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Dive into the research topics where Somasheila I. Murthy is active.

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Featured researches published by Somasheila I. Murthy.


Cornea | 2005

Cultivated corneal epithelial transplantation for severe ocular surface disease in vernal keratoconjunctivitis

Virender S. Sangwan; Somasheila I. Murthy; Geeta K. Vemuganti; Aashish K. Bansal; Nibaran Gangopadhyay; Gullapalli N. Rao

Purpose: To report cultivated epithelial transplantation in 2 patients with vernal keratoconjunctivitis (VKC) with severe ocular surface disease. Methods: Two patients initially diagnosed with burnt-out VKC presented with bilateral photophobia, decreased vision, and corneal neovascularization. The first patient underwent living-related conjunctival-limbal allograft in the left eye and cultivated limbal epithelial cell allotransplant in the right. The second patient underwent unsuccessful amniotic membrane transplantation (AMT) followed by autologous cultivated limbal epithelial cell transplantation in the worse eye. Results: Both patients had onset of VKC in the first decade. Surgical intervention in both led to marked amelioration in symptoms and improvement in vision. In patient 1, vision improved from 20/800 (both eyes) to 20/30 in the right and 20/100 in the left eye at a follow-up of 34 months. In patient 2, it improved from 20/400 to 20/50 after the second procedure, 25 months postoperatively. Histopathology of the excised pannus revealed fibrosis and mononuclear cell infiltrates in all 3 eyes. Conclusions: Severe ocular surface disease may occur in persistent VKC, leading to marked visual loss. AMT alone may be insufficient to restore the ocular surface, and limbal epithelial cell transplantation is warranted.


Cornea | 2012

Endothelial failure after collagen cross-linking with riboflavin and UV-A: case report with literature review.

Bhupesh Bagga; Shivani Pahuja; Somasheila I. Murthy; Virendra S. Sangwan

Purpose: To report a case of endothelial decompensation after a collagen cross-linking (CXL) procedure for keratoconus. Methods: An 18-year-old boy had CXL for keratoconus in the right eye. He developed keratouveitis with generalized corneal edema seen 3 weeks after the procedure. Polymerase chain reaction for aqueous humor Herpes simplex virus was negative. The patient was treated with topical steroids. Specular microscopy revealed mildly reduced density of endothelial cells. On follow-up to 6 months, corneal edema increased with the formation of epithelial bullae. Penetrating keratoplasty was performed. Possible causes for this complication are discussed. Results: Clinical and histopathological analyses revealed generalized loss of endothelial cells along with signs of inflammation. Conclusions: Although it is considered very safe, collagen CXL can cause severe keratouveitis and endothelial failure.


Survey of Ophthalmology | 2011

Microsporidial Keratitis: Need for Increased Awareness

Savitri Sharma; Sujata Das; Joveeta Joseph; Geeta K. Vemuganti; Somasheila I. Murthy

Since the devastation of the European silk worm industry in the 19th century, microsporidia have been recognized as important organisms. An enormous literature is available on their biology, phylogeny, classification, disease profile, diagnosis, and treatment; however, it is only recently that ophthalmologists have begun to take note of these organisms. The last two decades have seen several publications related to ocular microsporidiosis, in particular those forms affecting the cornea. Both immunocompetent and immunocompromised patients are at risk of developing corneal infections that may range from self limiting mild keratoconjunctivitis to severe stromal keratitis recalcitrant to medical treatment. Exposure to soil, muddy water, and minor trauma are possible risk factors. Although reliable prevalence data are lacking, recent studies indicate a high prevalence of microsporidial keratoconjunctivitis in the rainy season, especially in India and other countries with similar climates. For instance, a high prevalence has been documented in Singapore. We bring together the information available on ocular microsporidiosis.


Journal of Clinical Microbiology | 2006

Use of Different Stains for Microscopic Evaluation of Corneal Scrapings for Diagnosis of Microsporidial Keratitis

Joveeta Joseph; Somasheila I. Murthy; Prashant Garg; Savitri Sharma

ABSTRACT Retrospective evaluation of potassium hydroxide plus calcofluor white (KOH+CFW), Gram, Giemsa, and modified Ziehl-Neelsen (1% H2SO4, cold) stains for the detection of microsporidia in corneal scrapings from 30 patients showed KOH+CFW and acid-fast stains to be most efficient (29/30 [96.7%] and 28/30 [93.3%], respectively) in the diagnosis of microsporidial keratitis.


