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Biomedical subjects

G C Sekhar

Publications and source records attributed to G C Sekhar.

13 recordsLinked to original sources
PubMed1997

Orbital cysticercosis.

BACKGROUND: Human cysticercosis is secondary to an infestation by cysticercus cellulosae, the larval form of Taenia solium. Cysticercosis is endemic to regions with poor sanitation. The purpose of this report is to present a large series of patients with orbital cysticercosis and to discuss the current treatment. METHODS: A retrospective chart analysis of all patients with orbital cysticercosis from an urban practice in southern India was performed. The clinical features, the results of investigations, the therapies instituted, and the outcomes realized were recorded. RESULTS: Twenty patients diagnosed with orbital cysticercosis were identified (11 female and 9 male). Their ages ranged from 5 to 25 years with a mean age of 12.5 years. Nine patients manifested subconjunctival cysts. Eight were excised and 5 of these were densely adherent to the adjacent extraocular muscle (EOM). The remaining 11 patients had a cyst in a single EOM. The EOM cysts had proptosis, restricted motility, recurrent inflammation, and blepharoptosis. Two of the EOM cysts were excised surgically and four extruded spontaneously. Six patients with EOM cysts were treated medically: they all received oral corticosteroids and, additionally, five were given oral albendazole and one was given oral praziquantel. CONCLUSIONS: Excisional biopsy is recommended for subconjunctival cysticercosis. Idiopathic cystic myositis can present like EOM cysticercosis, but is differentiated by resolution with corticosteroid treatment. Medical therapy in orbital cysticercosis with oral albendazole and corticosteroids can arrest recurrent inflammation and improve ocular motility.

Adolescent↗
PubMed1997

Etiology of ptosis after cataract surgery.

PURPOSE: To determine whether using a lid speculum with a superior rectus bridle suture in cataract surgery results in levator rectus aponeurosis dehiscence caused by strong fascial attachments between the levator and superior rectus muscles. SETTING: L.V. Prasad Eye Institute, Hyderabad, India. METHODS: This study comprised 220 patients having cataract extraction with posterior chamber intraocular lens implantation. The patients were randomly assigned to one of two groups. In the first group (n = 108), a lid speculum was used during surgery. In the second group (n = 112), no speculum was used. All patients had a superior rectus bridle suture. The occurrence of ptosis was analyzed by a masked observer who was not involved in the surgery. RESULTS: The incidence of ptosis was significantly higher in the speculum (44.4%) than in the no-speculum (23.3%) group (P = .0009). CONCLUSION: The results indicate that the opposing forces created by the lid speculum and bridle suture can cause levator aponeurosis dehiscence because of the strong fascial attachments between the superior rectus and levator muscles. The occurrence of ptosis in the no-speculum group implies a multifactorial etiology, however.

Blepharoptosis↗
PubMed1996

Cystic lesions of the extraocular muscles.

Cystic lesions of the extraocular muscles (EOMs) are uncommon. Six patients with a cystic lesion in an extraocular muscle, as observed by computerized tomography (CT) scanning, were retrospectively identified from the practice of one of the authors (G.C.S.), and their clinical course was reviewed. All the patients were treated initially with oral corticosteroids. Those who did not respond to this therapy underwent surgical exploration. Four patients demonstrated complete resolution of clinical signs and symptoms with oral steroid therapy. Posttreatment CT scans performed in two of these patients showed resolution of the cystic lesion with residual muscle thickening in one. The two patients not responding to steroids underwent surgical excision and histopathology confirmed the diagnosis of cysticercosis. Cysticercosis is a previously reported cause of a cystic lesion in an EOM. To the best of our knowledge, cystic lesions of the EOMs resolving with steroids have not been previously reported. Response to oral steroids in four of our patients is suggestive of myositis with a cystic change in the muscle. We recommend a trial of oral steroid therapy in patients with a cystic EOM lesion before surgical exploration is performed.

Adolescent↗
PubMed1995

Ocular toxicity of tamoxifen.

Tamoxifen is an antioestrogen drug used widely in the management of oestrogen-dependent metastatic breast carcinoma. A number of ocular complications have been described secondary to tamoxifen therapy. We report two patients, one of whom had superior ophthalmic vein thrombosis and the other who had painful proptosis and acute angle-closure glaucoma with choroidal detachment secondary to tamoxifen therapy, both of which have not been reported earlier. In both patients the signs and symptoms resolved rapidly after the discontinuation of tamoxifen therapy. Awareness of the ocular toxicity of tamoxifen is essential as prompt withdrawal can result in resolution of most of the complications.

