulation, atypical ROP, management, temporalis muscle, lens, Corneal endothelium, graft failure, keratoconus, Birth weight, strabismus surgery, Gestational Age, fluoroquinolone, Brief Communication, retinoblastoma, Collagen cross linking, medicine, learning disabilities, multiple disabilities and visual impairment, porous orbital implant, progressive anterior segment fibrosis syndrome, Congenital cataract, transportation, Contrast sensitivity function, business.industry, developing country, Infant, Newborn, Contracted socket, Congenital aniridia, Retrospective cohort study, extracellular enzymes, citicoline, prevalence of blindness, presbyopia, stingers, sense organs, business, juvenile glaucoma, ultrasound biomicroscopy, Follow-Up Studies
Abstract

In this retrospective case series, we report the spectrum and outcomes of aggressive posterior retinopathy of prematurity (APROP) in infants ≥ 1500 g birth weight. Twenty-nine eyes of 15 infants are included. All infants were referred from level I or II nurseries, received supplemental unmonitored oxygen for prolonged duration (1 week) and had multiple systemic co-morbidities. Of the 29 eyes, 10 (34.5%) had zone 1 and 19 (65.5%) had posterior zone 2 disease. Twenty-five (86.2%) eyes had flat neovascularization and 4 (13.8%) eyes had brush like proliferation. We noticed large vascular loops in 10 (34.5%) eyes. After confluent laser photocoagulation, 22 (75.9%) eyes had a favorable outcome. The study concludes that APROP in heavier (≥ 1500 g birth weight) premature infants occurs mostly in posterior zone 2 with flat neovascularization and atypical features like large vascular loops. Supplemental unmonitored oxygen for prolonged duration and multiple systemic co-morbidities could be a contributing factor.

Published
2014

12. Azithromycin, fluoroquinolone and chloramphenicol resistance of non-chlamydia conjunctival bacteria in rural community of Ethiopia

Author

Mulugeta Kibret and Bayeh Abera

Subjects
Male, Rural Population, visual acuity, Chloramphenicol Resistance, Azithromycin, Blindness, Low vision care, Cataract surgery, ′BARC I-125 Ocu-Prosta seeds′, Community Eye care, lcsh:Ophthalmology, human corneal endothelial precursor cells, B-scan, Medicine, Chlamydia, Lagophthalmos, A-scan, Endophthalmitis, multimedia, patching, Incidence, school children, informed consent, Bacterial, Enterobacter, Colour perception, Ciprofloxacin, retinal angioma, keratitis, silicone sling, parapapillary atrophy, dermis fat graft, Conjunctiva, explantation, glaucoma experimental, eye lens, vision function, Fluoroquinolones, topography guided custom ablation treatment, Accommodation, reconstruction, complications, Microbial Sensitivity Tests, Amblyopia, Microbiology, Antibiotic resistance, recurrent, treatment of cataract, developmental cataract, vertical rectus transposition, Humans, stereo acuity, choroidal melanoma, choroidal mass, primary trabeculectomy, trabeculectomy in young, Retrospective Studies, Bacteria, testability, Pathogenic bacteria, Glaucoma, donor dislocation, Conjunctivitis, Ophthalmology, Cross-Sectional Studies, Glucose, Acoustic features, disability, lcsh:RE1-994, in vitro anticataract, Ethiopia, sphere forming assay, Juvenile open angle glaucoma, Retcam, chloramphenicol, Moringa oliefera, ciliary body melanoma, intraocular lens, non-chlamydia conjunctival bacteria, Drug resistance, medicine.disease_cause, in vitro expansion, multiple sclerosis, supraciliary segment implants, Eye Infections, Bacterial, function peak, Drug Resistance, Multiple, Bacterial, gonioscopy, risk factors, postoperative, rural health, Congenital glaucoma, topography guided photoablation, periosteal fixation, education, biology, Episcleral plaque brachytherapy, endothelial cell loss, toxins, Exotropic Duane retraction syndrome, spatial frequency, reading performance, Anti-Bacterial Agents, Descemet′s stripping endothelial keratoplasty, thermo-reversible gelation polymer, cataract, fungal, outcome, Female, vasoproliferative tumor, management, medicine.drug, Adult, temporalis muscle, lens, Corneal endothelium, graft failure, keratoconus, strabismus surgery, fluoroquinolone, retinoblastoma, Collagen cross linking, Streptococcus pneumoniae, learning disabilities, multiple disabilities and visual impairment, porous orbital implant, Congenital cataract, transportation, Contrast sensitivity function, business.industry, Contracted socket, extracellular enzymes, biology.organism_classification, citicoline, presbyopia, business, juvenile glaucoma, ultrasound biomicroscopy
Abstract

