Indian Journal of Ophthalmology最新文献

{"title":"Interventional glaucoma: Rethinking glaucoma treatment paradigms in the Asian context.","authors":"Alvin W J Teo, Dewang Angmo, Tina T L Wong, Monisha E Nongpiur","doi":"10.4103/IJO.IJO_517_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_517_24","url":null,"abstract":"<p><p>The emergence and advancements in glaucoma treatment modalities have expanded the options available to clinicians, particularly for patients with mild to moderate glaucoma. These newer approaches, such as minimally invasive glaucoma surgeries and selective laser trabeculoplasty, aim to effectively reduce intraocular pressure and potentially improve patient outcomes. 'Interventional glaucoma' reflects a paradigm shift in the glaucoma management strategies and involves adopting a more proactive approach and offering these interventions at earlier stages of the disease. By administering them earlier, these interventions can modulate the course of the disease and prevent significant visual loss, thereby reducing or delaying the need for subsequent filtering surgeries. In this review, we discuss the need for interventional glaucoma and the evidence behind these interventional techniques. We highlight key considerations that should be considered when implementing interventional glaucoma approaches in the Asian context.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 Suppl 2","pages":"S207-S213"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The long-term surgical outcomes of the Aurolab aqueous drainage implant versus the Ahmed glaucoma valve for refractory pediatric glaucoma in Saudi children.","authors":"Abdullah M Khan, Khabir Ahmad, Motazz Alarfaj, Humoud Alotaibi, Rizwan Malik, Konrad Schargel","doi":"10.4103/IJO.IJO_1370_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1370_24","url":null,"abstract":"<p><strong>Introduction: </strong>Glaucoma drainage devices (GDDs) play a crucial role in managing refractory pediatric glaucoma. The Aurolab aqueous drainage implant (AADI) is a promising option, especially in regions where cost-effective interventions are essential. We aimed to assess the long-term outcomes of AADI compared to the Ahmed glaucoma valve (AGV) in Saudi children.</p><p><strong>Methods: </strong>A cohort study was conducted at a tertiary eye care center in Riyadh, including patients ≤18 years who underwent AADI or AGV implantation between July 2014 and November 2019. Primary outcomes were intraocular pressure (IOP) control, anti-glaucoma medication (AGM) usage, the need for additional glaucoma surgery, and complications. Factors associated with treatment failure were examined using Cox proportion hazard modeling.</p><p><strong>Results: </strong>Among 126 eyes (AADI = 56, AGV = 70), the mean follow-up was 55.52 ± 14.47 and 53.02 ± 21.85 months for AADI and AGV, respectively. AADI demonstrated comparable IOP control and AGM reduction to AGV over five years. The AADI group exhibited higher success rates than AGV (76.8% vs. 47%). AGV showed a significantly higher risk of failure compared to AADI (adjusted hazard ratio 2.75, P = 0.041).</p><p><strong>Conclusion: </strong>AADI proves to be a safe and effective option for refractory pediatric glaucoma. The long-term outcomes of AADI were not inferior to AGV. Despite consistently lower IOP and AGM usage in the AADI group from the 3rd to the 60th month, statistical significance was not achieved.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 Suppl 2","pages":"S293-S297"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pupilmate: A do-it-yourself frugal pupilometer.","authors":"Ruhel K Chacko, Prithvi Chandrakanth, Aniket Roy, Hirika Gosalia, Gargi Aggarwal, V Narendran","doi":"10.4103/IJO.IJO_859_24","DOIUrl":"10.4103/IJO.IJO_859_24","url":null,"abstract":"<p><p>The pupillary direct and consensual reflex is an important non-invasive quick assessment of the neurological state of the eye. Currently, there is no cheap and affordable recording tool for screening and documentation of a relative afferent pupillary defect. We describe how to construct a frugal, do-it-yourself handheld scotopic binocular pupillometer device called Pupilmate. Two simple Wi-Fi-enabled board cameras fitted on both sides of the back of a rectangular cardboard box separated by a central paper divider, one side of the rectangular box was left open. An infrared red (IR) light source in the form of light-emitting diodes (LEDs) was fitted around each of the cameras. Two white light LEDs were fitted on either side of the box controlled by a two-way switch. A simultaneous video stream of both pupils could then be tuned in on any chosen device using the internet. Each pupil is manually illuminated for a desired time allowing recording of direct as well as consensual reflexes, which are objectively observed. Pupil reaction was easily recorded and repeatable using Pupilmate. It served as a good medium for initial screening in an outpatient department (OPD) setting, outreach programs, clinics, etc.