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Amar Agarwal

Publications and source records attributed to Amar Agarwal.

9 recordsLinked to original sources
PubMed2006

Iatrogenic descemetorhexis as a complication of phacoemulsification.

During clear corneal temporal phacoemulsification, an accidental iatrogenic descemetorhexis occurred. The entire cornea was hazy and edematous on the first postoperative day. By the 1-month postoperative review, the cornea had become clear with visible descemetorhexis margins; best corrected visual acuity was 20/25, and the pachymetry was 556 microm. The patient remained stable at the 2-years postoperative follow-up, and specular microscopy done at this time showed a cell density of 1301 cells/mm2 with evidence of pleomorphism and polymegethism. This is the first report of iatrogenic descemetorhexis in which the cornea had become clear and nonedematous by as early as 1 month postoperatively. This case highlights that a healthy endothelium can maintain corneal deturgescence despite a low endothelial cell count. Corneal thickness increases only when the number of endothelial cells has gone below a physiologic lower limit.

Aged↗
PubMed2004

Wavefront- and topography-guided ablation in myopic eyes using Zyoptix.

PURPOSE: To evaluate the results of wavefront- and topography-guided ablation in myopic eyes using Zyoptix (Bausch & Lomb). SETTING: Eye Research Center and Dr. Agarwal's Eye Hospital, Chennai, India. METHODS: This observational case study comprised 150 eyes with myopia and compound myopic astigmatism. Preoperatively, the patients had corneal topography with Orbscan IIz (Bausch & Lomb) and wavefront analysis with the Zywave aberrometer (Bausch & Lomb) in addition to the routine workup before laser in situ keratomileusis (LASIK). The results were assimilated using Zylink software (Bausch & Lomb), and a customized treatment plan was formulated. Laser in situ keratomileusis was performed with the Technolas 217 system (Bausch & Lomb). The patients were followed for at least 6 months. RESULTS: The mean preoperative best corrected visual acuity (BCVA) (in decimal equivalent) was 0.83 (20/25) +/- 0.18 (SD) (range 0.33 to 1.00) and the mean postoperative (6 months) BCVA, 1.00 (20/20) +/- 0.23 (range 0.33 to 1.50). Three eyes (2%) lost 2 or more lines of best spectacle-corrected visual acuity. The safety index was 1.20. The mean preoperative uncorrected visual acuity (UCVA) was 0.06 (20/350) +/- 0.02 (range 0.01 to 0.50) and the mean postoperative UCVA, 0.88 (20/25) +/- 0.36 (range 0.08 to 1.50). The efficacy index was 14.66. The mean preoperative spherical equivalent (SE) was -5.25 +/- 1.68 diopters (D) (range -0.87 to -15.00 D) and the mean postoperative SE (6 months), -0.36 +/- 0.931 D (range -4.25 to +1.25 D). At 6 months, the UCVA was 1.00 (6/6) or better in 105 eyes (69.93%) and 0.5 (6/12) or better in 126 eyes (83.91%). The postoperative aberrations were decreased compared with the preoperative aberrations. One eye (0.66%) had a free cap during LASIK with subsequent loss of 2 lines of BCVA and induced higher-order aberrations (HOAs). Nine patients (11.2%) complained of halos at night. CONCLUSIONS: Wavefront- and topography-guided LASIK leads to improve visual performance by decreasing HOAs. Scotopic visual complaints may be reduced with this method.

Adolescent↗
PubMed2003

Sealed-capsule irrigation device.

We present a sealed-capsule irrigation technique and a disposable instrument that facilitate selective targeting of lens epithelial cells after phacoemulsification.

Disposable Equipment↗
PubMed2003

Efficacy of a capsular tension ring for phacoemulsification in eyes with zonular dialysis.

