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Biomedical subjects

Shetal M Raj

Publications and source records attributed to Shetal M Raj.

12 recordsLinked to original sources
PubMed2006

Effect of hydrodissection alone and hydrodissection combined with rotation on lens epithelial cells: surgical approach for the prevention of posterior capsule opacification.

PURPOSE: To evaluate the impact of corticocleaving hydrodissection alone and hydrodissection combined with rotation on lens epithelial cells (LECs) and residual cortical fibers (RCFs). SETTING: Iladevi Cataract and IOL Research Center, Ahmedabad, India. METHODS: An experimental laboratory study of 20 fresh human cadaver eyes (10 pairs) was conducted. A single eye from each pair was assigned to the control group, in which no hydrodissection and no rotation were performed (control). The other eye was randomized to corticocleaving hydrodissection alone (Group 1) or corticocleaving hydrodissection with rotation (Group 2). Cataract extraction was standardized. Capsule polishing was omitted. Area of LEC loss (%) in the preequatorial zone (PZ) and equatorial zone (EZ) was calculated as: [Area of capsule without cells/Total area of capsule] x 100. Area of presence of RCFs (%) was calculated as: [Circumference of EZ of capsule with RCF/Total circumference of EZ of the capsule] x 100. The Mann-Whitney U and the Wilcoxon signed rank tests were applied. RESULTS: In the control group, area of cell loss (%) was 3.9 +/- 3.2 in the PZ and 2.7 +/- 0.8 in the EZ; presence of RCFs (%) was 83.8 +/- 1.7. Area of LEC loss (%) in Groups 1 and 2 was 24.8 +/- 4.5 and 42.6 +/- 5.4 (P = .008) in the PZ and 22.4 +/- 2.1 and 54 +/- 2.5 (P = .008) in the EZ, respectively. Area of presence of RCFs (%) in Groups 1 and 2 was 34.2 +/- 3.7 and 23.7 +/- 3.7 (P = .008), respectively. CONCLUSION: Corticocleaving hydrodissection combined with rotation removed significant quantities of LECs and RCFs.

Aged↗
PubMed2006

Effect of cortical cleaving hydrodissection on posterior capsule opacification in age-related nuclear cataract.

PURPOSE: To evaluate the effect of multiquadrant cortical cleaving hydrodissection on the development of posterior capsule opacification (PCO) after phacoemulsification. SETTING: Iladevi Cataract and IOL Research Center, Ahmedabad, India. METHODS: A prospective randomized triple blind clinical trial was conducted in 86 eyes (86 patients) having phacoemulsification. Eyes were assigned randomly to Group 1, multiquadrant cortical cleaving hydrodissection and hydrodelineation (n = 48 eyes), or Group 2, no multiquadrant cortical cleaving hydrodissection, only hydrodelineation (n = 38 eyes). Age-related nuclear sclerosis (grading system of 1 to 5) and age greater than 50 years were included. Diabetes mellitus and associated eye diseases were excluded. Standard phacoemulsification with implantation of an AcrySof MA30BA intraocular lens (IOL) was done in both groups. High-resolution digital retroillumination images of the posterior capsule were analyzed at 4 years using POCOman software. Seven patients dropped out (8.1%). Outcome measures were incidence and percentage area of PCO. Test of proportions, independent sample t test, and 95% confidence intervals (CIs) were noted. RESULTS: In Groups 1 and 2, the mean age was 58 years +/- 4 (SD) and 57 +/- 5 years, respectively (P = .702; 95% CI, 1.90-2.81); mean follow-up was 48.4 +/- 2.5 months and 49.3 +/- 1.9 months, respectively (P = .687; 95% CI, 1.186-0.7856); incidence of PCO was 11 of 44 (25%) and 12 of 35 (34.3%), respectively (P = .317; 95% CI, 0.359-0.0889); percentage area of PCO was 14.3% and 25.6%, respectively (P = .006; 95% CI, -19.19 to -3.44). One of 44 eyes (2.27%) and 2 of 35 eyes (5.7%) in the groups, respectively, had a neodymium:YAG capsulotomy. CONCLUSION: Although no difference was noted in the incidence of PCO, in eyes that had PCO, the percentage of the area of the central posterior capsule involved by PCO was significantly lower in eyes that had multiquadrant cortical cleaving hydrodissection than in those that did not.

