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Biomedical subjects

T Dada

Publications and source records attributed to T Dada.

69 records · Page 4Linked to original sources
PubMed1998

Conversion from phacoemulsification to extracapsular cataract extraction: incidence, risk factors, and visual outcome.

PURPOSE: To evaluate the incidence, risk factors, and visual outcome in cases converted from phacoemulsification to routine extracapsular cataract extraction (ECCE). SETTING: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. METHODS: A retrospective study was performed in 540 eyes that had clear corneal phacoemulsification performed by an experienced phacoemulsification surgeon. The cases in which phacoemulsification was initiated and then converted to ECCE were studied. The main parameters evaluated were the factors responsible for the conversion, corneal endothelial cell loss, and visual outcome. RESULTS: Twenty eyes (3.7%) required conversion to ECCE during phacoemulsification. Pupillary miosis (6 cases), posterior capsule rupture (5 cases), prolonged phaco time (4 cases), posterior extension of the capsulorhexis (2 cases), corneal thermal burn (1 case), subluxation of the lens (1 case), and malfunctioning of the ultrasonic handpiece (1 case) were the reasons for the conversion. The mean percentage of endothelial cell loss was 11.06% +/- 2.3 (SD); 18 cases (90.0%) achieved a visual acuity of 20/40 or better at 6 weeks. CONCLUSIONS: Intraoperative pupillary miosis, posterior capsule rupture, and very hard nuclear cataract causing prolonged phacoemulsification were the major risk factors for conversion to ECCE. Optimal preoperative preparation and prompt recognition of complications during phacoemulsification can lead to timely conversion to ECCE to achieve a good visual outcome.

Cell Count↗
PubMed1998

Sympathetic ophthalmia associated with antecedent adherent leucoma--a rare association.

PURPOSE: To report a rare association of sympathetic ophthalmia with an antecedent adherent leucoma. METHOD: A 40-year-old patient with an adherent leucoma developed sympathetic ophthalmia in the fellow eye, 15 years after the occurrence of a perforated corneal ulcer. RESULTS: Intravenous pulse dexamethasone therapy followed by tapering oral prednisolone led to complete resolution of the disease process in the sympathising eye. CONCLUSION: Patients with an adherent leucoma subsequent to a perforated corneal ulcer may remain at an increased risk of developing sympathetic ophthalmia during their lifetime.

Administration, Oral↗
PubMed1998

The relationship between follicular fluid aspirate volume and oocyte maturity in in-vitro fertilization cycles.

As a consequence of multiple follicular growth during ovarian stimulation for in-vitro fertilization (IVF), follicles of varying sizes often yield oocytes that vary in maturity and morphology of the oocyte-cumulus-corona complex. The objective of this prospective study was to explore the relationship between follicular fluid aspirate volume and the oocyte's developmental potential in an IVF treatment cycle. In total 9933 follicles were studied from 400 patients who underwent 535 consecutive IVF treatment cycles at St James's University Hospital, Leeds, UK, between February 1995 and February 1996. The volume of each individual follicle aspirated was recorded and related to the probability of obtaining an oocyte, its fertilizing capacity, the cleavage rate and the quality of embryos derived. We found no statistically significant difference in oocyte recovery rates between follicles with an aspirate volume < or = 1 ml and follicles with a volume > 1 ml. Although oocytes obtained from follicles with an aspirate volume > or = 1 ml showed a significantly lower fertilization rate, they went on to cleave at the same rate as oocytes obtained from larger follicles and resulted in embryos of comparable quality. Furthermore, there was no statistically significant difference in the implantation, clinical pregnancy or live birth rates per cycle between embryos derived from follicles with an aspirate volume < or = 1 ml and those derived from follicles with an aspirate volume > 1 ml. We conclude that follicular size and the oocyte's developmental potential in the stimulated ovary are not closely related and can be independent. This is in contrast to the Graafian follicle and the pre-ovulatory oocyte in the natural cycle.

Adult↗
PubMed1998

Combined astigmatic keratotomy with corneal valvular incision in the treatment of high surgical astigmatism.

BACKGROUND: Astigmatic keratotomy is used conventionally to correct moderate surgical astigmatism. However, cases with very high surgical astigmatism due to wound compression can show a dramatic response to relaxing keratotomies made in the steeper meridian. The effect obtained cannot be predicted pre-operatively by using standard nomograms. METHODS: Coupled arcuate keratotomies combined with corneal valvular incisions were performed in a case of high astigmatism post-cataract surgery. RESULTS/CONCLUSION: Coupled arcuate keratotomies were combined with a corneal valvular incision enabled a surgical correction of nearly 9 D of astigmatism.

Astigmatism↗
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↗
PubMed1997

Endogenous cortisol profile in patients with central serous chorioretinopathy.

AIM: To study the endogenous cortisol levels in patients with central serous chorioretinopathy (CSCR). METHODS: Endogenous cortisol levels in urine and plasma were determined in 30 patients with acute CSCR and compared with 30 age and sex matched controls. RESULTS: The mean values of the 8 am plasma cortisol (29.97 micrograms/dl v 18.76 micrograms/dl), 11 pm plasma cortisol (22.03 micrograms/dl v 13.06 micrograms/dl), and 24 hour urine cortisol (11.01 mg/24 h v 7.39 mg/24 h) revealed significantly higher values in the patient group (p < 0.001). CONCLUSIONS: Increased levels of endogenous cortisol are present in patients with CSCR.

Adult↗
PubMedDate not supplied

Management of posterior capsule tears.