Aim: To determine profiles of non-chlamydia conjunctival bacteria and their antimicrobial susceptibility from adults who underwent trachomatous trichiasis surgery in rural areas of Ethiopia. Materials and Methods: A cross-sectional study was conducted in rural districts in West Gojjam administrative zone. Conjunctival swabs were collected during surgery and transported using Stuart transport broth (Oxoid, UK). Antibiotic susceptibility of conjunctival isolates was determined using the Kirby-Bauer disc-diffusion method. Results: Non-chlamydia pathogenic bacteria were recovered from conjunctiva of 438 (31%) participants before treatment. The isolated conjunctival bacteria were Staphylococcus aureus, coagulase-negative Staphylococci, Streptococcus group (A, C, F and G), Enterococci, Streptococcus pneumoniae, Moraxella spp., Escherichia coli, Citrobacter spp., Proteus spp., Klebsiella spp., Pseudomonas spp. and Enterobacter spp. Overall, resistance rates of 57.8% to azithromycin and 68.5% to chloramphenicol were found. However, 86-94.4% sensitivity was demonstrated to ciprofloxacin and norfloxacin. Moderate sensitivity rates (61.8-78.4%) were observed to ceftriaxone, tetracycline and cotrimoxazole. Conclusion: Fluoroquinolones that have activity against the majority of bacterial isolates were potent at in vitro. However, unacceptably high levels of resistance to azithromycin and chloramphenicol in rural community indicated a need for further study and antimicrobial resistance surveillance.

Published
2014

13. Clinical features and management of ocular lesions after stings by hymenopteran insects

Author

R Revathi, K S Siddharthan, and Anita Raghavan

Subjects
Male, Visual Acuity, Ophthalmologic Surgical Procedures, Azithromycin, Blindness, Low vision care, Cataract surgery, ′BARC I-125 Ocu-Prosta seeds′, lcsh:Ophthalmology, human corneal endothelial precursor cells, B-scan, mimics microbial keratitis, Lagophthalmos, A-scan, Endophthalmitis, multimedia, descemet stripping endothelial keratoplasty, patching, school children, informed consent, Bacterial, Colour perception, retinal angioma, keratitis, silicone sling, parapapillary atrophy, Child, Preschool, dermis fat graft, visual outcome, high doses of steroids, explantation, glaucoma experimental, eye lens, vision function, near vision, topography guided custom ablation treatment, Accommodation, medicine.medical_specialty, reconstruction, complications, Amblyopia, Cataract, recurrent, Corneal edema, treatment of cataract, developmental cataract, vertical rectus transposition, Humans, stereo acuity, choroidal melanoma, choroidal mass, primary trabeculectomy, trabeculectomy in young, Aged, Corneal Damage, Corneal Decompensation, testability, Insect Bites and Stings, Glaucoma, donor dislocation, medicine.disease, eye diseases, Ophthalmology, Glucose, Acoustic features, disability, lcsh:RE1-994, in vitro anticataract, Ethiopia, sphere forming assay, Juvenile open angle glaucoma, Retcam, chloramphenicol, Intraocular pressure, Visual acuity, genetic structures, Moringa oliefera, ciliary body melanoma, intraocular lens, non-chlamydia conjunctival bacteria, Ocular trauma, in vitro expansion, multiple sclerosis, supraciliary segment implants, function peak, gonioscopy, High doses, risk factors, postoperative, rural health, Congenital glaucoma, topography guided photoablation, periosteal fixation, education, Early removal, Episcleral plaque brachytherapy, endothelial cell loss, Corneal Edema, toxins, Exotropic Duane retraction syndrome, spatial frequency, reading performance, Anti-Bacterial Agents, Descemet′s stripping endothelial keratoplasty, thermo-reversible gelation polymer, fungal, outcome, Female, vasoproliferative tumor, medicine.symptom, management, Adult, temporalis muscle, lens, Corneal endothelium, graft failure, keratoconus, strabismus surgery, fluoroquinolone, Brief Communication, Insect bites and stings, retinoblastoma, Collagen cross linking, medicine, learning disabilities, Animals, multiple disabilities and visual impairment, porous orbital implant, progressive anterior segment fibrosis syndrome, Congenital cataract, transportation, Contrast sensitivity function, business.industry, Contracted socket, Congenital aniridia, extracellular enzymes, citicoline, prevalence of blindness, Dermatology, Hymenoptera, Surgery, presbyopia, stingers, sense organs, Ophthalmic Solutions, business, juvenile glaucoma, ultrasound biomicroscopy, Follow-Up Studies
Abstract