Aging↗
PubMed2006

Analysis of patients with good uncorrected distance and near vision after monofocal intraocular lens implantation.

PURPOSE: To analyze factors contributing to uncorrected visual acuity of at least 6/12 for distance and at least J4 for near (pseudoaccommodation) after monofocal intraocular lens (IOL) implantation. SETTING: Iladevi Cataract and IOL Research Center, Ahmedabad, India. METHODS: In a case-controlled study of 30 eyes (30 patients) that had phacoemulsification, those with pseudoaccommodation were assigned to cases and 30 eyes (30 patients) without pseudoaccommodation were designated as controls. Controls were matched by identical best corrected visual acuity, age, and postoperative duration. Subjective refraction was done with retinoscopy. Factors analyzed included corneal astigmatism, pupil size, axial IOL movement, amplitude of accommodation, axial length (AL), and age. Corneal astigmatism was noted on topography and interpreted as against the rule (ATR) (180 +/- 15 degrees), with the rule (WTR) (90 +/- 15 degrees), and oblique (OB) (45/135 +/- 30 degrees). Pupil size was noted on topographic display and AL and anterior chamber depth (ACD) on immersion A-scan. The axial IOL movement was calculated as the difference in ACD after instillation of cyclopentolate 1% (Cyclopent) and subsequently pilocarpine nitrate 2% (Carpinol) at separate visits, and amplitude of accommodation was measured with static and dynamic retinoscopy. Multivariate logistic regression and odds ratio with 95% confidence intervals were determined. RESULTS: Mean spherical equivalent was -0.45 +/- 0.63 diopter (D) in cases and -0.35 +/- 0.83 D (P = .61) in controls. Multivariate logistic regression in cases versus controls: corneal astigmatism (ATR versus WTR and OB collectively): 10.19 [1.8,57.44], P = .009; pupil size: 0.45 [0.07,2.71], P = .38; axial IOL movement: 1.39 [0.51,0.77], P = .514; amplitude of accommodation: 2.95 [0.93,9.3], P = .065; AL: 0.55 [0.29,1.02], P = .058; and age: 0.98 [0.5,1.95], P = .963. CONCLUSION: The study suggests a significant role of ATR corneal astigmatism in good uncorrected distance and near vision after monofocal IOL implantation.

Accommodation, Ocular↗
PubMed2005

AcrySof Natural SN60AT versus AcrySof SA60AT intraocular lens in patients with color vision defects.

PURPOSE: To determine whether implantation of the AcrySof Natural intraocular lens (IOL) worsened the severity of existing color deficit in congenital partial red-green color deficient individuals (CPRG). METHODS: A prospective controlled randomized double-masked analysis of 30 consecutive patients with CPRG defect and bilateral cataracts received a Natural IOL (test group) in 1 eye and a single-piece AcrySof IOL (control group) in the other eye. Patients were tested unilaterally to detect CPRG defect using Ishihara pseudoisochromatic plates and the Farnsworth D-15 test. Plates 1 to 21 measured the Ishihara error score; plates 22 to 25 indicated severity of defect based on clarity of both numerals as partial mild/moderate (both visible), partial severe defect (only 1 visible). The D-15 test is based on number of diametrical crossings on the circular diagram; severity is graded as mild (1 crossing), moderate (2 crossings), or severe (>2 crossings). Tests were performed before and after IOL implantation at 1, 3, and 6 months. At mean follow-up of 6.13 months +/- 1.2 (SD), analysis of variance test judged the difference in error scores and cross tabulation represented change in number of diametrical crossings. RESULTS: The mean age was 62.3 +/- 8.5 years. All patients were men. Before IOL implantation, all patients had moderate CPRG defect on both tests. The Ishihara error score in the test and control groups did not reveal statistically significant differences (P = .505 and P = .119, respectively). With D-15, none of the patients in the test or control group showed >2 crossings. CONCLUSION: The implantation of AcrySof Natural IOL did not worsen the preexisting severity of color defect in CPRG individuals.

