Prem Prakash

Scleral perforations in strabismus surgery: incidence and role of prophylactic cryotherapy – a clinical and experimental study

PURPOSE To determine the incidence of scleral perforations in strabismus surgery in a tertiary centre setting in India and to evaluate the risk or benefit, if any, of prophylactic cryotherapy following experimental scleral perforations in rabbits. METHODS Seven hundred eyes of patients that had undergone strabismus surgery (1121 procedures) were examined postoperatively by indirect ophthalmoscopy. In the experimental component, 20 rabbit eyes were perforated with a 6-0 polyglactin suture. In each rabbit, one eye acted as a control while the other eye received a 20 seconds application of prophylactic cryo at the perforation site. They were then monitored for 6 weeks before subjecting some to histopathological examination by light and electron microscopy. RESULTS Ten scleral perforations were detected in 9 of the patients (incidence of 1.42% of the eyes and 0.89% of the strabismus procedures). In the rabbits, a chorioretinal scar was seen in all perforated eyes. A mild cryo reaction was observed in the cryoed eyes. No other sequelae were seen. Histopathologic studies showed changes consistent with the normal healing process. CONCLUSIONS Of the human eyes screened, 1.42% showed evidence of scleral perforation following strabismus surgery. In no case were sequelae leading to visual loss observed. In the rabbits no sequelae were observed at 6 weeks of follow-up apart from a chorioretinal scar and a cryoreaction in those eyes in which cryoprophylaxis had been given. Mild cryoprophylaxis did not exert any positive or negative influence on the natural course of scleral perforation in our short-term animal study.

The Effect of Dexamethason and Oxytetracyclin on the Growth of Candida albicans

Summary: Candida albicans was grown in Sabourauds dextrose liquid medium alone and with decadron®*, terramycin®** and both. Decadron® was incorporated in the strengths of 0.01, 0.05 and 0.1 % and terramycin® in 0.1, 0.2 and 0.5% strengths. Dry weight and pH values of the growths obtained were determined. The maximum increase in values occured when C. albicans was grown with decadron and terramycin together. The increase with decadron® or terramycin® individually or in combination was proportional to the increase in the concentration of the additives and was statistically significant when compared to the respective controls. The lesions in rabbit cornea were more severe with treated than untreated Candida.

Loperamide versus diphenoxylate in diarrhea of infants and children

The antidiarrheal activity of loperamide and diphenoxylate was studied in infants and children. Of 714 age and sex matched cases, 214 were treated conventionally (C group), 260 received loperamide (L group) and 240 diphenoxylate (D group) in addition to supportive antidiarrheal therapy. In C group 50 per cent, in L group 93.1 per cent and in D group 77.1 per cent of patients improved within 36 hours. Then active cases of diarrhea of L & D groups were crossed-over. In L group 61.2 per cent and in D group 22.2 per cent improved. With diphenoxylate side effects observed were vomiting, sedation, intoxication, and paralytic ileus and with loperamide vomiting and constipation. Loperamide was found to be more effective and safer than diphenoxylate.

Scleral dellen in strabismus surgery

Abstract. This communication highlights scleral dellen as an unusual complication of strabismus surgery in a 55‐year‐old hypertensive male. The clinical significance, differential diagnosis and management of this condition has been discussed.

Inverse Uhthoff's symptom

Two cases of optic neuritis are presented in whom an inverse Uhthoffs symptom was elicited, i.e., an improvement in visual acuity instead of expected deterioration following exercise. The probable mechanisms for the genesis of inverse Uhthoffs symptom are discussed.

Anton's syndrome: A case report

A case of Antons syndrome resulting from bilateral occlusion of the posterior cerebral arteries is reported. It initially presented with optic neuritis, and additional phenomena like pupillary abnormalities, dyslexia with dysgraphia. Visual improvement did not follow the usual pattern.