Any breach in the continuity of the posterior capsule is defined as a posterior capsule tear. Posterior capsule tears can be preexisting (congenital or traumatic), spontaneous, or intrasurgical. Preexisting/congenital posterior capsule tears have been related to an intrauterine insult. Posterior capsule tears due to trauma may occur as a consequence of direct mechanical impact due to perforation or blunt injury. Depending on the duration of time between the posterior capsular trauma and the cataract surgery, these posterior capsule tears can have different features. Intrasurgical posterior capsule tears are the most common and can occur during any stage of cataract surgery. Also, they may be planned in the form of primary posterior capsulorhexis. The conventional management consists of prevention of mixture of cortical matter with vitreous, dry aspiration, and anterior vitrectomy, if required. In addition, during phacoemulsification low flow rate, high vacuum, and low ultrasound are advocated if a posterior capsule tear occurs. Dislocated nucleus or nuclear fragments require vitrectomy and the use of perfluorocarbon liquids. In the presence of a posterior capsule tear, the IOL can be placed in the sulcus, if the capsular rim is available, or in the bag, if the tear is small. Scleral fixated posterior chamber lenses and anterior chamber IOLs can be implanted when the posterior capsule tear is large.

Eye Injuries↗
PubMedDate not supplied

Narrowing of the anterior chamber angle during Valsalva maneuver: a possible mechanism for angle closure.

PURPOSE: To evaluate changes at the anterior chamber angle during Valsalva maneuver in eyes suspected to have a primary adult glaucoma. METHODS: Seventy-six consecutive patients underwent recording of applanation tonometry, measurement of the anterior chamber angle recess, angle opening distance, angle recess area, scleral spur-iris root distance, iris thickness, iridociliary angle, ciliary body thickness, anterior chamber depth, and pupil size on ultrasound biomicroscopy before and during the Valsalva maneuver. The Valsalva maneuver was standardized to a pressure of 40 mmHg for 15 seconds, using a manometer. RESULTS: The mean baseline intraocular pressure changed from 19.5+/-4.1 mmHg to 29.5+/-4.8 mmHg during Valsalva (p<0.0001). The anterior chamber angle recess narrowed from 17.9+/-9.5 to 7.8+/-9.2 degrees (p=0.0001). The angle recess area diminished from 0.15+/-0.14 mm2 to 0.14+/-0.12 mm2 (p=0.03) and the scleral spur to iris distance decreased from 0.19+/-0.2 mm to 0.16+/-0.18 mm (p=0.0001). The iridociliary angle narrowed from 72.6+/-33.5 degrees to 62.5+/-32.8 degrees (p=0.04). There was a significant increase in the thickness of the ciliary body, from 0.99+/-0.19 mm to 1.12+/-0.16 mm (p=0.001) and in iris thickness from 0.47+/-0.07 mm to 0.55+/-0.09 mm (p=0.0001). There was no significant change in the angle opening distance, anterior chamber depth, or pupillary diameter. A significant narrowing of the angle to less than 5 degrees was seen in 37 eyes, with iridocorneal apposition present in 28 eyes. After multivariate regression analysis it was found that the baseline ciliary body thickness and angle recess were significant predictors of narrowing of the angle (R2=96.1%). CONCLUSIONS: Significant elevation of the intraocular pressure, narrowing of the anterior chamber angle recess, thickening of the ciliary body, and increase in the iris thickness is seen during the Valsalva maneuver. The Valsalva maneuver may lead to angle closure in eyes anatomically predisposed to primary angle closure glaucoma.

Adult↗
PubMedDate not supplied

Polymicrobial keratitis after laser in situ keratomileusis.

PURPOSE: To report a case of polymicrobial infectious keratitis in one eye of a patient who had undergone bilateral simultaneous laser in situ keratomileusis (LASIK). METHODS: A 21-year-old healthy female developed infectious keratitis in her right eye after bilateral LASIK surgery. Material obtained from the infective foci was sent for bacterial and fungal cultures and herpes simplex virus antigen detection, and broad spectrum antimicrobial therapy was instituted. RESULTS: Staphylococcus epidermidis and Fusarium solani were detected on culture and herpes simplex virus antigen was found to be positive. The patient did not respond to medical therapy and subsequently the ulcer perforated. A therapeutic keratoplasty was performed and the final best-corrected visual acuity was 20/40, 1 month after keratoplasty. CONCLUSION: Polymicrobial infectious keratitis, although rare, is a potential sight-threatening complication of LASIK.

Adult↗
PubMedDate not supplied

Petalloid phacoemulsification.

Hard grade IV nuclei are difficult to emulsify without causing additional stress on the zonular apparatus. We herein, describe a method to accomplish successful phacoemulsification in hard cataracts. This technique of "petalloid phacoemulsification" consists of partial central debulking, followed by sequential chopping to create petal-shaped nuclear fragments emanating from the partially debulked center. The rim of the petals are emulsified followed by the emulsification of the central disc and the base of the petal. Twenty eyes with grade IV nuclei underwent uncomplicated petalloid phacoemulsification. The mean phaco time was 1.02 +/- 0.06 minutes and mean percentage endothelial loss was 4.2 +/- 0.8%. Petalloid phacoemulsification is a safe and useful technique in cases of hard cataracts.

Humans↗
PubMedDate not supplied

Sinus fracture--phacoemulsification technique for dense cataracts.

A method of performing phacofracture of hard nuclei is presented. Following a central horizontal fracture into 2 hemisections, the phacoprobe is plunged into the inferior hemisection to create a sinus within its dense wall. The chopper/second instrument is placed into the sinus and force is applied along the lateral walls of the sinus. The phacoemulsification probe breaks it and splits the inferior hemisection into two quadrants. A similar method is employed for the superior-nuclear hemisection.

Cataract↗