Search PubMed⌕ Search

Biomedical subjects

R Sihota

Publications and source records attributed to R Sihota.

At least 37 records · Page 2Linked to original sources
PubMed1998

Intraoperative mitomycin C and the corneal endothelium.

PURPOSE: Mitomycin-C (MMC) is a useful adjunct to high risk glaucoma surgery. No clinical data regarding the deleterious effect of mitomycin-C on the corneal endothelial cells are available. METHODS: Thirty eyes of 28 adult patients with high risk glaucomas were randomized to three groups. Group-I underwent a trabeculectomy alone, Group II, trabeculectomy with intraoperative 0.2mg/ml MMC and Group III, trabeculectomy with intraoperative 0.4mg/ml MMC. Preoperative and 3-month postoperative corneal endothelial cell counts were analysed. RESULTS: The percentage cell loss in Group I was 3.73+/-2.73%, in Group II 13.90+/-4.69% and in Group III 14.52+/-7.8%. Statistical analysis revealed a significant difference in cell loss between Group I and Group II and Group I and Group III, but not between Group II and Group III. CONCLUSION: There is a significant loss of corneal endothelial cells three months after trabeculectomy with adjunctive MMC.

Adult↗
PubMed1998

Post-penetrating keratoplasty glaucoma: risk factors, management and visual outcome.

PURPOSE: To evaluate the incidence, associated risk factors, graft status and treatment modalities in patients with post-penetrating keratoplasty glaucoma. METHODS: A retrospective analysis of 747 consecutive penetrating keratoplasties was undertaken at a tertiary eye care centre. The frequency of post-penetrating keratoplasty glaucoma was determined and correlated with the pre-operative corneal diagnosis, lens status and associated surgeries performed during penetrating keratoplasty. The response to antiglaucoma therapy (i.e. medical, surgical or cyclo-destructive procedures) and graft outcome was also evaluated. RESULTS: The incidence of post-penetrating keratoplasty glaucoma was 10.6% (79/747). Pre-operative corneal diagnosis of adherent leucomas was significantly associated with the development of postoperative glaucoma. Post-penetrating keratoplasty glaucoma was significantly higher in aphakes (odds ratio (OR) 6.6; confidence interval (CI) 3.81-11.69) compared with phakic or pseudophakic eyes. Associated vitrectomy (OR 2.32; CI 1.16-4.73) and anterior segment reconstruction (OR 3.31; CI 1.43-7.72) were other high-risk factors. Most patients responded to medical therapy (41/79; 51.9%), whereas filtering surgery and cyclo-destructive procedures were performed in 29.1 (23/79) and 19% (15/79) of eyes, respectively. Despite clear grafts in 39 eyes (49.4%), visual acuity of 6/18 or better was achieved in 15 eyes (18.9%). CONCLUSIONS: A high incidence of post-penetrating keratoplasty glaucoma occurs in eyes with adherent leucomas. Anterior vitrectomy and associated surgeries further accentuate the risk Anti-glaucoma therapy may not achieve optimum visual outcome, despite a clear graft.

Antihypertensive Agents↗
PubMed1998

Optic neuritis following albendazole therapy for orbital cysticercosis.

PURPOSE: To report the occurrence of optic neuritis following oral albendazole therapy for orbital cysticercosis. METHODS: Two patients having definitively diagnosed orbital cysticercosis at the orbital apex developed an acute visual loss 1 week after initiation of oral albendazole. Ultrasonography and magnetic resonance imaging determined that the cause was optic neuritis due to disorganization of the cyst with inflammation of the adjacent optic nerve. RESULTS: Oral corticosteroids (prednisolone 1 mg/kg per day) given for a period of 4 weeks led to resolution of the optic neuritis, with full visual recovery. CONCLUSION: Corticosteroids should be given in addition to albendazole in the treatment of orbital cysticercosis when cysts are in close proximity to the optic nerve.

Administration, Oral↗
PubMed1998

Profile of the subtypes of angle closure glaucoma in a tertiary hospital in north India.