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"437-441"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trans-iris vertical intrascleral haptic fixation of IOL: The bypass technique in eyes with megalocornea.","authors":"Rajesh Sinha, Aafreen Bari, Shahnaz Anjum","doi":"10.4103/IJO.IJO_974_24","DOIUrl":"10.4103/IJO.IJO_974_24","url":null,"abstract":"<p><p>Intrascleral haptic fixation of intraocular lens (IOL) is an extremely useful technique to provide visual rehabilitation in eyes with inadequate capsular support. It requires exteriorization of haptics along with tucking of haptics in the scleral groove preferably and conventionally in the horizontal meridian. In eyes with large corneal diameter, there is difficulty in tucking enough length of the haptics into the intrascleral groove, carrying the risk of slippage of haptics and decentration of IOL. To exteriorize a larger segment of haptic for tucking, we describe a novel technique that involves creation of scleral groove at the posterior limbus and exteriorization of haptic through a small peripheral iridectomy through the posterior limbus. This provides a larger segment of haptic to tuck into the groove that might prevent slippage and decentration of IOL in eyes with megalocornea.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"446-449"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric IOL power calculation: Factors and considerations.","authors":"Aishwarya Rathod, Sudarshan Khokhar, Deeksha Rani","doi":"10.4103/IJO.IJO_1205_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1205_24","url":null,"abstract":"<p><p>This narrative review aims to compare and document various studies on pediatric intraocular lens (IOL) power calculation, highlighting the differences from adult IOL power calculations and assessing the need for accurate ophthalmic biometry and targeted refraction to improve visual outcomes and reduce amblyopia risk. A comprehensive search of the PubMed database was conducted using keywords such as \"pediatric cataract surgery,\" \"IOL power calculation,\" \"ocular biometry,\" and \"IOL formulas.\" Relevant articles were identified by evaluating titles and abstracts, followed by full-text examination. References were reviewed for thorough coverage. Pediatric eyes pose unique challenges for IOL power calculation due to smaller size, changing axial length, and corneal curvature. Accurate biometry, particularly axial length and keratometry, is crucial. Studies comparing IOL formulas, primarily developed for adults, show varying prediction errors in pediatric cases. Newer-generation formulas such as Barrett's Universal II and Kane demonstrate superior accuracy compared to older formulas (e.g., SRK/T). Undercorrection strategies account for myopic shifts due to eye growth, but consensus on the best formula and target refraction is lacking. Premium IOLs, such as multifocal and toric, offer benefits but require further long-term evaluation. Accurate IOL power calculation is critical for optimal visual outcomes in pediatric cataract surgery. While newer IOL formulas show promise, the unpredictable nature of eye growth and myopic shifts complicates long-term predictions. Premium IOLs offer potential advantages but necessitate careful consideration. Continuous advancements in IOL technology and personalized approaches to target refraction are essential to improve the quality of life of pediatric patients.