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Biomedical subjects

M S Sachdev

Publications and source records attributed to M S Sachdev.

At least 19 recordsLinked to original sources
PubMed1992

Morphologic effects of contact lens wear on the corneal surface.

We used specular microscopy of the corneal epithelium to examine 29 eyes of 29 patients each wearing one of five different types of contact lenses. We compared these with 24 eyes of 24 age-matched control patients. We found patients with aphakic extended wear soft contact lenses had significantly larger cells (818 +/- 186 microns2) than all other groups; and they were significantly larger than their age-matched control group (573 +/- 174 microns2) (P less than .002). The epithelial cells of extended wear soft contact lens patients (609 +/- 97 microns2) and daily wear rigid gas permeable contact lens patients (613 +/- 103 microns2) were larger than their control group of normal young patients (513 +/- 53 microns2). The cells of daily wear soft contact lens patients (484 +/- 111 microns2) and hard contact lens patients (517 +/- 46 microns2), however, were not different from controls. This study demonstrates a statistically significant shift in mean cell area of corneal epithelial cells in patients wearing some types of contact lenses.

Adult↗
PubMed1991

Meibomian gland dysfunction in chronic blepharitis.

We examined 57 patients with symptoms of chronic blepharitis using meibomian gland expression, meibography, tear osmolarity, and the Schirmer's test. We also performed meibography on 20 normal patients free of chronic blepharitis. We found that 42 blepharitis patients (74%) had evidence of meibomian gland loss, whereas only four of 20 normal patients (20%) had any gland dropout. We performed cluster analysis on the data from the patients with blepharitis and found that these patients tended to fall into distinct groups with clinically relevant characteristics. We also found that tear osmolarity correlated positively with gland dropout (+0.413) and negatively with excreta volume (-0.499). This study demonstrates that an objective analysis of meibomian gland function may be used to assess chronic blepharitis and define subsets of blepharitis with measurable differences. It also supports the significance of meibomian gland dysfunction on tear osmolarity and the evaporative state of the eye.

Adult↗
PubMed1991

Meibomian gland morphology and tear osmolarity: changes with Accutane therapy.

We evaluated the meibomian gland function of 11 patients before and during treatment with isotretinoin (Accutane) by assessing tear osmolarity, meibomian gland morphology, tear production, rose bengal staining, and meibomian gland excreta. We found, during Accutane use, that meibomian glands appeared significantly less dense and atrophic by meibography. Excreta thickness increased from 1.7 +/- 0.9 to 3.1 +/- 1.2 (p less than 0.005), and expressible excreta volume decreased from 1.52 +/- 0.68 to 1.10 +/- 0.3 (p less than 0.05) (scale 1-4). We also found a significant increase in tear osmolarity from 304.9 +/- 11 to 316.3 +/- 10 mosmol/L (p less than 0.005). There was no significant change in the Schirmer test during treatment. We suggest that the clinical symptoms of blepharitis during Accutane therapy are related to decreased meibomian gland function and consequent increased tear evaporation and tear osmolarity.

Acne Vulgaris↗
PubMed1990

Argon laser suturotomy: a technique for the correction of surgically induced astigmatism.

We prospectively studied 40 eyes with intraocular lenses and astigmatism of 4 or more diopters to evaluate the efficacy and safety of argon laser suture ablation as contrasted with surgical suture removal. Two groups of 10 eyes underwent argon laser suturotomy (ALS) 4 and 6 weeks, respectively, after surgery. Sutures were removed surgically in a third group of 10 eyes 6 weeks after surgery. The final group of 10 eyes served as controls. Serial keratometry and refraction demonstrated that ALS was as effective as surgical suture removal in reducing postoperative astigmatism, and complications associated with the procedure were negligible.

Aged↗
PubMed1990

Pupillary dilatation during cataract surgery--relative efficacy of indomethacin and flurbiprofen.