A prospective study of 500 consecutive patients of primary angle closure glaucoma was undertaken to study the clinical profile of the three subtypes: acute, subacute, and chronic. A record of age and sex distributions, symptomatology, the best corrected visual acuity, gonioscopy, visual fields, methods of control of intraocular pressure, and status of the second eye was maintained. Statistical analysis of these parameters and the subtypes of angle closure glaucoma was carried out using the chi-square test. Angle closure glaucoma constituted 45.9% of all primary adult glaucomas seen. 24.8% of these had acute angle closure glaucoma, 31.2% subacute, and 44% chronic glaucoma. Angle closure glaucoma occurred maximally in the sixth decade and females constituted 51.4% of those affected. The difference in symptoms among the subtypes was significant (p < 0.001). More than 80% of the chronic eyes had no significant symptoms. Visual field defects specific for glaucoma were seen in only 15.1% of chronic glaucoma eyes. Bilaterality was commonest in subacute angle closure glaucoma (95.5%) and least in acute angle closure 35.5%. Nd YAG iridotomy alone or with topical medication controlled the intraocular pressure in 48.3% of acute angle closure glaucoma, 78.8% of subacutes, and 30% of chronic eyes. Statistically, each parameter reviewed was significantly different among the subtypes. There are considerable differences as well as an overlap of clinical features in the subtypes of angle closure glaucoma, which suggest some anatomical differences or dissimilar pathogenic mechanisms in these eyes.

Acute Disease↗
PubMed1998

The role of artificial drainage devices in glaucoma surgery.

The use of artificial drainage devices (ADDs) or "setons" in glaucoma surgery is generally restricted to patients with refractory glaucoma at high risk for failure from conventional filtration surgery. ADDs, both valved and nonvalved are currently available in this country. Recently, some of these devices have been propogated as primary treatment even for primary glaucomas. This article examines the role of ADDs in the modern management of the glaucomas. Specific indications for ADDs and methods to reduce the complication of overfiltration are discussed. The use of antimitotics, such as 5-fluorouracil or mitomycin, with traditional filtration has decreased the indications for ADDs. The literature and our experience confirm that currently there is no role for use of ADDs as a primary procedure in most glaucomas.

Animals↗
PubMed1997

Mitomycin-C in congenital glaucoma.

BACKGROUND AND OBJECTIVE: To evaluate the adjunctive use of mitomycin-C (MMC) during trabeculotomy and trabeculectomy for eyes with high-risk congenital glaucoma. PATIENTS AND METHODS: A prospective, randomized, double-blind study was performed to compare the effect of a single, 4-minute intraoperative exposure to 0.2 mg/ml (group 1) or 0.4 mg/ml (group 2) of MMC on trabeculotomy with trabeculectomy in 16 high-risk cases (30 eyes) of congenital glaucoma. RESULTS: The preoperative and final postoperative intraocular pressures (IOPs) of the two groups did not differ significantly. At the final follow-up, IOP control (< 21 mm Hg) without medications was achieved in 60% of the eyes in group 1 and in 86.67% of the eyes in group 2 (P = 21). With medication, IOP control was achieved in 86.7% of the eyes of each group. In both groups, the rate of surgical failure was 13.3%. Avascular, thin, sharply demarcated blebs were noted in 33.3% of the eyes from group 1 and in 66.67% of those from group 2 (P = .14). Intraoperative and postoperative hyphema and postoperative hypotony were the complications encountered in both groups, whereas serous choroidal detachment and wound leakage were seen only in group 2. CONCLUSIONS: Intraoperative MMC applied at a concentration of 0.2 mg/ml controlled postoperative IOP as effectively as a 0.4-mg/ml concentration in high-risk cases of congenital glaucoma, but with a lower incidence of complications and thin-walled blebs.

Administration, Topical↗
PubMed1996

A comparative evaluation of pilocarpine 1% and clonidine 0.125% versus timolol 0.5%.

All the presently available antiglaucoma medications have either local or systemic adverse effects. Combinations of drugs are being used not only to increase the effectivity and compliance but also to decrease the incidence and magnitude of side effects. The single dose response of open angle glaucoma eyes to pilocarpine 1%, clonidine 0.125%, a combination of pilocarpine 1% and clonidine 0.125%, and timolol 0.5% was studied in a double blind, masked, cross over study. Over a period of twelve hours the effectivity of the combination of pilocarpine 1% and clonidine 0.125% was significantly more than that of either drug alone and was found to be similar to that of timolol 0.5%. No local or systemic adverse effects were seen.

