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Biomedical subjects

R Sihota

Publications and source records attributed to R Sihota.

At least 55 records · Page 3Linked to original sources
PubMed1990

Evaluation of peribulbar anesthesia in eye camps.

Modified peribulbar anesthesia was administered with a 26-gauge, half-inch, insulin needle to 367 eyes of 360 patients in three eye camps in India. The intraocular procedures consisted of cataract extraction in 349 eyes, trabeculectomy in 11 eyes, and combined cataract extraction and trabeculectomy in seven eyes. The overall success rate of the anesthesia technique was 90.2% (supplemental anesthesia was required in 36 eyes). There was good lid and globe akinesia and anesthesia, adequate pupillary dilatation for intracapsular cataract extraction, and excellent hypotony. No significant local or systemic complications were observed, except for mild to moderate chemosis in some eyes, which did not produce any intraoperative or postoperative problems. We found this technique easy to learn, relatively safe, effective, and well tolerated by our patients.

Anesthesia, Local↗
PubMed1988

Symmetrical partial lateral 'cryptophthalmos'. A new concept of its embryological pathogenesis.

A unique case of bilateral, partial cryptophthalmos is described, with no associated systemic anomalies. There were symmetrical, well-developed palpebral apertures medially with small conjunctival sacs, and symmetrical hemicryptophthalmos laterally. A faint groove extended temporally over the fused lids on both sides. There was a distinct plane of cleavage laterally between the disorganized microphthalmic globes and overlying tissues. The surgical observations are detailed.

Eye↗
PubMed1988

Photocoagulation of large iris cysts.

Large epithelial iris cysts, whose anterior walls are in contact with the corneal endothelium, are difficult to treat. Initial surgical decompression with later argon laser photocoagulation has been advocated, but the attendant complications are many. In four patients, we barraged the posterior wall of the cyst and the surrounding iris with the argon laser. The cyst was then collapsed using the argon or neodymium-yttrium aluminum garnet laser, and the anterior wall, which fell away from the cornea, was then photocoagulated. No recurrences or untoward sequelae were seen on follow-up. We recommend this noninvasive technique for all large iris cysts.

Adolescent↗
PubMed1987

Aspergillus endophthalmitis.

A case is reported of bilateral aspergillus endophthalmitis in an infant without any detectable systemic predisposition or focus of infection. The patient is the youngest recorded case of endogenous aspergillus endophthalmitis so far, with an onset of symptoms at the age of 15 days. After histopathological confirmation of the aetiology by enucleation of the atrophic eye, systemic amphotericin B therapy was instituted with excellent results in the fellow eye. This is the first recorded instance of a complete clinical cure in aspergillus ocular disease on systemic amphotericin B therapy alone.

Ampicillin↗
PubMedDate not supplied

Entropion uveae: early sphincter atrophy, signposting primary angle closure glaucoma?

PURPOSE: An easily recognized clinical marker for early changes of primary angle closure glaucoma (PACG) or eyes predisposed to angle closure is important so that timely laser iridotomy can prevent morbidity. Pupillary ruff changes, specifically appearance of entropion uveae (EU), are frequent in eyes with PACG. METHODS: Pupillary ruff was examined under magnification and EU, if present, was graded and correlated with gonioscopic grading and presence of peripheral anterior synechiae (PAS) in consecutive patients with primary open angle glaucoma (POAG), non-glaucomatous controls, and PACG of the subacute, acute, chronic symptomatic, and creeping angle closure glaucoma subgroups. RESULTS: No POAG eye had an abnormal pupillary ruff. A total of 86.7% of subacute PACG eyes and all eyes with acute and chronic PACG showed some grade of EU. Iridocorneal synechiae were more significantly correlated with EU than goniosynechiae (p<0.001). Meridian of iridocorneal but not iridotrabecular synechiae could be correlated with the meridian of EU. In age-matched patients EU was only present in eyes with steep iris configuration, with significant correlation with narrow angles and goniosynechiae. In the detection of PACG the presence of EU Grade I was 94.9% sensitive and 98.2% specific for PACG eyes compared to the gonioscopic picture of angle closure in occludable angles. Its positive predictive value was 91.4%. CONCLUSIONS: EU shows significant correlation with narrow angles, steep iris configuration, and PAS. Kinking of radial iris arteries during angle closure probably causes temporary ischemia, especially of end arteries supplying area of the pupil and sphincter pupillae. EU emerges as an easily observed, objective marker for PACG.

Acute Disease↗
PubMedDate not supplied

The neonatal fundus in maternal toxemia.

Toxemic changes in the maternal fundus and their relationship to fetal prognosis have been studied. A study of the neonatal fundus in maternal toxemia revealed a 76.67% incidence of vascular changes similar to those seen in the maternal fundus. Arteriolar spasm, focal or generalized, was present in 23 of the 30 neonates seen. A pallor of the disc was present in six cases. Four infants, 13.33%, had either extensive dot and blot retinal hemorrhages with soft exudates, or a serous retinal detachment. The last four neonates died within the first postnatal week. This work highlights the fact that retinal vascular decompensation mirrors similar changes in the cardiopulmonary or cerebral circulation and should be considered as a determinant of the fetal prognosis in maternal toxemia.

Female↗
PubMedDate not supplied

Cumulative effect of risk factors on short-term surgical success of mitomycin augmented trabeculectomy.

