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Biomedical subjects

M R Praveen

Publications and source records attributed to M R Praveen.

6 recordsLinked to original sources
PubMed2006

Completion rate of primary posterior continuous curvilinear capsulorhexis and vitreous disturbance during congenital cataract surgery.

PURPOSE: We sought to document the completion rate of primary posterior continuous curvilinear capsulorhexis during congenital cataract surgery and determine the incidence of disruption of vitreous face during this procedure. METHODS: One hundred six consecutive eyes of patients undergoing posterior continuous curvilinear capsulorhexis (PCCC) during congenital cataract surgery were evaluated prospectively for completion of PCCC and disruption of vitreous face. PCCC was performed under high-viscosity sodium hyaluronate (Healon GV 1.4%) initiated with 26 g of cystotome and later completed with Kraff-Uttrata forceps by frequent grasping and regrasping of the flap. Completion of PCCC and disruption of vitreous face during the procedure was noted. Even in cases of disrupted vitreous face, PCCC was performed and completed with forceps and, later, disruption of vitreous face was managed with 2-port automated limbal anterior vitrectomy. The size of PCCC was measured. An Alcon AcrySof SA30AL was implanted in-the-bag if the PCCC was 4 mm or smaller and in the sulcus when the PCCC was larger than 4 mm. RESULTS: The mean age of the 106 pediatric patients was 17 +/- 26 months (median, 6 months; range, 1 month to 8 years). PCCC was completed in all the eyes. Disruption of vitreous face during PCCC was noted in 5 of 106 (4.7%) eyes. The mean size of PCCC was 3.6 +/- 0.7 mm. A total of 98 (92.5%) had in-the-bag, and 8 (7.5%) eyes had sulcus implantation of IOL. CONCLUSION: PCCC was completed in all eyes with minimal disruption of vitreous face in a well-controlled manner under high-viscosity viscoelastics.

Capsulorhexis↗
PubMed2006

Preoperative prediction of posterior capsule plaque in eyes with posterior subcapsular cataract.

AIM: To determine whether the plaque on the posterior capsule can be predicted preoperatively, in patients with posterior subcapsular cataract (PSC), undergoing cataract surgery. MATERIALS AND METHODS: A prospective study of 140 consecutive eyes with PSC, who underwent cataract surgery, was conducted. The prediction of preoperative presence or absence of plaque within the PSC was noted on slit lamp examination, in dilated pupils. A single observer made the observations under oblique illumination, where the slit lamp was placed at an angle of 30 degrees to 45 degrees. Evaluation of the plaque through slit lamp examination was standardized in terms of illumination and magnification. The observations were recorded using a video camera (Image archiving system, Carl Zeiss, Jena Germany) attached to a slit lamp (Carl Zeiss, SL 120 Jena, Germany), keeping the illumination at 100%. The prediction of plaque was noted in terms of its presence or absence on the posterior capsule. All the patients received counseling regarding the presence of plaque. Capsule polishing of the posterior capsule in Cap Vac mode, was done in all cases. The posterior capsule was examined for presence or absence of plaque, either on the first postoperative day, or within a week, with maximal mydriasis. The observer's results were tabulated and later analyzed to judge the incidence of predictability of plaque in PSC. RESULTS: The mean age of the patients was 45+/-6.2 years (range 32-61 years); 104 (74.3%) were males. One hundred and eight (77.1%) patients were under 50 years. The presence or absence of plaque was predicted correctly in 124 (88.6%) eyes. The prediction of plaque was incorrect in 16 (11.4%) eyes. CONCLUSION: The prediction of presence or absence of plaque was accurate in 88.6% cases. We believe that counseling patients with posterior capsule plaque before the surgery is the key to avoiding unpleasant surprises.

Adult↗
PubMed2004

Diagnosis and management of congenital cataract with preexisting posterior capsule defect.