Administration, Topical↗
PubMed1995

Traumatic glaucoma.

In the management of an ocular injury, traumatic glaucoma is often overlooked. Prospectively reviewing 100 consecutive patients of traumatic glaucoma we found a very high correlation of postconcussional glaucoma with traumatic cataracts, angle recession of more than 180 degrees, significant injuries to the iris and a displacement of the lens. Two of these four clinical features were present in all cases. Penetrating injuries were followed by a secondary glaucoma if an adherent leucoma and/or evidence of lenticular damage or displacement were seen. These clinical features all point to a damage to the lens-iris diaphragm. The trabecular meshwork being directly related to these structures would also be involved in such an injury, leading to significant impairment of function, and the eye would therefore be more prone to developing glaucoma. Our study has highlighted certain clinical findings which could act as 'markers' for the early diagnosis of traumatic glaucoma.

Adolescent↗
PubMed1994

The fat pad in dermis fat grafts.

BACKGROUND: Dermis fat grafts are used in orbital reconstruction in a variety of procedures. However, there have been few controlled studies testing their effectiveness. This is a prospective study on 40 patients. METHODS: Primary and secondary orbital dermis fat grafts were evaluated with regard to the long-term cosmetic results of two thicknesses, 10 and 20 mm, of fat pad, keeping all other parameters as constant as possible. Adequacy of the socket, lid anomalies; superior sulcus deformity, exophthalmometry, and motility of the prosthesis were assessed periodically. CONCLUSION: There was a significantly lower incidence of enophthalmos and superior sulcus deformity with the use of a fat pad thickness of 20 mm, without any compromise in the motility of the prosthesis or take of the graft.

Adipose Tissue↗
PubMed1994

Oral albendazole in the management of extraocular cysticercosis.

Surgical removal of extraocular cysticerci is fraught with complications. The effect of oral albendazole in such cases has been evaluated in a randomised, controlled, clinical trial. Of 24 ultrasonographically diagnosed, and ELISA positive cases of extraocular cysticerci, 12 received oral albendazole 15 mg/kg once daily for 1 month, while the 12 controls received a placebo. Marked clinical improvement was seen in all the cases in the treatment group at 4 weeks, with collapse of the cyst at 6 weeks (75%), and complete disappearance at 3 months (100%). No clinical or ultrasonographical change was noted in the control group. A trial of medical management with oral albendazole merits consideration in cases of extraocular cysticerci.

Administration, Oral↗
PubMed1994

Aqueous humour lactic acid and proteins in eyes with iris neovascularization.

The content of lactic acid and proteins in the aqueous humour of eyes with neovascularization of the iris (NVI) of various etiology was determined. The results were analysed for any possible correlation with the angiogenesis observed in such eyes. Aqueous humour from patients with immature senile cataracts served as the control. The total protein concentration in cases of NVI (mean +/- SD, 345.7 +/- 161.0 mg/dl; n = 15) was significantly raised (P < 0.001) as compared with the control values (mean +/- SD, 30.91 +/- 14.95 mg/dl; n = 12). On the other hand, the concentration of lactic acid in cases of NVI (mean +/- SD, 45.97 +/- 15.5 mg/dl; n = 13) was significantly lower (P < 0.01) as compared with the controls (mean +/- SD, 65.86 +/- 10.9 mg/dl; n = 8). These findings show that angiogenesis is not associated with a raised level of lactic acid in the aqueous humour, whereas the elevated protein values are suggestive of a breakdown of the blood-aqueous barrier.

Adult↗
PubMed1993

Role of anterior retinal cryoablation in the management of neovascular glaucoma.

