Jagjit S Saini

INDICATIONS AND OUTCOME OF OPTICAL PARTIAL THICKNESS LAMELLAR KERATOPLASTY

Purpose. To review the indications and outcome of optical partial thickness lamellar keratoplasty (LKP) over a 22-year period. Methods. The study is a retrospective review of 138 eyes of 126 patients. Snellen visual acuity, preoperative clinical condition, and postoperative clinical status were assessed. Results. Postoperative follow-up ranged from 1 month to 174 months (average, 34.5). In descending order of frequency, climatic droplet keratopathy, infectious keratitis scar, and band-shaped keratopathy were the most common indications for surgery. Follow-up records were available for 130 eyes; 93% of grafts remained transparent. One hundred eyes (80%) preoperative measured Snellen acuity of 6/60 or less. Postoperatively, only 20 eyes (13.4%) were assessed as worse than 6/60. Mean best-corrected visual acuity postoperative was 0.58 ± 0.24. Twenty-two eyes (16.9%) demonstrated postoperative visual acuity of better than 6/12. Complications included presumed rejection in two eyes, nonhealing epithelial defect in two eyes, and graft infection in seven eyes. Conclusion. Vision gain following LKP is generally moderate (visual acuity, 6/18–6/12) in the majority of eyes (61.5%). Vision-threatening complications are low (6.9%). There is scope for reducing complications like postoperative infections and improving visual gain through deep lamellar keratoplasty.

Keratoconus in Asian eyes at a tertiary eye care facility

Background: The purpose of this study was to assess the demographic variables, age at diagnosis, keratometry and slitlamp signs in keratoconus.

Anterior and posterior capsulorhexis in pediatric cataract surgery with or without trypan blue dye: randomized prospective clinical study.

Purpose: To evaluate the clinical efficacy of trypan blue 0.1% dye (Blurhex®) in creating a complete anterior and posterior capsulorhexis during pediatric cataract surgery. Setting: Tertiary eyecare center, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Methods: In a prospective randomized study, an anterior (ACCC) and posterior (PCCC) continuous curvilinear capsulorhexis were performed in pediatric patients. In Group 1 (n = 19), the ACCC and PCCC were created without use of trypan blue dye. In Group 2 (n = 23), intracameral trypan blue dye was used to stain the anterior and posterior capsules. Results: In Group 1, 14 eyes (73.6%) had a complete ACCC and 10 (52.6%) had a complete PCCC. In Group 2, 21 eyes (91.3%) had a complete ACCC and 19 (82.6%) had a complete PCCC. Conclusion: In cases of pediatric cataract, staining the anterior and posterior capsules with trypan blue 0.1% allowed recognition of capsule flaps and facilitated the creation of complete ACCCs and PCCCs.

Phacoemulsification and intraocular lens implantation in an Alport's syndrome patient with bilateral anterior and posterior lenticonus

We report a case of intraocular lens (IOL) implantation with a continuous curvilinear capsulorhexis and phacoemulsification in a 30-year-old man manifesting anterior and posterior lenticonus. The surgery was uneventful and on follow-up, the IOL was well centered in the bag.

Evaluation of Endothelial Function in Postkeratoplasty Eyes

BACKGROUND AND OBJECTIVE To evaluate corneal endothelium function in postkeratoplasty eyes. PATIENTS AND METHODS Endothelial function was assessed in 23 clear corneal grafts. After a measurable corneal edema was induced by soft contact lens wear, serial pachometric readings were taken for 3 hours to arrive at the percentage recovery per hour (PRPH) index. RESULTS The assessed PRPH values of the clear corneal grafts ranged from 24.6% to 73.0%, with a mean value of 51.8% +/- 12.2%. Of the six corneal grafts that demonstrated an initial PRPH value of less than 47.5%, four became edematous within 6 months of follow-up. CONCLUSIONS Assessed PRPH, as an in vivo-measured index of endothelial function, is a valuable method for monitoring endothelial function in postkeratoplasty eyes. The low PRPH index identifies eyes at risk of spontaneous nonimmunologic failures.

Bilateral Orbital Pseudotumor in a Child: Ten Years' follow-up

A ten-year follow-up is presented of a five-year-old child with histopathologically confirmed, bilateral orbital pseudotumor and sinus involvement. Bilateral proptosis progressed, despite systemic steroids and brachytherapy, to both orbits. No phase of spontaneous resolution was observed. During ten years the child did not demonstrate any significant systemic or ocular morbidity.

In Vivo Evaluation of Corneal Endothelial Function Following Cataract Surgery

BACKGROUND AND OBJECTIVE To quantify corneal endothelial function measured in vivo following extracapsular cataract extraction (ECCE) and posterior chamber intraocular lens (PC IOL) implantation. PATIENTS AND METHODS Endothelial function was assessed in 18 patients using recovery of the corneal hydration rate following induced cornea swelling before and after ECCE and PC IOL implantation. RESULTS The mean percentage recovery per hour (PRPH) showed a significant decrease at 12 and 24 weeks after surgery compared with before surgery (P < .01). A decrease in PRPH of more than 5% was observed in 55.6% and 66.7% of the eyes at 12 and 24 weeks after surgery, respectively. CONCLUSIONS PRPH measured in vivo demonstrates decreased endothelial function following ECCE and PC IOL implantation. The PRPH measures even slight changes in endothelial function and could be useful in evaluating endothelial damage.