Rajeev Sudan

Combined surgery, cryotherapy, and mitomycin-C for recurrent ocular surface squamous neoplasia.

Purpose. To report the outcome of combined excision, cryotherapy, and antimetabolite treatment of recurrent ocular surface squamous neoplasia. Methods. The patients with recurrent ocular surface squamous neoplasia were treated by excision of lesion, cryotherapy of limbus, and conjunctival margin followed by 0.02% Mitomycin C application at the time of surgery. Patients have been followed up for at least 1 year. Results. A total of five eyes of five patients with recurrent ocular surface squamous neoplasia were treated by combined excision, cryotherapy, and Mitomycin C. Histopathologic diagnosis included invasive squamous cell carcinoma in four cases and squamous dysplasia in one case. No recurrences have been noted for a follow-up period of more than 1 year now. Conclusion. Combining excision with cryotherapy and Mitomycin C application at the time of surgery is a very effective therapy for recurrent ocular surface squamous neoplasia. It is relevant for cases in large, poor countries where patients present late and are less likely to come for follow-up care.

Formalin-induced cataract in goat eyes as a surgical training model for phacoemulsification

&NA; We compared 2 techniques of inducing cataract in enucleated goat eyes as a training model for phacoemulsification. The cataract was induced using 0.2 to 0.5 mL of formalin 20%. In 10 eyes, formalin was injected through a clear corneal side port into the nucleus after capsulorhexis and in 10 eyes, through the pars plana before capsulorhexis. The pars plana technique achieved a cataract of different grades of nuclear hardness with the added advantage of anterior capsule elasticity closely simulating that of senile cataract but without compromising corneal clarity.

Animal model for teaching phacoemulsification.

lead to a devastating situation in the patients. A person who for medical or other reasons cannot have anesthesia twice will not have a significant disadvantage by having good vision in only 1 eye. The objective in such cases is to remove the visual handicaps hampering the day-to-day life rather than aiming for good binocular vision. A good uniocular surgical visual result can certainly achieve this goal, so why pursue research or debate on this issue, which definitely involves a potential risk, even though it may be small. Modern anesthesia is quite safe, and we are now moving toward topical anesthesia, which does not have significant adverse effects on a patient’s general health. We hope our views will be given adequate consideration by the authors as many surgeons around the globe share them.

Postkeratoplasty endophthalmitis by Alcaligenes faecalis: a case report.

Purpose. To describe a postkeratoplasty endophthalmitis owing to Alcaligenes faecalis that resolved with medical management. Methods. Case report and review of literature. Results. To best of our knowledge, postkeratoplasty endophthalmitis caused by A. faecalis has not been reported in literature. The source of infection was found to be the donor tissue. The organism isolated was resistant to gentamicin, which was the only antibiotic present in the storage medium (McCarey and Kaufman medium). The patient was treated aggressively with topical, systemic and intravitreal antibiotics. The endophthalmitis resolved completely within two weeks. Conclusion. A. faecalis is a gram negative, non-spore forming rod that can cause endophthalmitis if donor tissue is contaminated with the organism. Clinical suspicion, review of bacterial culture and sensitivity report from donor tissue, anterior chamber and vitreous taps, along with early therapy with appropriate antibiotics can lead to resolution of infection.

Iris retraction and retroflexion after transscleral contact diode laser photocoagulation

A 9-year-old girl with refractory glaucoma with an anterior chamber intraocular lens underwent transscleral contact diode laser cyclophotocoagulation. Slit-lamp examination and ultrasound biomicroscopy revealed iris retraction and retroflexion at 2 weeks of follow-up. The probable cause of this complication is discussed.