Acute Disease↗
PubMed1994

Ocular manifestations of Hansen's disease.

A detailed ophthalmic evaluation including slitlamp biomicroscopy, measurement of corneal sensitivity using Cochet and Bonnet aesthesiometer, Schirmer's test and Goldmann applanation tonometry was carried out in 89 patients of Hansen's disease attending the leprosy clinic with or without ocular symptoms and willing to undergo eye evaluation. Thirty-one patients had lepromatous leprosy (8 with erythema nodosum leprosum), 56 patients had borderline disease (13 with reversal reactions) and 2 had tuberculoid disease. In addition to the well documented changes of lagophthalmos (6.7%), uveitis (7.3%) and cataracts (19%), we noted prominent corneal nerves in 133 eyes (74.7%), beaded corneal nerves in 19 eyes (10.7%), corneal scarring in 10 eyes (5.6%), corneal hypoaesthesia in 51 eyes (28%) and dry eye in 18 eyes (13%). Beaded corneal nerves and/or stomal infiltrates occurred mainly in the lepromatous group (75%). Ocular hypotony (IOP less than 12 mm Hg) was not seen more frequently in Hansen's as compared to age and sex matched controls with refractive errors or cataracts (33.7%, vs. 37.8%, p = 0.33). Our study highlights the primary corneal involvement with corneal neuropathy as the predominant feature of Hansen's disease.

Adolescent↗
PubMed1994

Outside-in transscleral fixation for ciliary sulcus intraocular lens placement.

We describe a new technique of transscleral intraocular lens fixation in the absence of adequate posterior capsular support. This technique of suture placement within the ciliary sulcus employs routinely used instruments, requires minimum manipulation, and has good visual outcome and negligible complications. We performed five intraocular lens implantations using the technique with good visual outcomes in each. No significant intraoperative or postoperative complications were noted.

Adult↗
PubMed1993

Non specific orbital inflammatory diseases.

The understanding of 'pseudotumors' has significantly changed with the advent of modern imaging techniques by which the tissues affected in the orbit can be identified, and nonspecific orbital inflammatory disease is classified according to the tissue involved. Twenty cases of nonspecific orbital inflammatory diseases were treated between July 1987 and September 1991. Eight patients had myositis, 6 had diffuse disease, 2 each had dacryoadenitis, periscleritis and perineuritis. Involvement of all four recti in one patient and isolated superior rectus and superior oblique each in 2 others are the unusual forms of myositis. Perineuritis presented as diffuse thickening of the optic nerve on CT scan with disc edema and normal vision in both patients with external ophthalmoplegia in one of them. All patients responded to oral steroids while the patient with myositis of all four recti required radiotherapy in addition. This series documents the spectrum of clinical presentation, diagnosis and management of nonspecific orbital inflammatory disease.

Acute Disease↗
PubMed1993

Post-penetrating keratoplasty glaucoma.

To study the risk factors in the development of glaucoma following penetrating keratoplasty, we retrospectively analysed 190 eyes of 185 consecutive patients who had undergone surgery during 1990. The donor button was larger by 0.2 mm and 0.5 mm in phakia and aphakia/pseudophakia patients, respectively. Over a mean follow-up period of 14.5 months, 52 of the 190 eyes (27.4%) either developed glaucoma de novo or had worsening of preexisting glaucoma. Of these 52 eyes, 38 were managed medically and 14 required surgery. From our study, aphakia (37%), pseudophakia (24%), preexisting glaucoma (81.8%), and regrafting (43.18%) were found to be the significant risk factors in the development of glaucoma following penetrating keratoplasty.

Aphakia, Postcataract↗
PubMed1991

Problems associated with conjunctivodacryocystorhinostomy.

Fifty-eight patients (69 eyes) underwent conjunctivodacryocystorhinostomy for lacrimal canalicular obstruction. The cause of lacrimal obstruction and the results and complications of the operation were analyzed. Trauma and idiopathic disease were the most common causes of lacrimal canalicular obstruction in 24 of 69 (34.8%) eyes each. Relief of epiphora was achieved in 68 of the 69 eyes (98.5%). The complications included tube displacement in 40 of the 69 eyes (57.9%), tube obstruction in 19 of the 69 eyes (27.5%), and infection of the lacrimal sac in four of the 69 eyes (5.8%). Despite frequent complications, most Jones tubes can be made to function satisfactorily. Conjunctivodacryocystorhinostomy remains the best surgical treatment at this time for permanent loss of canalicular function.

Adolescent↗