In a prospective, randomized, double-blind trial, we evaluated the relative efficacy of indomethacin and flurbiprofen when used as adjuvants to routinely used mydriatics for maintenance of pupillary dilatation in patients with heavily pigmented iris undergoing extracapsular cataract extraction. The drugs were administered orally as well as topically according to a fixed regimen. The pupillary diameters, measured with calipers at various surgical steps, were significantly larger at every step in the study groups in which either of the adjuvants had been used than they were in the control group (P less than .001). Flurbiprofen tended to help maintain a larger pupillary diameter in the later stages of surgery than indomethacin, but this difference was not statistically significant. We conclude that it is important to use prostaglandin synthetase inhibitors as adjuvants to routine mydriatics, and that flurbiprofen may be somewhat more effective than indomethacin in this capacity.

Cataract Extraction↗
PubMed1990

External ophthalmomyiasis associated with herpes zoster ophthalmicus.

Ophthalmomyiasis is a rare entity caused by infestation with certain dipterous larvae. We describe a 71-year-old farmer with herpes zoster ophthalmicus on the left side of the face in whom the blisters became secondarily infested with Chrysomyia bezziana maggots. The maggots were removed mechanically, and the corneal involvement secondary to zoster ophthalmicus responded to therapy with topical steroids and cycloplegics. To our knowledge this is the first report of external ophthalmomyiasis due to C. bezziana.

Aged↗
PubMed1989

Electrophysiological studies of the eye, peripheral nerves and muscles in epidemic dropsy.

The involvement of the neurological system in epidemic dropsy is controversial. During two outbreaks of epidemic dropsy, detailed neurological and ocular examinations and electrophysiological studies of peripheral nerves and muscles (motor nerve conduction velocities, sensory nerve latencies and electromyography) and eye (electroretinogram and visually evoked cortical responses) were therefore undertaken. Amongst the 239 subjects examined, burning sensation and tingling paraesthesias of feet were reported by 42.3 and 35.6%, respectively; but none had any objective evidence of central or peripheral nervous system involvement. Electrophysiological studies of peripheral nerves and muscles (10 cases with subjective manifestations) and eyes (24 eyes of 12 patients hospitalized for control of glaucoma) were essentially normal. It is concluded that Argemone mexicana or its toxins do not have any significant effect on the nervous system.

Adolescent↗
PubMed1988

Pathogenesis of epidemic dropsy glaucoma.

Thirty-one cases of epidemic dropsy with raised intraocular pressure were studied. Glaucoma was bilateral in all, with open angles and no signs of anterior segment inflammation. The outflow facility was unimpaired (C value, 0.24 +/- 0.09 microL/min/mm Hg). Aqueous bioassays revealed significantly elevated prostaglandin E2 level (23.33 +/- 4.32 ng/mL) and histamine activity (13.0 +/- 2.76 ng/mL) in all samples from patients with epidemic dropsy glaucoma as compared with negligible levels in control samples from patients with open angle glaucoma. Aqueous biochemical analysis revealed increased total protein level (1.03 +/- 0.10 g/L) with a normal globulin pattern as compared with controls (0.26 +/- 0.08 g/L). On histopathologic and histochemical testing, a normal trabecular meshwork was found in 11 of the 12 trabeculectomy specimens. It is concluded that dropsy glaucoma is hypersecretory in nature; prostaglandin and histamine release may have significant roles in its pathogenesis.

Alkaloids↗
PubMed1988

Topical silver sulphadiazine--a new drug for ocular keratomycosis.

The efficacy of silver sulphadiazine in human keratomycosis has not been evaluated so far. Encouraged by the success of an earlier experimental trial, a prospective, controlled, randomised double masked clinical study was designed to evaluate the efficacy of 1% silver sulphadiazine ophthalmic ointment in 20 eyes of mycotic keratitis. Miconazole 1% was used for comparative evaluation in another 20 eyes. Silver sulphadiazine had a higher success rate (80% vs 55%) than miconazole. It had broad antifungal activity and was found to be effective in fusarium keratitis. Absence of side effects, economy, and its efficacy in deeper and extensive lesions were additional advantages. It is concluded from this study that silver sulphadiazine is a safe and effective broad spectrum antifungal agent which can be used for the treatment of human keratomycosis.