We describe the ocular alterations and the management after stings from Hymenopteran insects. In all the five patients, the insect was identified as bee. The patients presented with significant corneal edema, which resolved dramatically in three of them after removal of stingers. Among the other two one went for permanent corneal decompensation and the other developed Intumuscent cataract with increased intraocular pressure. Although a rare occurrence, ocular trauma caused by Hymenopteran insects has a potential to cause severe ocular damage in humans. A high level of clinical suspicion and immediate removal of the stingers along with administration of high doses of topical and systemic steroids is a must to prevent chances of permanent corneal damage and intraocular complications.

Published
2014

14. Prevalence, causes of blindness, visual impairment and cataract surgical services in Sindhudurg district on the western coastal strip of India

Author

Anil Kulkarni, Shailbala Patil, B R Shammanna, Siddharth Vora, Ramkrishna N Hingane, Sachin Ainapure, and Parikshit Gogate

Subjects
Male, Rural Population, Urban Population, visual acuity, Cross-sectional study, medicine.medical_treatment, Azithromycin, Blindness, Low vision care, Cataract surgery, ′BARC I-125 Ocu-Prosta seeds′, Community Eye care, lcsh:Ophthalmology, human corneal endothelial precursor cells, B-scan, Lagophthalmos, Aged, 80 and over, A-scan, Endophthalmitis, multimedia, education.field_of_study, patching, school children, informed consent, Bacterial, Colour perception, retinal angioma, keratitis, silicone sling, parapapillary atrophy, dermis fat graft, visual outcome, explantation, glaucoma experimental, eye lens, vision function, near vision, topography guided custom ablation treatment, Accommodation, medicine.medical_specialty, reconstruction, complications, Visual impairment, Vision, Low, Amblyopia, recurrent, treatment of cataract, developmental cataract, vertical rectus transposition, Humans, stereo acuity, choroidal melanoma, choroidal mass, education, primary trabeculectomy, trabeculectomy in young, Aged, testability, Glaucoma, donor dislocation, medicine.disease, eye diseases, Ophthalmology, Cross-Sectional Studies, Glucose, Acoustic features, disability, lcsh:RE1-994, in vitro anticataract, Ethiopia, sphere forming assay, Juvenile open angle glaucoma, Retcam, chloramphenicol, Pediatrics, Visual acuity, genetic structures, Moringa oliefera, ciliary body melanoma, intraocular lens, non-chlamydia conjunctival bacteria, in vitro expansion, multiple sclerosis, supraciliary segment implants, function peak, gonioscopy, Prevalence, risk factors, postoperative, rural health, Congenital glaucoma, topography guided photoablation, periosteal fixation, Episcleral plaque brachytherapy, endothelial cell loss, toxins, Exotropic Duane retraction syndrome, Middle Aged, spatial frequency, reading performance, Descemet′s stripping endothelial keratoplasty, thermo-reversible gelation polymer, cataract, fungal, outcome, Female, vasoproliferative tumor, medicine.symptom, management, temporalis muscle, lens, Corneal endothelium, graft failure, keratoconus, Population, India, strabismus surgery, Cataract Extraction, fluoroquinolone, retinoblastoma, Collagen cross linking, Diabetes mellitus, medicine, learning disabilities, multiple disabilities and visual impairment, porous orbital implant, Congenital cataract, transportation, Contrast sensitivity function, business.industry, Contracted socket, extracellular enzymes, citicoline, prevalence of blindness, Confidence interval, presbyopia, business, juvenile glaucoma, ultrasound biomicroscopy
Abstract

Background : Konkan coast of India is geographically distinct and its pattern of blindness has never been mapped. Aim : To study the prevalence and causes of blindness and cataract surgical services in Sindhudurg district of West Coast. Subjects : Individual aged > 50 years. Materials and Methods: Rapid assessment of avoidable blindness used to map blindness pattern in the district. Statistical analysis: SPSS version 19. Results: Amongst those examined 1415 (51.7%) had visual acuity (VA) >20/60, 924 (33.8%, confidence interval (C.I) 30.5%-36.8%) had VA 20/200

Published
2014

15. Corneal changes following collagen cross linking and simultaneous topography guided photoablation with collagen cross linking for keratoconus