In a prospective study, the effect of anterior retinal cryoablation (ARC) in the management of neovascular glaucoma (NVG) was evaluated over two years, in 72 patients (74 eyes). The outcome of trabeculectomy/seton surgery preceded by 360 degrees ARC was also analysed in 12 eyes of 12 patients (6 eyes in each group). Following ARC, pain relief with dramatic regression of anterior chamber inflammatory reaction was observed in 95% of the patients (59 eyes). At the end of the follow up, as confirmed by iris fluorescein angiography, regression of neovascularization of the iris was documented in 93.5% (58 eyes) of the cases. Intraocular pressure control (< or = 22 mm Hg) was achieved in 82.3% (51 eyes) cases. IOP control of < or = 22 mm Hg was achieved in all the 6 eyes with the seton surgery following ARC. Similarly, control of IOP was successfully achieved in all the 6 eyes of patients with NVG with trabeculectomy with post operative course of 5-fluorouracil following ARC. ARC is strongly recommended in NVG, especially in eyes with media opacities and as a preliminary procedure for filtering surgery or drainage implant surgery.

Adolescent↗
PubMed1993

Sturge-Weber syndrome: management of glaucoma with combined trabeculotomy-trabeculectomy.

We reviewed the records of 16 patients (19 eyes) with Sturge-Weber syndrome (SWS). Scleral pigmentation was present in 12 (63.2%) of these eyes; nevus of Ota in two (10.6%). Combined trabeculotomy-trabeculectomy was performed in 18 eyes. After a mean follow up of 42 months (range, 1 to 8 years), intraocular pressure was controlled (< or = 22 mm Hg) in 11 eyes (61.1%), and visual acuity was better than 6/60 in eight. Intraoperative hyphema occurred in four eyes (22.2%); vitreous loss in three (16.7%). Postoperative choroidal detachment occurred in three eyes (16.7%); vitreous hemorrhage in one (5.6%). In all of the cases of repeat surgery (three eyes), postoperative subconjunctival injections of 5-fluorouracil resulted in a diffuse filtering bleb. We conclude that combined trabeculotomy-trabeculectomy is a promising treatment for patients with SWS with glaucoma.

Child↗
PubMed1992

Vitreofoveal traction syndrome in the young.

Young patients with sub-optimal visual acuity and no obvious ophthalmic pathology were found to complain of a 'shadow' or decreased brightness, with no metamorphopsia, at the point of regard, suggesting a pathology anterior to the neuroepithelium of the retina. Examination of fourteen such patients with a fundus contact lens revealed a focal vitreo-foveal detachment in eleven patients. Nine patients had a white plaque attached to this detachment, with a corresponding visible loss of superficial retinal tissue in one case. One patient had minute lamellar holes bilaterally. We feel that tenuous attachments of the vitreous body to the fovea could exert traction on the vitreo-retinal interface or shrinkage of a fibrocellular membrane on the inner foveal surface could lead to the observations made by us. The diagnosis of such lesions could be used to determine the cause of a sudden loss of vision in young patients, preventing the needless use of expensive and invasive investigations.

Adolescent↗
PubMed1992

Echographic measurement of extraocular muscle thickness in proptosis.

Echographic extraocular muscle thickness was measured in 102 eyes of 51 patients with proptosis of varied etiology. That of vascular origin was associated with extraocular muscle enlargement in all cases. Enlargement of the medial rectus was found to be statistically significant in thyroid orbitopathy. Sixty percent of cases with nonspecific orbital inflammatory disease had enlarged extraocular muscles. We discuss the supportive role of determining echographic measurements of extraocular muscle thickness in proptosis and highlight the uniform extraocular muscle enlargement found in proptosis of vascular origin.

Adolescent↗
PubMed1991

A prospective evaluation of anterior retinal cryoablation in neovascular glaucoma.

We report a prospective evaluation of the effect of anterior retinal cryopexy on 62 eyes with neovascular glaucoma. Pain was relieved and anterior chamber inflammatory reaction regressed dramatically in 95%. Iris neovascularization was reduced or regressed in 93.5%. Control of intraocular pressure was clinically significant in 82.3% 1 year after the procedure, especially in patients with pretreatment pressures less than 40 mm Hg on maximal medical therapy. Anterior retinal cryopexy is recommended in eyes with media opacities and as a preliminary procedure for filtering surgery in eyes with neovascular glaucoma.

Adolescent↗