Biomedical subjects

Jayprakash Muliyil

Publications and source records attributed to Jayprakash Muliyil.

3 recordsLinked to original sources

PubMed2003

Comparison between phacoemulsification and the Blumenthal technique of manual small-incision cataract surgery combined with trabeculectomy.

OBJECTIVE: To compare results of filtration combined with either phacoemulsification or the Blumenthal technique of manual small-incision cataract surgery. MATERIALS AND METHODS: Records of glaucoma "triple" operations from March 1997 to May 2000 were reviewed. Seventy-eight eyes (70 patients) that underwent phaco-triple were compared with 86 eyes (80 patients) that underwent the Blumenthal technique of manual small-incision cataract surgery combined with filtration (Blumenthal triple). Three minutes of 0.4 mgs/ml Mitomycin was used in all eyes. Posterior chamber IOLs were implanted through 5.5-mm incisions in both groups. Outcome measures were intraocular pressure (IOP) reduction and achievement of target IOP. Fourteen patients who underwent phacoemulsification-triple in one eye and Blumenthal triple in the other eye were also evaluated separately. RESULTS: The minimum follow-up period was 6 months (range 6-30 months). At last follow-up review, mean reduction in IOP was 17.7 mm Hg (+/- 9.3 mm Hg) in the phaco group and 17.1 mm Hg (+/- 10 mm Hg) in the Blumenthal group. At last visit, target IOP was achieved in 75.6% of the phaco group and 73% of the Blumenthal group. There was no significant difference between groups in IOP reduction or achievement of target IOP. In the 14 patients who had undergone phaco-triple in one eye and Blumenthal-triple in the other, there was no inter-eye difference in IOP reduction. CONCLUSIONS: In this small retrospective study we could not demonstrate a difference in IOP outcomes between the two procedures.

Cataract Extraction↗

PubMed2003

The incidence of vitreous loss and visual outcome in patients undergoing cataract surgery in a teaching hospital.

PURPOSE: To determine the incidence of vitreous loss in patients undergoing cataract surgery and the visual outcome in a tertiary teaching hospital. METHODS: Hospital records of 2095 consecutive patients undergoing cataract surgery between July 1999 and June 2000 were reviewed in this non-concurrent cohort study. Incidence and visual outcome of vitreous loss managed using standard vitrectomy techniques were assessed for different cataract surgical techniques (extracapsular, Blumenthal technique and phacoemulsification) as well as at different levels of surgical training. The outcome was compared with matched cases without vitreous loss (controls). RESULTS: Vitreous loss occurred in 160 of 2095 eyes (7.63%; CI -7 to 9.3): 8.3% for ECCE, 8.1% for the Blumenthal technique and 5% with phacoemulsification. Vision > or = 6/18 was achieved in 85% of cases and 95% of controls. For experienced surgeons, 95% of the cases and controls had vision > or = 6/18. 5.8% of cases and 0.7% of controls had vision < 6/60. One patient in each group was blind following cataract surgery; both had operable cataracts in the fellow eye. CONCLUSIONS: The vitreous loss rate in this tertiary teaching hospital is relatively high. This complication, managed with standard surgical techniques, is compatible with good visual outcome. In eyes with vitreous loss, the final visual acuity achieved by experienced surgeons was similar to that in uncomplicated cases.

Adult↗

PubMed2002

Population-based screening versus case detection.

India has a large burden of blindness and population-based screening is a strategy commonly employed to detect disease and prevent morbidity. However, not all diseases are amenable to screening. This communication examines the issue of "population-based screening" versus "case detection" in the Indian scenario. Using the example of glaucoma, it demonstrates that given the poor infrastructure, for a "rare" disease, case detection is more effective than population-based screening.

Blindness↗