PURPOSE: To establish and evaluate the diagnostic signs, intraoperative performance, and postoperative outcomes in children with congenital cataract with a preexisting posterior capsule defect (PCD). SETTING: Iladevi Cataract & IOL Research Centre, Ahmedabad, India. METHODS: This study evaluated 400 consecutive eyes that had congenital cataract surgery, of which 27 (20 children) had a confirmed preexisting PCD. Seven children had bilateral defects. The preoperative diagnostic signs of PCD under maximum pupil dilation included well-demarcated, thick defect margins; white dots on the posterior capsule; and white dots in the anterior vitreous that moved with the degenerated vitreous like a fish tail (fish-tail sign). Hydrodissection was not attempted. Bimanual irrigation/aspiration and 2-port anterior vitrectomy were performed. The mean follow-up was 17.9 months +/- 16.96 (SD). RESULTS: The mean age of the 16 boys and 4 girls with a PCD was 21.98 +/- 33.33 months. Nineteen eyes (70.3%) had total white mature cataract. In 7 eyes (25.92%), the preexisting PCD was converted into a posterior capsulorhexis. Twenty eyes (74.07%) had an AcrySof MA30BA intraocular lens (IOL) implanted in the bag and 4 eyes (14.81%), in the sulcus. Three eyes (11.11%) were left aphakic. The visual axis remained clear in all eyes, and the IOL was well centered in 24 eyes (88.88%). CONCLUSION: Establishing the diagnostic signs of PCD with the eye fully dilated and carefully planning the surgery produced satisfactory technical and visual outcomes.

Cataract↗
PubMed2003

Management of bilateral anterior dislocation of a lens in a child with Marfan's syndrome.

A 13-year-old boy with Marfan's syndrome presented with bilateral, acute, complete anterior dislocation of the crystalline lens. The lens substance was aspirated intracapsularly after 2 linear capsulotomies were created. The empty capsular bag was removed from the eye as a vitrectome was used to severe the adhesions between the capsule and vitreous face through 1 paracentesis and a forceps was used to pull the capsule through the other paracentesis. Aphakia was corrected by glasses and contact lenses. Two years after surgery, the best corrected visual acuity was 20/32 in both eyes.

Adolescent↗
PubMed2003

Phacoemulsification in subluxated cataract.

PURPOSE: To evaluate the outcome of phacoemulsification in eyes with subluxated cataract. MATERIALS AND METHODS: This retrospective study comprised 22 eyes of 20 consecutive patients with subluxated cataracts of varying aetiology operated between March 1998 and March 2001. Detailed preoperative assessment included visual acuity (VA), slitlamp examination, presence of vitreous in anterior chamber extent of subluxation, intraocular pressure (IOP) and detailed fundus examination. Phacoemulsification was done to retain the natural bag support and all patients had acrylic foldable Acrysof IOL implantation either in-the-bag or by scleral fixation. Postoperative observations included best-corrected visual acuity (BCVA), IOP, pupillary reaction and the IOL position. RESULTS: The aetiology of the subluxation was traumatic in 11 patients and non-traumatic in 9 patients. Fifteen were males and 5 were females. Mean follow-up was 11.7 +/- 9.71 months (range 4-39). The average age was 39.15 +/- 16.33 (range 5-74). A 2-port anterior chamber vitrectomy was performed in 6 eyes (27.2%). Capsule tension ring (CTR) was implanted in 15 eyes (68.18%). Twelve eyes (54.5%) had in-the-bag implants, while 5 (22.72%) had scleral fixation. The remaining 5 eyes (22.72%) had one haptic in-the-bag and another sutured to sclera. No major intraoperative complications were noted. Twelve eyes (54.5%) had clinically and geometrically well centered IOLs while 9 eyes (40.9%) had geometrically decentered IOLs. One patient was lost to follow-up. Fifteen eyes (55.55%) had postoperative BCVA of 6/12 - 6/6 while 2 eyes (7.40%) had BCVA of 6/18. The remaining 4 eyes (14.81%) had less than 6/24 BCVA due to pre-existing posterior segment pathology. Postoperative complications included rise in IOP in 1 eye (4.54%), pupillary capture of the IOL optic in 2 eyes (9.09%); the same 2 eyes (9.09%) required redialing of IOL. One eye (4.54%) had to undergo refixation (one haptic was fixed to sclera) year after cataract surgery. Postoperative retinal detachment was noticed in one patient after a month of phacoemulsification. CONCLUSION: In subluxated cataracts it is essential to have appropriate parameters depending on the grade of cataract. This contributes to a safe and predictable outcome in subluxated cataract surgery.

Adolescent↗