Indian Journal of Ophthalmology最新文献

{"title":"Comparative analysis of pachymetry and assessment of corneal topography in pediatric congenital corneal opacities: A study of AS-OCT and UBM imaging modalities.","authors":"Sonam Yangzes, Deeksha Sharma, Anchal Thakur, Jitender Jinagal, Sushmita Kaushik, Chintan Malhotra, Amit Gupta","doi":"10.4103/IJO.IJO_242_25","DOIUrl":"10.4103/IJO.IJO_242_25","url":null,"abstract":"<p><p>This study aimed to assess the interchangeability of pachymetry measurements obtained by anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in children with congenital corneal opacity (CCO). In this single-centre, comparative case series, children with unilateral or bilateral CCO who underwent examination under anesthesia (EUA) were evaluated using both AS-OCT and UBM. Pachymetry values from both modalities were compared using Bland-Altman analysis, and topography maps from AS-OCT were examined. A total of 54 eyes from 34 children (16 males, 18 females) were included. The mean age at first EUA was 263.93 ± 348.98 days (range: 11 days to 4 years). Mean pachymetry was 785.83 ± 23 μm with UBM and 719.80 ± 247 μm with AS-OCT, showing a statistically significant mean difference of 66.04 ± 133.55 μm (P = 0.0006). UBM consistently yielded higher measurements, and Bland-Altman analysis indicated poor agreement between the two devices. The findings suggest that AS-OCT and UBM are not interchangeable for pachymetry assessment in CCO. However, AS-OCT, being non-contact and usable without sedation, provides practical advantages for longitudinal follow-up and also offers topographic imaging, making it a useful tool in pediatric corneal evaluation.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 9","pages":"1383-1388"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952538","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":"A prospective study of efficacy and safety of Kahook Dual Blade (KDB) glide in Indian patients with glaucoma.","authors":"Shayana Bhumbla, Suneeta Dubey, Julie Pegu, Atanu Majumdar","doi":"10.4103/IJO.IJO_82_25","DOIUrl":"10.4103/IJO.IJO_82_25","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the success rate and complications of Kahook Dual Blade (KDB) procedure in Indian patients diagnosed with glaucoma.</p><p><strong>Methods: </strong>This prospective study was done on 68 Indian patients who underwent KDB procedure combined with phacoemulsification. Baseline demographic and clinical characteristics were recorded, including visual acuity, intraocular pressure (IOP), number of anti-glaucoma medications (AGM), and complications. Follow-up assessments were conducted regularly over 1 year, evaluating changes in IOP, visual acuity, medication usage, and occurrence of adverse events.</p><p><strong>Results: </strong>KDB procedure demonstrated significant reductions in mean ± SD IOP from baseline (17.2 ± 5.9) to 1 year (14.1 ± 3.5) (P < 0.001). This was accompanied by improvements in mean ± SD BCVA of 0.7 ± 0.7 preoperatively to 0.2 ± 0.5 postoperatively (P < 0.001). Simultaneously, there were significant reductions in the median (IQR) number of AGM from 2 (1-4) at the preoperative level to 1 (0-1) at 1 year (P < 0.001). A common adverse effect noted was hyphema (n = 11), which was self-resolving in 10 out of 11 cases, with one case needing anterior chamber wash.</p><p><strong>Conclusion: </strong>KDB procedure shows promising outcomes, as evidenced by significant reductions in IOP and decreased dependence on AGM at 1-year follow-up. Further long-term studies are warranted to assess the sustained efficacy and safety profile of the KDB procedure in this patient population.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 9","pages":"1293-1296"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952564","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":"Teleconsultation: Ophthalmology reaching every nook and corner.","authors":"Ankeeta A Thali, Jagadeesh K Reddy, Vandhana Sundaram, Mithun Thulasidas","doi":"10.4103/IJO.IJO_3004_24","DOIUrl":"10.4103/IJO.IJO_3004_24","url":null,"abstract":"<p><p>This study evaluates the impact of teleconsultation services in rural communities across India through a retrospective analysis. Teleconsultation units, also referred to as vision centres (VCs), are established in multiple rural regions, each serving a population of 20,000 to 50,000. These units are equipped with a slit lamp and a fundus photography system, and are managed by trained optometrists. Communication with ophthalmologists at base hospitals is facilitated through apps, namely Skype and Remidio. Data collected from 41 such units across 9 states over 18 months, from April 2022 to September 2023, were analysed. A total of 1,91,194 patients were examined during this time. Of these, 30,840 (16.13%) were prescribed and dispensed spectacles, 57,425 (30.03%) received medication and were followed up with at the VCs, and 23,623 (12.35%) underwent free cataract surgery. Additionally, 48,657 patients (25.44%) were referred to the base hospital for further management of more complex conditions. Given India's low doctor-to-patient ratio and the challenges in accessing quality eye care in rural areas, these findings suggest that teleophthalmology is a powerful tool in bridging the healthcare gap. It not only brings accessible and affordable eye care to underserved populations but also helps reduce the burden on tertiary care centres.