CONTEXT: Risk factors for failure of trabeculectomy may have a cumulative effect on the outcome. AIMS: To study the effect of preoperative ocular risk factors on the surgical outcome of trabeculectomy augmented with 2 commonly used doses of Mitomycin C. SETTINGS AND DESIGN: In a prospective cohort study, cases were recruited over an 18 month period. 92 eyes of 83 patients with one to three known risk factors for failure of trabeculectomy underwent Mitomycin-C (MMC) augmented trabeculectomy. METHODS AND MATERIAL: Trabeculectomy was done with a randomly chosen MMC dose of 0.2 mg/ml or 0.4 mg/ml. All cases were followed up for a period of at least 3 months. Surgical success was defined as the lowering of intraocular pressure (IOP) below 21 mmHg during the follow up period. STATISTICAL ANALYSIS USED: Chi square test, paired t test, odds ratio, effect size. RESULTS: Eyes with two or three risk factors (out of aphakic glaucoma, failed trabeculectomy, neovascular glaucoma, post uveitic glaucoma, traumatic glaucoma, adherent leucoma, juvenile glaucoma, prolonged medical therapy, steroid induced glaucoma, post penetrating keratoplasty glaucoma and developmental glaucoma) had a significantly poorer surgical success rate (88% and 78%) than eyes with one risk factor (100%). 0.4 mg/ml MMC used sub-sclerally had a statistically similar effect on lowering the IOP as 0.2 mg/ml in all groups. The rate of complications was significantly higher in the 0.4 mg/ml subgroup. CONCLUSIONS: The presence of more than one preoperative ocular risk factor, affects the surgical success of MMC augmented trabeculectomy in high-risk cases. Because of the significantly higher rate of complications with the higher dose of MMC, this should be used sparingly, only in cases with more than two risk factors.

Adult↗
PubMedDate not supplied

Clinico-biochemical study of experimental complicated cataracts.

Clinically observed complicated cataracts, generally do not have a definite causal factor. We studied the effects of E. coli toxin injected suprachoroidally, to simulate the effect of toxins released by extraocular organisms on the lens. 79.2% of eyes had a definable cataract at the end of the 6th week of observation. The biochemical changes portrayed an increased oxidative activity in the lens, evidenced by a fall in glutathione concentration, and the consequent tertiary reorientation of proteins to increase insoluble proteins, forming a cataract.

Animals↗
PubMedDate not supplied

The additive influence of nevus flammeus and the nevus of Ota on congenital glaucoma.

Nevus flammeus and nevus of Ota are commonly encountered dermatological conditions, but both individually, are only occasionally associated with glaucoma. The occurrence of isolated nevus flammeus along with nevus of Ota in the same patient is also extremely rare. We are presenting two unusual cases, both having a nevus of Ota, together with nevus flammeus and severe congenital glaucoma.

Child↗
PubMedDate not supplied

Medical and socio-economic aspects of long term therapy of open angle glaucoma.

Hundred patients of open angle glaucoma (OAG) who were on any one of the three drugs pilocarpine, timolol and epinephrine--for an average period of 3.3 years were chosen. Proforma regarding socio-economic status and the patients' reaction to long-term medication were recorded. Though the objective and subjective effects of long term medication were negligible the financial constraints were considerable. More than 70% patient would prefer laser's and surgery because of the cumbersome schedule and financial burden. The visit to the clinic was a time consuming process suggesting a lack of adequate glaucoma follow-up at the peripheral level. The study reflects a need for reorientation of glaucoma management.

Adult↗
PubMedDate not supplied

Secondary juvenile glaucomas in India.

A comparative retrospective study of 164 cases of juvenile secondary gla as presenting to the glaucoma service in 1984 and 100 cases in 1988, to the changes brought about by health education and innovations in ophthalmic care is undertaken.

Adolescent↗
PubMedDate not supplied

Congenital nystagmus with head posture (a modified approach in surgical management).

The surgical methods for correction of an abnormal head posture in congenital nystagmus presently in use, do not correct the head posture adequately and in some cases produce a postoperative tropia. We felt that this may be related to the arbitrary quantities of surgery suggested by various workers. We have observed that surgery on the medial rectus is approximately one and a half times as effective as on the lateral. Using this ratio, excellent results have been obtained in 5 cases which are reported herein.

Adolescent↗
PubMedDate not supplied

The neonatal fundus in maternal toxemia.

Fetal mortality appears to be related to the neonatal fundus findings of a generalized arteriolar spasm, together with either a serous retinal detachment or the presence of numerous superficial and deep retinal hemorrhages with "cotton wool" spots. The excellent management of maternal blood pressure does not allow changes to occur in the maternal fundus; thus, the existence of adverse factors to the fetus/newborn cannot be determined by an examination of the maternal fundus. The fundus examination of a neonate at risk is likely to be very helpful in identifying those babies who would require intensive monitoring and care, resulting in an infant mortality rate far lower than the current rate.

Female↗
PubMedDate not supplied

Role of 5 fluorouracil in the management of failed glaucoma surgery.

Filtering surgery for glaucoma usually controls the intraocular pressure adequately. However, in glaucoma patients with aphakia, neovascularisation of iris, previous failed filtering surgeries and relatively young patients, results of surgery leave much scope for improvement. Most failures of filtering surgery are related to extra-ocular factors. Histopathological studies of eyes after failed filtering operations have suggested that proliferation of fibroblasts and deposition of collagen constitute a barrier to filteration. There is also a positive correlation between success of filtering surgery and inhibition of fibroblast growth by the patients aqueous humour. Thus agents inhibiting fibroblast proliferation should play an important role in increasing the success rate of filtering surgery. 5 Fluorouracil is a pyrimidine analogue which has been utilised for over 15 years as an antimetabolite in cancer therapy. Its efficiency in inhibiting fibroblast proliferation in vitro and in rabbit eyes has been proved beyond doubt. We undertook a pilot project to estimate the efficiency of the subconjunctival 5 FU to increase the changes of success in problematic cases of glaucoma in pigmented eyes.

Adolescent↗