Administration, Topical↗
PubMed1988

Comprehensive visual and cosmetic rehabilitation of cornea plana.

A case of bilateral cornea plana with high hypermetropia is reported in a 20-year-old woman. Neither routine spectacles nor polymethylmethacrylate (PMMA) contact lenses could achieve satisfactory visual and cosmetic results. Comprehensive visual and cosmetic rehabilitation was accomplished with a high-plus, low-water-content, lenticular soft lens. This new concept of management of cornea plana appears promising in cases not amenable to routine spectacles or hard contact lenses.

Adult↗
PubMed1987

Tear and serum immunoglobulins during corneal graft rejection.

Tear and serum concentrations of IgG, IgA, and IgM were estimated in serially drawn samples of 50 patients undergoing optical keratoplasty. Fifteen healthy individuals served as controls. Samples were collected at different postoperative intervals. An immunological rejection phenomenon was observed in nine patients. The rejection could be reversed in five of these nine cases. A decline in serum immunoglobulins was observed during the postoperative follow-up of these cases. This was unrelated to rejection phenomenon and was attributed to systemic steroid therapy. In tears, IgM was not detectable in majority of samples. No significant variation in tear IgA levels was observed between the cases where rejection was reversed and the ones in which it resulted in an opaque graft. In contrast, significant tear IgG increase was observed during the rejection phenomenon. The increased IgG levels returned to the basal value in each case in which rejection was reversed, but remained elevated much above basal and maximum control values in cases in which rejection could not be reversed. This differential response of tear IgG was highly significant. Our results suggest that raised tear IgG levels and its persistence despite therapy may be an indicator of corneal transplant rejection.

Adolescent↗
PubMed1987

Bilateral simultaneous corneal graft rejection--role of tear immunoglobulins.

A report is made on an unusual case of corneal graft which was clear for well over a decade, and then manifested allograft rejection phenomenon concurrently in both eyes initiated by keratoplasty in the second eye. A bilateral and simultaneous corneal graft rejection in an individual does not seem to have been reported previously. Serial tear immunoglobulin (IgG) levels, which were normal in the initial postoperative period, demonstrated an elevation throughout the rejection phenomenon. The possible significance of this rise in the tear IgG levels is discussed.

Adult↗
PubMed1987

Optic disc vasculitis in epidemic dropsy.

During an outbreak of epidemic dropsy in Delhi, 233 patients were studied. Retinal changes including venous dilatation and tortuosity, haemorrhages and disc oedema were observed. A clinical picture compatible with type I optic disc vasculitis was seen in 13 eyes and that of type II in 3 eyes. Fluorescein angiography was carried out in 23 randomly selected cases. Relevant angiographic findings included dilated and tortuous retinal veins, prominent vascular staining, blocked fluorescence, microaneurysms, disc oedema and peripapillary dye spillage. Presence of positive angiographic findings correlated well with the severity of the systemic disease, glaucoma, however, revealed no correlation. Papillophlebitis, a new ocular manifestation of Argemone mexicana oil toxicity, as also the fluorescein angiographic picture in epidemic dropsy is being reported for the first time in the literature.

Disease Outbreaks↗
PubMed1987

Bilateral disc oedema in retinitis pigmentosa--an unusual sign.

An unusual case of Bardet-Biedl syndrome which presented with sudden total visual loss in both eyes is documented. The fundus picture and angiographic findings were consistent with the diagnosis of bilateral disc oedema with retinitis pigmentosa. The various etiological possibilities resulting in the manifestation of bilateral disc oedema in this case of retinitis pigmentosa are considered. Inflammatory disc oedema secondary to photoreceptor degeneration as a possible cause of acute loss of vision in retinitis pigmentosa is discussed.

Adult↗