Cornea | 2011

Vernal keratoconjunctivitis with limbal stem cell deficiency.

Virender S. Sangwan; Jain; Geeta K. Vemuganti; Somasheila I. Murthy

Purpose: To describe the clinical features of patients affected with vernal keratoconjunctivitis (VKC) with associated limbal stem cell deficiency (LSCD). Methods: In a retrospective observational case series, data relating to 49 eyes of 27 patients with VKC and features of LSCD seen from January 2000 to August 2005 at the Cornea Service of LV Prasad Eye Institute were reviewed. Detailed history, visual acuity at presentation, clinical findings, disease activity, duration of complaints, and extent of LSCD and management were noted. The presence of concurrent keratoconus and other ocular or systemic disorders if any were recorded. Results: During this period, 2225 patients with VKC were seen at our institute. Of the 49 eyes, (1.2%) showed features of LSCD. The mean age was 21.37 ± 10.14 years. The male to female ratio was 4 to 1. Twenty-two cases had bilateral disease, and 5 had unilateral affection. The visual acuity at presentation ranged from hand motions to 20/20. The duration of disease ranged from 1 to 25 years, with a mean of 10 ± 6.66 years. Total LSCD was seen in 33 eyes (67.3%), and partial LSCD was seen in 16 (33%). Disease at the time of presentation was active in 15 cases (55.5%) and was quiescent in 12 cases (44.5%). Pannus resection with amniotic membrane graft was done in 5 eyes. Live-related allolimbal transplantation was done in 6 eyes of 3 patients. VKC patients with or without associated LSCD had similar characteristics, but the age of presentation was lower in patients without LSCD (P = 0.0005, unpaired Student t test), and the duration of disease was shorter (P < 0.0001, unpaired Student t test). Conclusions: LSCD seems to be one of the complications of long-standing VKC, contributing to severe visual impairment in young individuals. The chronic nature and prolonged duration of the disease may be responsible for this secondary ocular surface affection, leading to the clinical manifestation of LSCD.


Indian Journal of Ophthalmology | 2010

Current approach in diagnosis and management of anterior uveitis

Rupesh Agrawal; Somasheila I. Murthy; Sangwan; Jyotirmay Biswas

Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated appropriately. The present article will assist ophthalmologists in accurately diagnosing anterior uveitis, improving the quality of care rendered to patients with anterior uveitis, minimizing the adverse effects of anterior uveitis, developing a decision-making strategy for management of patients at risk of permanent visual loss from anterior uveitis, informing and educating patients and other healthcare practitioners about the visual complications, risk factors, and treatment options associated with anterior uveitis.


Cornea | 2003

Surgical treatment of chronically recurring pterygium.

Virender S. Sangwan; Somasheila I. Murthy; Aashish K. Bansal; Gullapalli N. Rao

Purpose. To report the result of a combined surgical procedure of pterygium excision with simultaneous amniotic membrane transplant, conjunctival limbal autograft, and mitomycin C application in the management of two cases of chronically recurring pterygium. Methods. Report of two cases. Results. The two male patients, ages 24 and 42 years, had undergone six previous surgeries for pterygium, with and without adjunct procedures. In the follow-up period of 26 months for the first case and 25 months for the second case, no recurrence or complications were encountered. Conclusion. A combined procedure seems to be beneficial in cases of chronically recurring pterygia in younger patients. This approach may be considered when all other types of surgery have failed.


