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Kaveri Mandal

Publications and source records attributed to Kaveri Mandal.

5 recordsLinked to original sources
PubMed2005

Is post-trabeculectomy hypotony a risk factor for subsequent failure? A case control study.

BACKGROUND: Ocular hypotony results in an increased break down of the blood-aqueous barrier and an increase in inflammatory mediator release. We postulate that this release may lead to an increased risk of trabeculectomy failure through increased bleb scarring. This study was designed to try to address the question if hypotony within one month of trabeculectomy for Primary Open Angle Glaucoma (POAG), is a risk factor for future failure of the filter. METHODS: We performed a retrospective, case notes review, of patients who underwent trabeculectomy for POAG between Jan 1995 and Jan 1996 at our hospital. We identified those with postoperative hypotony within 1 month of surgery. Hypotony was defined as an intraocular pressure (IOP) < 8 mmHg or an IOP of less than 10 mmHg with choroidal detachment or a shallow anterior chamber. We compared the survival times of the surgery in this group with a control group (who did not suffer hypotony as described above), over a 5 year period. Failure of trabeculectomy was defined as IOP > 21 mmHg, or commencement of topical antihypertensives or repeat surgery. RESULTS: 97 cases matched our inclusion criteria, of these 38 (39%) experienced hypotony within 1 month of surgery. We compared the survival times in those patients who developed hypotony with those who did not using the log-rank test. This data provided evidence of a difference (P = 0.0492) with patients in the hypotony group failing more rapidly than the control group. CONCLUSION: Early post-trabeculectomy hypotony (within 1 month) is associated with reduced survival time of blebs.

Case-Control Studies↗
PubMed2004

The contribution to ophthalmic literature from different regions of the world.

PURPOSE: To compare the volume of ophthalmic literature from the developed and developing countries. METHODS: We performed a retrospective review of the five highest scoring impact factor journals in ophthalmology within the 3 year period 1998-2000 inclusive. Europe, North America, Australia, New Zealand and Japan were categorised as developed countries, all others were categorised as developing market economies. Correspondence, news articles and book reviews were excluded from our study. RESULTS: The developing world contributed to only 5.47% of the literature compared to the 92.19% from the developed world. The majority of the contribution to ophthalmic literature from the developing countries originated from Israel, S. America, China, Saudi Arabia, India, Singapore and Korea. 2.33% of literature was the result of collaborative research from the two groups. CONCLUSION: The developing countries account for 90.8% of world blindness, compared to 9.2% from the developed countries, there is therefore, an inverse relationship between the burden of world blindness and the contribution to the highest impact factor ophthalmic journals with the developed countries only contributing to 5% of this research.

Bibliometrics↗
PubMed2004

Comparative study of first-day postoperative cataract review methods.

PURPOSE: To assess whether telephone review on the first day after uneventful phacoemulsification is as effective as postoperative review in a hospital or the patients' home by nursing staff. SETTING: Sunderland Eye Infirmary, Sunderland, United Kingdom. METHOD: This prospective study comprised 3 arms, each of which consisted of 100 patients who had uneventful phacoemulsification with intraocular lens implantation. Patients received the same postoperative medications and were given a questionnaire regarding their opinions on the method of postoperative review. The method of review was different for each arm as follows: (1) home review by a nurse, (2) return to the hospital for review by a nurse, and (3) telephone review by a nurse. Statistical analysis of relative frequencies was done; exact testing was applied throughout to test for differences in proportions and, where applicable, to construct 95% confidence intervals. RESULTS: There were no significant differences between the 3 groups in the degree to which patients understood the instructions and questions. The telephone group was significantly less reassured than the home-visit group, but there was no significant difference in the degree of reassurance between the telephone and hospital-visit groups. Seventy percent of patients in the telephone group listed telephone review as their preferred method of postoperative review. CONCLUSION: In cases of uneventful phacoemulsification, telephone review is safe, effective, and acceptable and is a reasonable alternative to other first-day review methods.

House Calls↗
PubMed2004

Investigation into postoperative endophthalmitis and lessons learned.

PURPOSE: To describe an approach to the investigation of a series of endophthalmitis cases to determine whether there was a true outbreak. SETTING: Outpatient facility, Sunderland, England. METHODS: Different approaches to statistical analysis of the probability of infrequent events being due to chance occurrence are described. Potential factors leading to an outbreak were reviewed. RESULTS: Bayesian statistical analysis was shown to be appropriate in the determination of an endophthalmitis outbreak. The only factor found to account for the outbreak was the operating surgeon's recent abandonment of subconjunctival antibiotic prophylaxis. This decision was based on the absence of good evidence that subconjunctival antibiotic injection is effective in prophylaxis. These endophthalmitis cases demonstrate that the absence of evidence for effect is not the same as there being no effect. CONCLUSIONS: Bayesian statistical analysis has a place in determining whether an outbreak has occurred. Withdrawing treatment simply on the basis of a lack of good evidence can lead to undesirable outcomes.

Aged↗