Author

Abinaya Priya Venkataraman, Bhaskar Srinivasan, Aishwaryah Radhakrishnan, Prema Padmanabhan, and Nidhi Gupta

Subjects
Male, Collagen cross linking, visual acuity, Blindness, Low vision care, Cataract surgery, Cornea, ′BARC I-125 Ocu-Prosta seeds′, lcsh:Ophthalmology, human corneal endothelial precursor cells, B-scan, Medicine, Prospective Studies, Lagophthalmos, A-scan, Endophthalmitis, multimedia, Photosensitizing Agents, patching, school children, informed consent, Bacterial, Colour perception, retinal angioma, Single centre, keratitis, silicone sling, parapapillary atrophy, dermis fat graft, Collagen, Laser Therapy, explantation, glaucoma experimental, eye lens, vision function, topography guided custom ablation treatment, Accommodation, medicine.medical_specialty, reconstruction, complications, Amblyopia, recurrent, treatment of cataract, developmental cataract, vertical rectus transposition, Humans, stereo acuity, choroidal melanoma, choroidal mass, primary trabeculectomy, trabeculectomy in young, testability, Glaucoma, donor dislocation, medicine.disease, eye diseases, Ophthalmology, Glucose, Acoustic features, Photochemotherapy, disability, lcsh:RE1-994, in vitro anticataract, sphere forming assay, Juvenile open angle glaucoma, Retcam, genetic structures, Moringa oliefera, ciliary body melanoma, intraocular lens, Photoablation, in vitro expansion, multiple sclerosis, supraciliary segment implants, function peak, gonioscopy, risk factors, postoperative, rural health, Congenital glaucoma, topography guided photoablation, periosteal fixation, Best corrected visual acuity, education, Episcleral plaque brachytherapy, endothelial cell loss, toxins, Exotropic Duane retraction syndrome, spatial frequency, reading performance, Descemet′s stripping endothelial keratoplasty, Cross-Linking Reagents, Surgery, Computer-Assisted, thermo-reversible gelation polymer, cataract, fungal, outcome, Original Article, Female, vasoproliferative tumor, management, Adult, Keratoconus, temporalis muscle, Adolescent, lens, Corneal endothelium, graft failure, keratoconus, strabismus surgery, retinoblastoma, Young Adult, learning disabilities, multiple disabilities and visual impairment, porous orbital implant, Congenital cataract, transportation, Contrast sensitivity function, business.industry, Corneal Topography, Contracted socket, extracellular enzymes, citicoline, presbyopia, sense organs, business, juvenile glaucoma, ultrasound biomicroscopy, Follow-Up Studies
Abstract

Purpose: To compare the outcome of Collagen cross-linking (CXL) with that following topography-guided customized ablation treatment (T-CAT) with simultaneous CXL in eyes with progressive keratoconus. Materials and Methods: This was a prospective, non-randomized single centre study of 66 eyes with progressive keratoconus. Of these, 40 eyes underwent CXL and 26 eyes underwent T-CAT + CXL. The refractive, topographic, tomographic and aberrometric changes measured at baseline, 1, 3 and 6 months post-operatively were compared between both groups. Results: After a mean follow-up of 7.7 ± 1.3 months, the mean retinoscopic cylinder decreased by 1.02 ± 3.16 D in the CXL group ( P = 0.1) and 2.87 ± 3.22 D in the T-CAT + CXL group ( P = 0.04). The Best corrected visual acuity increased by 2 lines or more in 10% of eyes in the CXL group and in 23.3% of eyes in the T-CAT + CXL group. The mean steepest-K reduced by 0.40 ± 3.71 D ( P = 0.77) in the CXL group and by 2.91 ± 2.01D ( P = 0.03) in the T-CAT + CXL group. The sag factor and surface asymmetry index showed no significant change in the CXL group but reduced by 3.59 ± 5.94 D ( P = 0.01) and 0.72 ± 1.18 ( P = 0.02) respectively in the T-CAT + CXL group. There was a significant increase in the highest posterior corneal elevation in both groups (9.57 ± 14.93 μ in the CXL group and 7.85 ± 9.25 μ in the T-CAT + CXL group, P ≤ 0.001 for both). There was significantly greater reduction of mean coma ( P < 0.001) and mean higher-order aberrations ( P = 0.01) following T-CAT + CXL compared to CXL. Conclusions: CAT + CXL is an effective approach to confer biomechanical stability and to improve the corneal contour in eyes with keratoconus and results in better refractive, topographic and aberrometric outcomes than CXL alone.

Published
2014

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