Ophthalmology | 2011

Intracameral Perfluoropropane Gas in the Treatment of Acute Corneal Hydrops

Sayan Basu; Pravin K. Vaddavalli; Muralidhar Ramappa; Sushmita Shah; Somasheila I. Murthy; Virender S. Sangwan

PURPOSE This study is aimed to evaluate the role of 14% nonexpansile concentration of perfluoropropane (C(3)F(8)) gas in the management of acute hydrops in corneal ectasias. DESIGN Retrospective, nonrandomized, comparative, interventional case series. PARTICIPANTS AND CONTROLS The study group consisted of 62 eyes of 57 patients and the control group included 90 eyes of 82 patients with acute corneal hydrops who presented within 30 days of onset of symptoms. INTERVENTION Patients in the control group underwent a single intracameral injection of 0.1 mL of nonexpansile concentration (14%) of C(3)F(8) gas. Patients in the control group were treated conservatively. Patients in both groups were followed regularly for 12.6±7.7 and 13.4±8.3 months in the study and control groups, respectively, and assessed clinically for complete disappearance of epithelial and stromal edema on slit-lamp biomicroscopy. MAIN OUTCOME MEASURES The primary outcome measure was mean time to resolution of corneal edema, which was calculated both from the date of onset of hydrops and the date of initiation of therapy to the date of resolution in days. RESULTS The overall time to resolution both from the date of onset of symptoms (90.5±55.8 vs 125±68.9 days; P = 0.0005) and from the date of initiation of therapy (78.7±53.2 vs 117.9±68.2 days; P = 0.0001) was significantly lower in the study group compared with the control group. However, on subgroup analysis a significant difference in the resolution time was found only in eyes with keratoconus (P<0.0001). No difference in the resolution time was seen in eyes with pellucid marginal corneal degeneration (PMCD) or keratoglobus. The main complication of this procedure was reversible pupillary block (16%; P<0.0001). There was no difference in the final visual acuity or endothelial cell counts between the 2 groups. CONCLUSIONS Intracameral C(3)F(8) gas in a nonexpansile concentration is a useful modality for faster resolution of corneal edema in patients with acute corneal hydrops and keratoconus, and its role in the treatment of PMCD and keratoglobus needs further evaluation.


Cornea | 2012

Anterior segment optical coherence tomography features of acute corneal hydrops.

Sayan Basu; Pravin K. Vaddavalli; Geeta K. Vemuganti; Ali Mh; Somasheila I. Murthy

Purpose: To describe the clinical significance of in vivo corneal findings in eyes with acute corneal hydrops. Methods: Medical records and anterior segment optical coherence tomography (ASOCT) images of 24 patients with keratoconus and unilateral acute corneal hydrops were reviewed. Clinical findings and position, integrity, and orientation of the Descemet membrane (DM) on ASOCT were noted. Size of the DM break, depth of the DM detachment, and corneal thickness were measured by ASOCT and correlated with the duration of corneal edema, assessed clinically. Outcomes of intracameral perfluoropropane (C3F8) gas in 13 eyes and histopathological findings after penetrating keratoplasty in 2 eyes were also correlated with serial ASOCT findings. Results: Duration of corneal edema was 9.3 ± 4.4 weeks. On ASOCT, DM showed 3 patterns: detachment with break and rolled ends (n = 13), detachment with break and flat ends (n = 10), and detachment with no break (n = 1). Initial corneal thickness was 1.3 ± 0.25 mm, size of the DM break was 1.1 ± 0.8 mm, and depth of the DM detachment was 0.9 ± 0.6 mm. On multiple regression analysis, duration of corneal edema showed significant positive association with the depth of DM detachment (P = 0.0002) and size of DM break (P = 0.002) and negative association with intracameral C3F8 (P < 0.0001). Correlation of ASOCT with histopathological findings revealed 2 stages of resolution of hydrops: reattachment of DM and endothelial migration. Conclusions: Eyes with deeper DM detachments and larger DM breaks required more time for resolution of corneal edema despite intracameral C3F8. This association needs to be validated by a prospective study.


Journal of Medical Microbiology | 2009

Post-operative endophthalmitis due to an unusual pathogen, Comamonas testosteroni

Ashok Kumar Reddy; Somasheila I. Murthy; Subhadra Jalali; Usha Gopinathan

Here, we describe the first report of post-operative endophthalmitis due to Comamonas testosteroni in an elderly diabetic patient after complicated cataract surgery. The isolate was identified by using Mini API strips. The patient was successfully treated with intravitreal ceftazidime and oral ciprofloxacin.

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Prashant Garg

L V Prasad Eye Institute

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Savitri Sharma

L V Prasad Eye Institute

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Joveeta Joseph

L V Prasad Eye Institute

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