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Prashant Bhartiya

Publications and source records attributed to Prashant Bhartiya.

8 recordsLinked to original sources
PubMed2005

Central penetrating keratoplasty with peripheral intrastromal tuck.

PURPOSE: To report a new technique of central penetrating keratoplasty with peripheral intrastromal tuck in cases of chronic corneal decompensation. METHODS: Central penetrating keratoplasty with peripheral intrastromal tuck was undertaken in 8 eyes with chronic corneal decompensation. An 8-mm donor tissue with a peripheral flange of 2 mm was fashioned and sutured into a 7.5-mm recipient bed having a 2-mm intralamellar pocket. Sixteen full-thickness interrupted sutures were passed. Suture removal was possible as early as 1 month, and all sutures were removed by 4 months. RESULTS: Postoperative BCVA improved to 20/40 to 20/80 in all eyes, and astigmatism was <4 diopters in all cases at the last follow-up, which ranged from 5 to 16 months. CONCLUSIONS: Central penetrating keratoplasty with peripheral intrastromal tuck is a useful technique because it allows early suture removal and visual rehabilitation.

Adult↗
PubMed2002

Levodopa-carbidopa with occlusion in older children with amblyopia.

PURPOSE: To study the role of levodopa-carbidopa in supplementing occlusion therapy in older children with strabismic or anisometropic amblyopia. METHODS: A clinical study was performed on 40 amblyopic children (19 strabismic and 21 anisometropic), 6 to 18 years old (mean age, 10.9 years). They received an average dose of 1.86 mg/kg/day (1.33-2.36 mg/kg/day) of levodopa and carbidopa (4:1 ratio) or a placebo in 3 divided doses over a 4-week period, combined with full-time occlusion. The occlusion was continued for the study duration of 3 months. Early Treatment Diabetic Retinopathy Study visual acuity charts and Cambridge low-contrast gratings for contrast sensitivity (CS) were used to assess visual functions. Tolerance and compliance with occlusion and capsule consumption were assessed. RESULTS: Visual acuity of the nonamblyopic eye did not deteriorate during the study in either group. CS decreased by 22 units in the levodopa group and increased in the placebo group by 53 units at the first month. The CS in the levodopa group recovered later by the third month of follow-up. Both the levodopa and the placebo groups showed significant improvement in visual function in the amblyopic eye (P <.001). Overall changes in logarithm of minimum angle of resolution values and CS in the amblyopic eyes were similar in both groups (P >.05). Strabismic and anisometropic amblyopes did not behave differently. Drug tolerance, occlusion compliance, and capsule ingestion compliance were similar between the groups, with no significant side effects. CONCLUSIONS: Clinically, levodopa supplementation does not offer any advantage over occlusion alone. Moreover, the risk of occlusion amblyopia could increase with the use of drugs like levodopa that might affect the plasticity of the visual cortex.

Adolescent↗
PubMed2002

Central lamellar keratoplasty with peripheral intralamellar tuck: a new surgical technique for keratoglobus.

PURPOSE: To report a new technique of lamellar keratoplasty in a case of keratoglobus. METHODS: A patient with bilateral keratoglobus with maximal thinning in the juxtalimbal periphery underwent a lamellar procedure in the right eye. The visual acuity was 3/60. Refraction was not possible due to severe irregular astigmatism, and the central pachymetry was 430 microm. A central 8.5 mm diameter lamellar dissection along with a peripheral intrastromal pocket up to the limbus was fashioned. The donor corneal button (12 mm) denuded of its endothelium was beveled at the periphery to create a flange. This flange was tucked into the peripheral pocket and the graft was sutured with interrupted nylon sutures. RESULTS: No intra-or postoperative complication was encountered. Reepithelialization was complete within 1 week. At 1 month postoperatively, the preoperative keratometric astigmatism of >12 D decreased to <2.75 D. The spectacle-corrected visual acuity at 1 month was 6/18. CONCLUSIONS: This new technique of central lamellar keratoplasty with intralamellar tucking of the peripheral flange for keratoglobus not only provides optical clarity and tectonic support but also helps in preservation of the host limbal stem cells.

Adult↗
PubMedDate not supplied

Laser in-situ keratomileusis after penetrating keratoplasty.

Laser in situ keratomileusis (LASIK) after penetrating keratoplasty has been used more commonly for the correction of myopia or myopic astigmatism and less so for hypermetropia or hyperopic astigmatism. The primary goal after LASIK in such cases is resolution of sufficient myopia and astigmatism to allow spectacle correction of the residual refractive error and decrease anisometropia. All sutures should be removed prior to LASIK and the interval between penetrating keratoplasty and LASIK should be a minimum of 1 year. Preoperative evaluation includes refraction, slit-lamp biomicroscopy, corneal topography, and specular microscopy. The technique of LASIK surgery after penetrating keratoplasty is similar to the standard procedure. However, many variations have been described. These include maneuvers during surgery such as augmentation with arcuate cuts on the stromal bed and topographically guided LASIK. Other variations are relaxing incisions followed by LASIK surgery and sequential treatment by LASIK, that is, raising of the flap as a first stage procedure followed by ablation if required, 4 to 6 weeks later after relifting the flap in the second stage. Improvement in both uncorrected visual acuity and spectacle-corrected visual acuity, as well as a decrease in spherical equivalent, cylinder, and anisometropia, has been reported in various studies. All grafts were clear and no occurrence of wound dehiscence has been reported. Intraoperative complications include hemorrhage, microkeratome failure, flap buttonhole, dislocation, and perforation. Postoperative complications include undercorrection, decentered ablation, and regression. Re-enhancements after LASIK following keratoplasty are possible with acceptable visual outcome.

Cornea↗