Indian Journal of Ophthalmology最新文献

{"title":"Comparison of postoperative cyclosporine 2.0% versus betamethasone 0.1% eye drops following trabeculectomy: A randomized clinical trial.","authors":"Esmaeil Babaei, Alireza Eslampoor, Ramin Daneshvar","doi":"10.4103/IJO.IJO_345_24","DOIUrl":"10.4103/IJO.IJO_345_24","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of cyclosporine A 2% eye drop following trabeculectomy on intraocular pressure (IOP) and surgical success compared to postoperative steroid drop.</p><p><strong>Study design: </strong>Prospective, randomized clinical trial in an institutional setting.</p><p><strong>Methods patients: </strong>Forty patients with primary open-angle glaucoma and candidates for trabeculectomy were included in this study. Standard fornix-based trabeculectomy augmented with mitomycin C was performed for all patients. None of the included subjects had a history of prior laser or intraocular surgery in that eye.</p><p><strong>Intervention: </strong>All included subjects were randomly assigned to either postoperative cyclosporine A 2% or betamethasone 0.1% eye drops.</p><p><strong>Main outcome measures: </strong>IOP measured by applanation tonometer and surgical success rate.</p><p><strong>Results: </strong>Seventy-five potentially eligible POAG patients were seen during the study period, and 40 met the study criteria and were randomly assigned to one of the study groups. Patients in the cyclosporine A 2% group had consistently lower IOP, fewer glaucoma medications, and higher success rates for at least 24 months after surgery ( P < 0.0001). Complete success was more frequent in the cyclosporine group. Moreover, the cyclosporine A group had more diffuse and elevated bleb with less vascularity in the first 3 months after surgery ( P ≤ 0.01). This was paralleled with fewer dry eye signs and symptoms in the cyclosporine group in the first 3 months ( P < 0.03).</p><p><strong>Conclusion: </strong>Postoperative cyclosporine A 2% eye drop can be used instead of steroid drops and is associated with improved surgical success and decreased dry eye manifestations.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"S272-S281"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary ab interno stenting to manage early tube-related hypotony.","authors":"Prasanna Venkataraman, Anahita Shroff","doi":"10.4103/IJO.IJO_3032_23","DOIUrl":"10.4103/IJO.IJO_3032_23","url":null,"abstract":"<p><p>Trabeculectomy is the gold standard procedure to achieve control of intraocular pressure surgically. However, glaucoma drainage devices have their place in certain refractory glaucomas not amenable to control by the standard trabeculectomy. These devices come with their own set of complications, cognizance of which is critical to anticipate and manage appropriately. With the nonvalved devices, hypotony is one difficult problem to deal with. Several modifications have been described to manage refractory hypotony after tubes. We present here a simple, less invasive surgical technique of secondary ab interno suture stenting to manage tube-related early hypotony.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"S334-S335"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world use of integrated intraoperative OCT in pediatric cataract.","authors":"Savleen Kaur, Jaspreet Sukhija, Ken K Nischal","doi":"10.4103/IJO.IJO_1478_24","DOIUrl":"10.4103/IJO.IJO_1478_24","url":null,"abstract":"<p><strong>Purpose: </strong>To study the utility of integrated intraoperative OCT (i 2 OCT) in pediatric patients with cataracts in the real world.</p><p><strong>Methods: </strong>It was a retrospective case series. We included patients aged 0-12 years with unilateral or bilateral cataracts who underwent cataract surgery or membranectomy for visual axis opacification between July 2022 and December 2023, where intraoperative OCT was used. We matched the clinical data with i 2 OCT images and tried to identify any useful information i 2 OCT provided. Intraoperative notes were reviewed to analyze any changes in the surgical plan or steps after doing i 2 OCT.