PURPOSE: To determine the safety and efficacy of capsular tension ring (CTR) insertion in eyes with zonular dialysis of less than 150 degrees having phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation. SETTING: Dr. Agarwal's Eye Hospital, Chennai, India. METHODS: This prospective study comprised 21 eyes of 19 patients with zonular dialysis of less than approximately 150 degrees determined preoperatively or intraoperatively. After insertion of a CTR, phacoemulsification with PC IOL implantation was performed. The mean follow-up was 242.33 days. RESULTS: Capsule collapse did not occur in any eye with a CTR. Intraoperative extension of the dialysis occurred in 2 eyes (9.52%). The IOL was placed in the bag in all the eyes except 1 that had traumatic cataract and received a scleral-fixated IOL during a subsequent surgery. Postoperatively, there was minimal corneal edema in 2 eyes (9.52%) and mild iritis in 5 eyes (23.80%). Three eyes (14.28%) developed raised intraocular pressure that responded well to medical therapy. The symptoms resolved in the 3 patients with preoperative diplopia. Fifteen eyes (71.42%) had a final visual acuity of 6/12 or better. Six eyes had a final best corrected visual acuity of worse than 6/12 because of coexisting fundus pathology. A dilated pupil examination at 6 months showed a well-centered IOL in all eyes. CONCLUSIONS: Phacoemulsification with in-the-bag PC IOL and CTR implantation in eyes with zonular dialysis of up to approximately 150 degrees had a success rate of 90.47%. Visual recovery was not as good as in normal eyes because of the problems associated with zonular dialysis.

Adolescent↗
PubMed2003

Clear lens extraction with intraocular lens implantation for hyperopia.

PURPOSE: To analyze the results of clear lens extraction (CLE) with posterior chamber intraocular lens (IOL) implantation to correct hyperopia. SETTING: Eye Research Center and Dr. Agarwal's Eye Hospital, Chennai, India. METHODS: This prospective study comprised 20 hyperopic eyes of 12 patients between 19 and 50 years who had CLE with posterior chamber IOL implantation. Five patients had peripheral iridectomy during CLE as the angles were occludable. RESULTS: The mean hyperopic spherical equivalent refraction was +6.66 diopters (D) +/- 2.17 (SD) (range +4.75 to +13.00 D). The IOL power was calculated using the Holladay 2 formula. The mean follow-up was 16.96 months (range 6 to 35 months). The mean postoperative uncorrected visual acuity was 0.45 +/- 0.25 (range 0.10 to 1.00), a mean improvement of 3 Snellen lines from preoperatively. The mean postoperative best corrected visual acuity (BCVA) was 0.63 +/- 0.30, a mean improvement of 1 Snellen line. Three patients gained 2 lines of BCVA and 2 patients, 1 line. One patient lost 1 line of BCVA. Seventy percent of patients were within +/-0.50 D of the intended refraction. CONCLUSION: The results indicate that CLE with posterior chamber IOL implantation is safe, predictable, and effective.

Adult↗
PubMed2002

Trypan blue as an adjunct for safe phacoemulsification in eyes with white cataract.

PURPOSE: To assess the feasibility, risks, and postoperative outcomes of phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorhexis (CCC) in the absence of a red reflex. SETTING: Dr. Agarwal's Eye Hospital, Chennai, India. METHODS: This prospective study comprised 52 eyes of 52 patients with white cataract that had phacoemulsification through a clear corneal temporal incision with PC IOL implantation. In all the cases, trypan blue was used under air to stain the anterior lens capsule and the karate-chop technique was used to emulsify the nucleus. The mean follow-up was 192.2 days. RESULTS: Trypan blue adequately stained the anterior lens capsule in all cases. The CCC was completed uneventfully in 96.15% eyes; 3.85% of cases had to be converted to a conventional extraction technique because of the loss of the CCC. The mean phacoemulsification time was 2.2 minutes. Intraocular complications included incomplete capsulorhexis (3.85%) and pupillary miosis (3.80%). Postoperatively, 3 eyes (5.77%) had corneal edema (striate keratopathy) and 1 eye (1.9%) had fibrin in the anterior chamber. Five eyes (9.61%) had more than 2+ cells and flare at 2 weeks. All responded well to intensive topical and subconjunctival steroids. There were no cases of endophthalmitis. The mean central endothelial cell loss, measured in 37 eyes, was 8.5%. Of the 4 eyes (7.69%) that had increased intraocular pressure (IOP) postoperatively, all responded well to medications and the IOP was normal by the second postoperative week. Fifty eyes (96.16%) had a final best corrected visual acuity of 20/30 or better. In 2 cases, the final visual acuity was worse than 20/200 because of preexisting posterior segment pathology. CONCLUSION: Phacoemulsification using trypan blue was safe and effective in managing white cataract and had a high success rate.

Aged↗