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 9","pages":"1371-1375"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952577","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":"Lens survival after tube shunt surgery: Risk factors impacting time to cataract extraction following glaucoma drainage implant surgery.","authors":"Brian P Hall, Maitri S Mehta, Sakshi Shiromani, Deepta A Ghate","doi":"10.4103/IJO.IJO_137_25","DOIUrl":"10.4103/IJO.IJO_137_25","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the lens survival time following glaucoma drainage implant (GDI) surgery and identify the risk factors that may predict the time to cataract surgery.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Methods: </strong>Phakic patients who underwent GDI surgery at a large tertiary referral center between January 1, 2016 and June 1, 2022 were included. Demographic and clinical data were collected and analyzed using multivariate and survival analyses, with statistical significance set at P < 0.05. The main outcome was time to cataract surgery (called lens survival time). Survival analyses were conducted using Kaplan-Meier and Cox regression methods.</p><p><strong>Results: </strong>Sixty-eight phakic subjects underwent GDI surgery, with a mean age of 56.4 ± 14.9 years. Of them, 36 subjects (53%) had primary glaucoma and 32 (47%) had secondary glaucoma. GDI 6-month success (intraocular pressure ≤21 mmHg) was achieved in 63 subjects (92%). Forty-three subjects had three or more years of follow-up data available and were included in the survival analysis. Median and mean lens survival time were 16 ± 2 and 20 ± 3 months, respectively. At 1, 2, and 5 years, the proportions of lenses that survived were 60.5% (26 lenses), 27.9% (12 lenses), and 2.3% (one lens), respectively. Timing of subsequent cataract surgery did not correlate significantly with subject demographics or type of glaucoma.</p><p><strong>Conclusions: </strong>Cataract progression occurred in nearly all patients following GDI surgery. None of the factors studied predicted the timing of cataract surgery, suggesting that cataract formation is primarily influenced by the surgery itself, with minimal impact from patient-specific risk factors.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"1263-1268"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659114","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":"\"Practicing in and out till perfection\"-Use of mobile repairing microscope for home wet lab practice and as an alternative to high-end microscopes in wet lab.","authors":"Bidisha Rani, Gautam Singh Parmar, Ashok Kumar Meena","doi":"10.4103/IJO.IJO_355_25","DOIUrl":"10.4103/IJO.IJO_355_25","url":null,"abstract":"<p><p>Ophthalmic surgeries are microsurgeries that require fine motor skills and precision of movements. Practicing under microscope during wet lab sessions develops hand-eye coordination, removes performance anxiety, builds muscle memory, and helps attain fineness of movement. However, not every training center is equipped with a wet lab. Development of a wet lab facility is an expensive task, as the cost of operating microscopes, simulators, and phacoemulsification machines is significant. A mobile repairing tabletop, portable stereo microscope can be utilized to develop a basic, affordable wet lab facility in under-resourced training centers, so that resident training is not compromised. Besides, it can be utilized by residents to develop a personal, basic wet lab space at their own room, where they can practice at their convenience. Here, we aim to introduce this stereo microscope for training and skill development of residents.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"1390-1392"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659108","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: Navigating pediatric corneal imaging: Contextualizing Anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in the assessment of congenital corneal opacities.","authors":"Muralidhar Ramappa","doi":"10.4103/IJO.IJO_1670_25","DOIUrl":"10.4103/IJO.IJO_1670_25","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 9","pages":"1388-1389"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952488","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":"Trends in cataract surgery practice.","authors":"Murugesan Vanathi","doi":"10.4103/IJO.IJO_2079_25","DOIUrl":"10.4103/IJO.IJO_2079_25","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 9","pages":"1241-1242"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952517","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":"Inferior oblique graded marginal myotomy versus myectomy for treatment of inferior oblique overaction.","authors":"Mai Mostafa Ismail Hassan, Shaimaa Arfeen, Nermeen Mostafa Bahgat, Mahmoud M Gamal Eldin Ibrahim, Rehab Rashad Kassem","doi":"10.4103/IJO.IJO_789_25","DOIUrl":"10.4103/IJO.IJO_789_25","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare the surgical outcomes of inferior oblique marginal myotomy versus myectomy for treatment of inferior oblique overaction (in terms of correction of upshoot on adduction, V pattern, vertical deviation, torsion, and abnormal head posture) and document any encountered complications.</p><p><strong>Methods: </strong>Thirty-nine patients (78 eyes), having bilateral inferior oblique overaction, were included in a randomized prospective study, to compare inferior oblique marginal myotomy (Group O, 26 patients/52 eyes) to myectomy (Group E, 13 patients/26 eyes). Group O was further divided into subgroups Z and M, 26 eyes each. Subgroup Z underwent inferior oblique Z (2 cuts) myotomy to treat grade 1 or 2 inferior oblique overaction, while subgroup M underwent inferior oblique M (3 cuts) myotomy to treat grade 3 or 4 inferior oblique overaction, thus termed \"graded marginal myotomy\".