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 3","pages":"312-319"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of new competency-based medical education (CBME) ophthalmology curriculum - students' perspective.","authors":"Jyoti Deswal, Urmil Chawla, Rajender Singh Chauhan, Khushboo Sheoran","doi":"10.4103/IJO.IJO_2061_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2061_24","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 3","pages":"463"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, etiology, and risk factors for tube explantation in patients undergoing patch-free glaucoma drainage device.","authors":"Vijayalakshmi A Senthilkumar, Umme Salma Akbar, Sharmila Rajendrababu","doi":"10.4103/IJO.IJO_958_24","DOIUrl":"10.4103/IJO.IJO_958_24","url":null,"abstract":"<p><strong>Purpose: </strong>To report the incidence, etiology, and risk factors for tube explantation in patients undergoing patch-free glaucoma drainage device (GDD).</p><p><strong>Methods: </strong>Of the total 1303 patients who underwent patch-free GDD (703 non-valved GDD and 600 valved GDD) for refractory glaucoma during January 2020-October 2023, we identified five cases of postoperative complications following GDD that required tube or shunt removal.</p><p><strong>Results: </strong>Median (IQR) age of our study cohorts was 54.5 (8-66) years. The incidence of tube exposure and tube explantation was 0.003% and 0.004%, respectively. The median time interval for tube or plate explantation from the time of GDD surgery was 11.5 (2-16) months. The diagnoses of refractory glaucoma for which GDD was performed were secondary glaucoma following multiple vitreoretinal (VR) surgery (60%), primary open-angle glaucoma (20%), and aphakic glaucoma (20%). Of these, two patients (40%) presented with recurrent tube exposures, two patients (40%) with tube exposure and early endophthalmitis, and one patient (20%) with persistent hypotony. Four patients (80%) had undergone non-valved Aurolab aqueous drainage implant and one underwent (20%) Ahmed glaucoma implant. Three patients (60%) had diabetes mellitus with a history of multiple VR surgical intervention. GDD explantation was done in three patients (60%), and the remaining two patients (40%) required only tube amputation. One patient presented with orbital cellulitis, and there was no culture growth seen in any of our study cohorts.</p><p><strong>Conclusion: </strong>Tube and plate exposures pose a significant risk for potential infections and warrant prompt explantation of GDD to avoid endophthalmitis. Previous history of multiple VR surgeries, diabetes mellitus, and non-valved implants were the common risk associations noted for tube exposures in our retrospective study.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"S267-S271"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early outcomes of 5-0 Prolene gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in eyes of Indian glaucoma patients.","authors":"Devendra Maheshwari, Madhavi Ramanatha Pillai, Nimrita Gyanchand Nagdev, Shivam Gupta, Rengappa Ramakrishnan, Mohideen Abdul Kader, Mohammed Sithiq Uduman","doi":"10.4103/IJO.IJO_3065_23","DOIUrl":"10.4103/IJO.IJO_3065_23","url":null,"abstract":"<p><strong>Purpose: </strong>To study the early postoperative efficacy and safety of 5-0 Prolene gonioscopy-assisted transluminal trabeculotomy (GATT) combined with phacoemulsification in Indian eyes.</p><p><strong>Methods: </strong>This was a prospective, interventional study. Patients with primary and secondary glaucoma who underwent GATT combined with phacoemulsification (Phaco-GATT) or standalone GATT were included. All patients were evaluated on postoperative days 1, 15, and 30, as well as 3 months and 6 months postoperatively. Baseline and follow-up visits were compared to determine the significant difference in the number of intraocular pressure (IOP), antiglaucoma medications (AGM), and best corrected visual acuity (BCVA). Other outcome measures included surgical success, complications, and interventions. A P value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>One hundred and five eyes (95 patients) were included. Seventy-five eyes underwent GATT along with phacoemulsification and 30 eyes underwent GATT. In the Phaco-GATT group, the mean IOP reduced significantly from 17.71 ± 6.85 to 12.29 ± 4.44, 12.33 ± 4.44, and 12.18 ± 3.49 mmHg and in the GATT group, it reduced from 21.67 ± 11.42 mmHg to 16.38 ± 8.42, 16.47 ± 10.26, and 13.10 ± 3.25 mmHg at 1, 3, and 6 months, respectively ( P < 0.001). The number of AGM also significantly reduced from 1.67 ± 1.22 to 0.41 ± 0.87 and 0.34 ± 0.82 in the phaco-GATT group and from 2.63 ± 1.19 to 0.67 ± 1.09 and 0.60 ± 1.25 in the GATT group at 3 and 6 months, respectively ( P < 0.001). Complete success (IOP > 6-≤21 mmHg/20% reduction without AGM) was 96.7% in the Phaco-GATT group and 91.2% in the GATT group. BCVA improved from log of minimum angle of resolution 0.30 to 0.00 ( P < 0.001) in phaco-GATT group. Hyphema was the most common complication. Macrohyphema (>1 mm) was seen in six patients, out of which two patients required anterior chamber wash. IOP spikes (>30 mmHg) were seen in three patients.