</p><p><strong>Results: </strong>The mean age of the children undergoing surgery was 5.9 ± 2.4 years (range: 6 months-9 years). OCT provided valuable insights into the anterior, posterior capsule, and vitreolental surface morphology. The surgical decision was modified in 10 cases after doing the intraoperative OCT (31.3%).</p><p><strong>Conclusions: </strong>The study adds to the database of pediatric patients imaged using i 2 OCT in the real world. i 2 OCT complements the preoperative examination and aids intraoperative decision-making in cases of white cataracts with excellent real-time delineation of the vitreolental interface in children.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"320-324"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-frequency Nd:YAG laser reduction of peripheral iridotomy size for treatment of visual symptoms.","authors":"Harsh Kumar, Surbi Taneja","doi":"10.4103/IJO.IJO_2797_24","DOIUrl":"10.4103/IJO.IJO_2797_24","url":null,"abstract":"<p><p>Peripheral iridotomy is a standard treatment for conditions like primary angle-closure glaucoma. However, the associated visual symptoms, such as glare and dysphotopsia, often reduce patient satisfaction. This article presents a novel surgical technique utilizing a double-frequency Nd:YAG laser (532 nm) to reduce the size of existing iridotomies, addressing these visual disturbances without compromising the functional efficacy of the iridotomy. The technique is performed under topical anesthesia, with minimal discomfort and no significant downtime for the patient. This innovative use of double-frequency Nd:YAG laser technology introduces a refined approach to managing postoperative visual outcomes in peripheral iridotomy, offering a valuable addition to the repertoire of ophthalmic surgical techniques.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 Suppl 2","pages":"S341-S342"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atropine (0.05%) for rapid progressive childhood myopia (ARM study).","authors":"Rohit Saxena, Vinay Gupta, Himani Thakur, Rebika Dhiman, Thirumurthy Velpandian, Swati Phuljhele, Namrata Sharma","doi":"10.4103/IJO.IJO_1526_24","DOIUrl":"10.4103/IJO.IJO_1526_24","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the effectiveness of atropine 0.05% for myopia control among children exhibiting (documented) rapid myopia progression (>0.75D/year).</p><p><strong>Methods: </strong>This prospective interventional single-arm clinical trial included children aged between 6-12 years, spherical equivalent refractive (SER) error between - 2 and - 6D, and having documented myopia progression of >0.75D in the preceding year. All participants were administered atropine 0.05% in both eyes once at bedtime for 1 year. The primary outcome measure was a change in the rate of myopia progression (D/year) and change in SER and axial length (AL) at 1 year and documentation of any adverse effects related to therapy.</p><p><strong>Results: </strong>Forty children were enrolled with a mean age of 8.5 ± 2.2 years. (45% male) The mean SER 1 year before starting atropine treatment was -3.53 ± 0.78D. At baseline, the mean SER was -4.58 ± 1.03D, which increased to -4.98 ± 0.97D after 1-year follow-up. The study reported a 62% reduction in the rate of myopia progression after 1 year of atropine 0.05% treatment (-1.05 ± 0.21D/year [baseline] to - 0.4 ± 0.14D/year[1-year follow-up] [ P < 0.001]). The mean AL increased from 24.98 ± 2.43 mm (baseline) to 25.21 ± 2.32 mm (1 year). There was no significant correlation between changes in AL and SER ( r : 0.57; P : 0.063). The study observed the response to treatment was independent of the age at baseline, baseline refractive error, baseline rate of progression, gender, and family history of myopia. No adverse effects from atropine 0.05% were reported.</p><p><strong>Conclusions: </strong>Atropine 0.05% could be an effective treatment for children with rapidly progressing myopia with no significant side effects.