</p><p><strong>Results: </strong>A successful outcome was achieved in 25/26 patients (96.2%) in Group O and 9/13 patients (80.8%) in Group E, P = .035, after 6 months of postoperative follow-up. Inferior oblique graded myotomy could correct up to +4 inferior oblique overaction and up to 30 ∆ of hypertropia, with elimination of head posture in all cases. No complications were encountered in any case.</p><p><strong>Conclusion: </strong>The novel inferior oblique M-myotomy extended the application of marginal myotomy for cases of marked inferior oblique overaction and large hypertropias, with outcomes significantly superior to myectomy.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"1314-1323"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659113","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":"Outcomes of needle-assisted circumferential goniotomy (NAG) in primary congenital glaucoma (PCG).","authors":"Dewang Angmo, Ekta Shaw, Kanchan Satpute, Anuja Patil, Namrata Sharma, Shivam Pandey, Tanuj Dada","doi":"10.4103/IJO.IJO_1976_24","DOIUrl":"10.4103/IJO.IJO_1976_24","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of needle-assisted circumferential goniotomy (NAG) in primary congenital glaucoma (PCG).</p><p><strong>Methods: </strong>This is a hospital-based prospective interventional study. Patients diagnosed with PCG, aged <2 years with good corneal clarity, who underwent NAG procedure in a single tertiary eye care center, were included in the study and were followed up regularly in the post-operative period. The pre- and post-operative intraocular pressure (IOP), number of anti-glaucoma medications (AGMs), corneal diameter, axial length, fundus findings, and any complications were recorded at 3, 6, 9, and 12 months. Success was defined as IOP ≤ 18 mmHg with or without two topical AGMs.</p><p><strong>Results: </strong>A total of 52 eyes (14 bilateral and 24 unilateral) of 31 children were included in the study. A total of 80.6% were males and 19.4% were females, with a mean age of 1.14 ± 1.04 years. The baseline IOP was 23.28 ± 5.98 mmHg, which decreased to 11.03 ± 5.06 mmHg at 3 months, 12.08 ± 3.80 mmHg at 6 months, and 12.54 ± 5.09 mmHg at 12 months, P value < 0.001. The mean number of topical AGMs reduced from 2.48 ± 1.03 to 1.35 ± 1.23 at 12 months follow-up, P value < 0.001. Complete success was seen in 88.46% (46/51) eyes. Failure was noted in 11.52% (10/51) eyes, out of which 9.61% (9/51) eyes required trabeculectomy. There were no significant vision-threatening intraoperative or post-operative complications.</p><p><strong>Conclusion: </strong>A 24G NAG is a safe and effective surgical procedure to control the IOP in PCG with good corneal clarity. NAG is a single-sitting, minimally invasive, circumferential angle surgery that spares the conjunctiva completely for future surgeries, if needed.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 9","pages":"1276-1281"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952519","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":"Travel and financial burdens of cataract surgical care in South India: Comparison of postoperative follow-up at local vision centers versus an urban eye hospital.","authors":"In Young Chung, Merlin Benzy, Srinivasan Kavitha, Rengaraj Venkatesh, Nakul Shekhawat","doi":"10.4103/IJO.IJO_2271_24","DOIUrl":"10.4103/IJO.IJO_2271_24","url":null,"abstract":"<p><strong>Purpose: </strong>Access to eye surgical care in low- and middle-income countries (LMICs) remains limited due to geographical and financial barriers. This survey evaluated the travel and financial burden on patients and caregivers attending perioperative cataract care at an urban base hospital (UBH) versus community clinics (vision centers [VC]) at the Aravind Eye Care System in South India.</p><p><strong>Methods: </strong>This cross-sectional study surveyed 105 cataract surgery patients divided into three groups based on perioperative appointment location: UBH-only (appointments at UBH), VC-only (appointments at VCs), and UBH/VC (Day 1 postoperative appointment at VCs, others at UBH). Descriptive statistics and linear regression assessed associations between subgroups and travel and financial burden. The UBH/VC group reported their preferred location and the reasons.</p><p><strong>Results: </strong>Over the entire appointment period, transport time for VC-only (353 ± 118 min) was over 3 h lower than UBH-only (589 ± 418 min) and UBH/VC (568 ± 230 min; P < 0.001). Total appointment time was lowest for VC-only (562 ± 177; 1069 ± 439 in UBH-only; 1021 ± 383 min in UBH/VC; P < 0.001). Compared to UBH-only, the VC-only group had the lowest transport time (-236 min, 95% CI: -371 to -102, P = 0.001) and total appointment time (-507 min, 95% CI: -673 to -340, P < 0.001). Transport costs and missed wages were lower for VC-only participants for preoperative and postoperative Day 1 appointments (P < 0.001). Among UBH/VC, 63% (n = 22) preferred VC, while 37% (n = 13) preferred UBH.</p><p><strong>Conclusions: </strong>Decentralized perioperative follow-up care is associated with reduced travel and financial burdens for cataract surgery patients in rural, low-resource settings. Further research is needed to evaluate the clinical effectiveness and operational feasibility of decentralized postoperative care in LMICs.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 9","pages":"1364-1370"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952528","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}