Acrylic Resins↗
PubMed2004

Rate of axial growth after congenital cataract surgery.

PURPOSE: To evaluate the rate of axial growth after congenital cataract surgery. DESIGN: Prospective observational case series. METHODS: Rate of axial growth of 158 eyes (79 children < 10 years) undergoing surgery was correlated with age at surgery, laterality, and visual axis obscuration. After measuring axial length (AL) at each follow-up, the mean AL was calculated, adding the AL of all eyes divided by their total number. Rate of axial growth is the percentage difference between preoperative mean AL and mean AL at last follow up. The temporal profile of RAG is the difference between two consecutive mean ALs with respect to the previous reading. The follow-up period was 58.96 +/- 2.02 months. The student' paired t test and independent sample t test were applied. The main outcome measure was RAG. RESULTS: Rate of axial growth in children operated at < or = 1 year (23.5%) was significantly higher than in those at < or = 3 years (4.8%; P = .0001, confidence interval [CI] 1.05-3.2) and at < or = 10 years (4.3%; P = .0001, CI 1.3-3.1). In children operated at <or = 1 year, temporal profile of RAG was higher in the first 2 years after surgery. Rate of axial growth was higher in patients with unilateral pseudophakia at < or = 1 year (25.53%) than in age-matched patients with bilateral pseudophakia (18.50%; P = .001, CI -13 to -0.2). Rate of axial growth was negligible in children with visual axis obscuration in any group. CONCLUSION: Rate of axial growth is higher in children < or = 1 year and increases until the second year after surgery. Unilateral pseudophakia revealed accelerated growth compared with bilateral pseudophakia. Visual axis obscuration does not influence rate of axial growth.

Age Factors↗
PubMed2004

Inside-out delineation.

A technique of achieving precise hydrodelineation, in which fluid is injected from the inside of the nucleus to the outside, is described. The desired thickness of the nucleus-epinucleus bowl can be accomplished because the right-angled cannula can direct the fluid in the desired plane. This technique is useful in eyes with posterior polar cataracts and in eyes with dense cataracts in which aggressive phacoparameters are necessary for their removal.

Capsulorhexis↗
PubMed2004

NeoSoniX ultrasound versus ultrasound alone for phacoemulsification: randomized clinical trial.

PURPOSE: To evaluate the difference in consumption of ultrasound (US) energy required with NeoSoniX (Alcon) in conjunction with US (NeoSonix US) versus US alone. SETTING: Iladevi Cataract & IOL Research Center, Ahmedabad, India. METHODS: This prospective randomized study comprised 120 consecutive eyes having phacoemulsification with the Alcon Legacy 20000 series at Iladevi Cataract & IOL Research Centre. Two groups of 60 eyes each were formed based on cataract grade according to the Emery classification: grade 2 and 3 nuclear sclerosis (Group A) and grade 4 and 5 nuclear sclerosis (Group B). In each group, 30 eyes had phacoemulsification using NeoSoniX US and 30 eyes, using US alone. The main parameters were intraoperative US time and mean US power. Effective phaco time (EPT) was calculated by multiplying the US time and mean US power and dividing the product by 100. The unpaired Student t test was used to evaluate the differences between NeoSoniX US and US alone. The corresponding 95% confidence intervals were calculated. RESULTS: In Group A, the mean US time was 106 seconds with NeoSoniX US and 144.30 seconds with US alone (P = .002), the mean US power was 13.50% and 15.83%, respectively (P = .059), and the mean EPT was 15.17 seconds and 22.94 seconds, respectively (P = .006). In Group B, the mean US time was 193.67 seconds with NeoSoniX US and 255.17 seconds with US alone (P = .000), the mean US power was 18.31% and 22.76%, respectively (P = .000), and the mean EPT was 35.67 seconds and 59.15 seconds, respectively (P = .000). The EPT was 33.5% and 39.6% less with NeoSoniX US than with US alone in Group A and Group B, respectively. CONCLUSIONS: Ultrasound energy consumption with NeoSoniX was significantly less than with US alone, indicating the value of NeoSoniX in emulsifying cataracts of optimum density and dense hard cataracts. Combining NeoSoniX and US significantly reduced the consumption of US energy.