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"358-361"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irrigating bent ab-interno needle goniectomy (i-BANG) technique.","authors":"Shikha Gupta, Hemant Jhajharia, Baiju M Virani, Viney Gupta","doi":"10.4103/IJO.IJO_3310_23","DOIUrl":"10.4103/IJO.IJO_3310_23","url":null,"abstract":"<p><strong>Background: </strong>The bent ab-interno needle goniectomy (BANG) represents a low-cost indigenous modification designed for ab-interno excisional goniectomy. This technique employs a reverse cystitome (24 G needle) and yields outcomes equivalent to those achieved with the Kahook Dual Blade goniectomy. However, reflux bleeding from Schlemm's canal, with or without anterior chamber shallowing, often impedes angle visualization, thereby limiting the desired treatment extent. Recommended preventive measures for managing or treating hyphema include avoiding treatment in high-risk patients (on anticoagulants), blood washing, employing cohesive ophthalmic viscosurgical device (OVD), hydrating wounds under high air pressure tamponade, and maintaining a propped-up position postoperatively. Despite these precautions, hyphema can impair intraoperative angle visualization. Among patients experiencing hyphema, a quarter require drainage. Washing blood away by re-injecting OVD or with bimanual irrigation aspiration often leads to intraoperative delay and subsequent rebleeding.</p><p><strong>Purpose: </strong>This article describes a novel modification aimed at managing intraoperative angle bleeding and anterior chamber shallowing while ensuring a clear angle view, as performed in 27 eyes, including patients with primary open-angle and angle-closure glaucoma.</p><p><strong>Synopsis: </strong>Our surgical technique, termed irrigating BANG (i-BANG), involves bending a 1 mm 24 G needle toward the bevel at a right angle to create a goniectome. The needle hub is connected to Alcon's CENTURION® system, and continuous infusion is initiated at 100 mmHg IOP. A 120° goniectomy is fashioned under continuous fluid infusion nasally, allowing for the clearance of any refluxing blood during the procedure. Air is injected through the side port as the irrigating needle is withdrawn, and the ports are hydrated.</p><p><strong>Highlights: </strong>• i-BANG achieves passive aspiration at minimal cost. • It effectively addresses intraoperative hyphema and anterior chamber shallowing. • None of the 27 patients in our study experienced procedure abandonment or incomplete treatment during i-BANG. • Only 12 eyes exhibited minimal blood layering in the angle, which was completely absent by one week postoperatively.</p><p><strong>Video link: </strong>https://youtu.be/YmPeoBDpN54.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 Suppl 2","pages":"S354"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: Empowering insights on IOL refixation techniques.","authors":"Prasanna Venkatesh Ramesh, Shruthy Vaishali Ramesh, Anugraha Balamurugan, Ajanya K Aradhya, Sundaram Natarajan","doi":"10.4103/IJO.IJO_2937_24","DOIUrl":"10.4103/IJO.IJO_2937_24","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 3","pages":"461-462"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: IOL dynamics after capsular tension ring implantation.","authors":"Manpreet Kaur, Jeewan S Titiyal","doi":"10.4103/IJO.IJO_2794_24","DOIUrl":"10.4103/IJO.IJO_2794_24","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 3","pages":"345-346"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percentage macular ganglion cell complex and peripapillary retinal nerve fiber layer loss in different stages of glaucoma.","authors":"Shah Zalak, Sihota Ramanjit, Sen Ray Swarnali, Choudhary Samiksha, Dhillon Jasleen","doi":"10.4103/IJO.IJO_3238_23","DOIUrl":"10.4103/IJO.IJO_3238_23","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study is to evaluate the percentage differences in ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) parameters in fellow eyes of the same patient with varying severities of glaucomatous damage. As only the eyes of the same patient with different severities of glaucoma were included in the present study, it could be inferred that the difference in parameters represents the loss leading to the next stage of glaucoma.