</p><p><strong>Conclusion: </strong>In Indian eyes, GATT combined with phacoemulsification and standalone GATT are efficacious and safe with good surgical outcomes.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"S287-S292"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A partial-thickness 'scleral belt loop' for MicroShunt implant.","authors":"Michele Figus, Francesco Sartini, Martina Menchini, Gianluca Guidi, Giamberto Casini, Chiara Posarelli","doi":"10.4103/IJO.IJO_1212_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1212_24","url":null,"abstract":"<p><p>The purpose of this article is to introduce a new surgical technique for the PreserFloTM MicroShunt implant. This technique involves creating a partial-thickness scleral belt loop before repositioning the Tenon's capsule and the conjunctiva toward the limbus. The distal end of the device is passed under the lamellar belt of the sclera, but the tip remains open and not covered by the loop. With this surgical technique, the MicroShunt adheres perfectly to the scleral profile of all eyes. As a result, the device's end tip does not stress the Tenon's/conjunctival flap during postoperative eye movements, thereby minimizing conjunctival erosion and inflammation. This method is efficient, requiring very short additional time. Consequently, it can be seamlessly integrated into the standard MicroShunt implant procedure without incurring extra costs, ultimately trying to reduce the need for surgical revisions of the filtration bleb.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 Suppl 2","pages":"S336-S338"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical performance of enhanced monofocal intraocular lens in presence of low degree of corneal astigmatism.","authors":"Neha Neha, Aafreen Bari, Namrata Sharma, Rajesh Sinha, Prafulla Kumar Maharana, Manpreet Kaur, Jeewan Singh Titiyal, Tushar Agarwal","doi":"10.4103/IJO.IJO_1639_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1639_24","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the optical performance of an enhanced monofocal intraocular lens (IOL) in the presence of cataract and a low degree of corneal astigmatism.</p><p><strong>Methods: </strong>A prospective, comparative, nonrandomized study was conducted to compare the results of an enhanced monofocal IOL with a standard monofocal IOL in cases of cataract with corneal astigmatism ≥0.75 D and <1.5 D. A total of 38 patients meeting the inclusion criteria were enrolled in the study. Group A patients (19) were implanted with enhanced monofocal IOLs bilaterally, and Group B patients (19) received standard monofocal IOLs bilaterally. Both groups underwent standard procedures (phacoemulsification with IOL implantation in the capsular bag), and final outcomes were analyzed after a 3-month follow up. A P value < 0.05 was considered significant.</p><p><strong>Results: </strong>The binocular uncorrected intermediate visual acuity, near visual acuity, and contrast sensitivity at 3 months was better in the enhanced monofocal group compared to the standard monofocal group (P < 0.001, P < 0.001, P = 0.02 respectively). The binocular uncorrected distance visual acuity at 3 months was comparable between the groups (P = 0.2); however, a higher number of cases attained visual acuity better than 6/9 in the enhanced monofocal IOL group. Post-operative higher-order aberrations were comparable between the groups. (P = 0.125).</p><p><strong>Conclusion: </strong>Bilateral implantation of enhanced monofocal IOLs in patients with cataract and low degrees of corneal astigmatism demonstrates better tolerance to astigmatism compared to standard monofocal IOLs. In cases with <1 D corneal astigmatism, the enhanced monofocal IOL is the preferred choice over the standard monofocal IOL.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 3","pages":"377-381"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}