Aged↗
PubMed2004

Anterior capsule relationship of the AcrySof intraocular lens optic and posterior capsule opacification: a prospective randomized clinical trial.

OBJECTIVE: To evaluate the relationship of the anterior capsule and the AcrySof MA30BA intraocular lens (IOL) and its impact on the development of central posterior capsule opacification (PCO). DESIGN: Prospective, randomized, controlled trial. PARTICIPANTS: Two hundred two patients with senile cataracts received an AcrySof IOL between July and December 1998 at Iladevi Cataract and IOL Research Center, Ahmedabad, India. INTERVENTION: Patients were randomized prospectively to receive 1 of the 3 possibilities of anterior capsule and IOL optic relationship: group 1, total anterior capsule cover (360 degrees ) of the optic; group 2, no anterior capsule cover (360 degrees ) of the optic; group 3, partial anterior capsule cover (<360 degrees ) of the optic. After surgery, slit-lamp video photography was performed every 6 months for 3 years. Analyses of variance and chi-square tests were used to compare treatment groups. MAIN OUTCOME MEASURES: Incidence of PCO in the 3 groups. The posterior capsule was divided into 3 zones: peripheral, central 3 mm, and midperipheral (the space between the peripheral and the central zones). RESULTS: The average follow-up was 35.3 +/- 1.52 months in all the groups. At 3 years, the rate of central PCO was 6.4% in group 1, 7.1% in group 2, and 5.9% in group 3 (P = 0.9). Midperipheral PCO was present in 24.2% in group 1, 16% in group 2, and 20.6% in group 3 (P = 0.9). Peripheral PCO was seen in 100% of patients in all groups. The neodynium:yttrium-aluminum-garnet laser (Nd:YAG) posterior capsulotomy rate was 0% in all groups. CONCLUSIONS: There was no significant difference in the incidence of development of central PCO among the 3 groups. No patient experienced central PCO that required Nd:YAG capsulotomy. When using the AcrySof IOL model MA30BA, the relationship of the anterior capsule and the IOL does not seem to be a factor that relates to the development of central PCO.

Acrylic Resins↗
PubMed2002

Cell response to AcrySof intraocular lenses in an Indian population.

PURPOSE: To evaluate the quantitative cytological response to AcrySof (Alcon) intraocular lenses (IOLs) in an Indian population by studying the incidence, fate, progression, and severity of cell deposits after uneventful phacoemulsification. SETTING: Iladevi Cataract & IOL Research Center, Ahmedabad, India. METHOD: This clinical prospective study comprised 64 eyes of 64 healthy patients with senile cataract and no other ocular pathology having phacoemulsification and implantation of an AcrySof IOL. The eyes were observed for cell deposits. One week and 1, 3, 6, 12, and 15 months postoperatively, specular reflex was obtained by slitlamp biomicroscopy under x 20 magnification to record the incidence, progression, morbidity, and severity of small and large (including giant) cells on the IOLs. RESULTS: The highest incidence of small cells was 18.7%. The cell deposits appeared at 1 week, peaked at 1 month, and were gone after 6 months. The severity was never more than grade 2 (5 to 10 cells). The highest incidence of large cells, including giant cells, was 23.4%. The deposits appeared at 1 month, peaked at 3 months, and were gone after 12 months. The severity was never more than grade 2 (3 to 5 cells). The highest incidence of giant cells was 6.2%. The deposits appeared at 3 months and were gone by 15 months. Severity was never more than grade 1 (2 cells). No IOL had cell deposits at the last follow-up (mean 14 months +/- 3.25 [SD]). CONCLUSIONS: The incidence, and especially the severity, of cell deposits in the Indian population was low. All cell types, including giant cells, disappeared within 12 months. This could reflect the biocompatibility of the AcrySof IOL and the appropriate surgical technique.

Acrylic Resins↗