</p><p><strong>Methods: </strong>This was a cross-sectional study of 136 adult primary glaucoma eyes of 68 patients. They were divided as follows: Group 1 - normal visual field in one eye and superior nasal step, (mild), in the other, Group 2 - superior nasal step in one eye and superior arcuate scotoma, (moderate) in the other, and Group 3 - superior arcuate scotoma in one eye and biarcuate scotoma, (severe) in the other. GCC and pRNFL measurements on spectral domain optical coherence tomography (SD-OCT) were statistically assessed as applicable.</p><p><strong>Results: </strong>The percentage difference in GCC parameters in fellow eyes from normal field to mild, mild to moderate, and moderate to severe glaucoma in average GCC was 10.04 ± 6.33%, (P = 0.0001), 15.77 ± 9.62%, (P = 0.0001), and 9.06 ± 6.41%, (P = 0.021); in inferior GCC, it was 13.25 ± 8.7%, (P = 0.0002), 18.94 ± 12,61%, (P = 0.0001), and 9.02 ± 6.92%, (P = 0.658), and in superior GCC, it was 7.42 ± 5.79%, (P = 0.002) 15.31 ± 11.07%, (P = 0.004), and 11.23 ± 9.82%,(P = 0.003), respectively. The percentage difference in average pRNFL of fellow eyes from normal field to mild, mild to moderate, and moderate to severe glaucoma in was 16.9 ± 9.85%, (P = 0.001), 18.23 ± 10.47%, (P < 0.0001), and 9.0 ± 7.35%, (P = 0.0004); in inferior pRNFL, it was 18.76 ± 12.38%, (P = 0.001), 19.6 ± 10.3%, (P < 0.0001), and 8.41 ± 7.3%, (P = 0.019), and in superior pRNFL, it was 15.3 ± 9.8%, (P = 0.015), 18.24 ± 13.56%, (P = 0.0003), and 11.46 ± 9.74%, (P = 0.001), respectively. A total of 136 eyes were regrouped by glaucoma severity, and in mild, moderate, and severe glaucoma subgroups. The percentage difference in average GCC was 11.01 ± 9.07%, 17.53 ± 11.29%, and 18.48 ± 11.69%.</p><p><strong>Conclusion: </strong>A percentage difference of GCC and pRNFL values could be used for both diagnosis and progression of glaucoma.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 Suppl 2","pages":"S308-S312"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeatability and agreement of a new anterior segment optical coherence tomography with standard devices in normal, keratoconus, and post-refractive eyes.","authors":"Gairik Kundu, Naren Shetty, Durgalaxmi Modak, Luci Kaweri, Pooja Khamar, Vishal Arora, Rudy M M A Nuijts, Rohit Shetty","doi":"10.4103/IJO.IJO_805_24","DOIUrl":"10.4103/IJO.IJO_805_24","url":null,"abstract":"<p><strong>Purpose: </strong>To assess repeatability and agreement of Eyestar 900 (Haag-Streit, Köniz, Switzerland) with Pentacam AXL Wave system (Oculus, Wetzlar, Germany), Anterion (Heidelberg Engineering GmBH, Heidelberg, Germany), and MS-39 (CSO, Florence, Italy) in measuring anterior segment parameters.</p><p><strong>Methods: </strong>Two hundred normal eyes, 50 keratoconus (KC) eyes, and 50 post-refractive surgery eyes underwent three sequential scans on each instrument. The order of scans was randomized. Repeatability was assessed using within-subject standard deviation (Sw) and intraclass correlation coefficient (ICC). Bland-Altman analysis was used to assess the 95% limits of agreement.</p><p><strong>Results: </strong>Eyestar 900 had comparable repeatability to Anterion and MS-39 across groups. ICC was overall >0.8. Pentacam AXL Wave had lower Sw (better repeatability) across all groups. In normal eyes, Eyestar 900 can be used interchangeably with MS-39 and Anterion (P > 0.23). Eyestar 900 and Pentacam AXL Wave did not show agreement on any parameter, except anterior chamber depth (ACD) (P = 0.92). Eyestar 900 in KC eyes can be used interchangeably with MS-39, except for posterior keratometry (pK) and thinnest corneal thickness (TCT) (P < 0.001), and with Anterion, except for TCT and ACD (P < 0.001). In post-refractive eyes, Eyestar 900 can be used interchangeably with MS-39, except for pK (P < 0.001), and with Anterion, except for ACD (P < 0.001). Pentacam AXL Wave and Eyestar 900 cannot be used interchangeably in KC and post-refractive eyes.</p><p><strong>Conclusions: </strong>Newer devices such as Eyestar 900 can be used interchangeably with Anterion and MS-39 in normal eyes and partly in KC and post-refractive eyes. Pentacam AXL Wave and Eyestar 900 cannot be used interchangeably across the various groups. However, these multifunctional hybrid tools of combined topography, AS-OCT, can be helpful in refractive clinics.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 3","pages":"325-334"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}