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Biomedical subjects

R B Vajpayee

Publications and source records attributed to R B Vajpayee.

107 records · Page 6Linked to original sources

Sunlight and cortical cataract.

We undertook a prospective clinical study to test our initial impression that cortical opacities are seldom present in the upper part of the lens. Data analysis revealed that of 174 eyes having cortical opacities, only 15 (8.62%) had opacities in the area of the lens between the 10- and 2-o'clock positions. Lid retraction, defined as upper lid position at or above the limbus, was seen in 13 (88.66%) of these eyes. Our study indicates that in the absence of lid retraction, cortical opacities are very rarely seen in the upper segment of the lens, a segment that is normally covered by the upper lid. This suggests a protective effect of the upper lid against cortical opacities, and indirectly it supports the theory that senile cortical opacities may be the result of thermal damage to the lens.

Adult↗

Acute hemorrhagic conjunctivitis due to enterovirus 70 in India.

An outbreak of acute hemorrhagic conjunctivitis occurred in Delhi, India, during August and September 1996. The etiologic agent was confirmed as enterovirus type 70 by a modified centrifugation-enhanced culture method followed by immunofluorescence and neutralization tests. After nearly a decade, this virus is reemerging as a cause of acute hemorrhagic conjunctivitis in India.

Adolescent↗

Epikeratoplasty for keratoconus using manually dissected fresh lenticules: 4-year follow-up.

BACKGROUND: Epikeratoplasty for keratoconus, in the absence of apical scarring, aims at reducing high irregular myopic astigmatism and provides an ectatic cornea with mechanical support. METHODS: We performed epikeratoplasty on 11 keratoconic corneas using fresh or McCarey-Kaufman preserved, manually dissected donor lenticules. A disparity of 0.5 mm was maintained between the host and the donor. Patients with keratoconus having a preoperative spectacle-corrected visual acuity of less than 6/60 and intolerance to contact lens wear were included in this prospective study. Spectacle-corrected visual acuity, keratometry, and refraction were analyzed over a 4-year follow-up period. RESULTS: Four year follow-up was completed on 10 eyes. Of these, 80% achieved a postoperative spectacle-corrected visual acuity of 6/12 or better. Average postoperative keratometry was 45.79 +/- 2.07 D and a decrease of 4.60 +/- 0.09 D was observed in refractive cylinder. Spherical equivalent showed a significant decrease in myopia of -4.35 +/- 0.26 D. Mean time to stabilization was 8 +/- 2.3 weeks. Epithelial defects occurred in three eyes; two were successfully treated by patching. One lenticule was removed due to graft infection following a persistent epithelial defect. CONCLUSION: Epikeratoplasty for keratoconus is a useful procedure with good long-term visual acuity results and an early stabilizing period.

Adolescent↗

Polymicrobial keratitis after laser in situ keratomileusis.

PURPOSE: To report a case of polymicrobial infectious keratitis in one eye of a patient who had undergone bilateral simultaneous laser in situ keratomileusis (LASIK). METHODS: A 21-year-old healthy female developed infectious keratitis in her right eye after bilateral LASIK surgery. Material obtained from the infective foci was sent for bacterial and fungal cultures and herpes simplex virus antigen detection, and broad spectrum antimicrobial therapy was instituted. RESULTS: Staphylococcus epidermidis and Fusarium solani were detected on culture and herpes simplex virus antigen was found to be positive. The patient did not respond to medical therapy and subsequently the ulcer perforated. A therapeutic keratoplasty was performed and the final best-corrected visual acuity was 20/40, 1 month after keratoplasty. CONCLUSION: Polymicrobial infectious keratitis, although rare, is a potential sight-threatening complication of LASIK.

Adult↗

Sinus fracture--phacoemulsification technique for dense cataracts.

A method of performing phacofracture of hard nuclei is presented. Following a central horizontal fracture into 2 hemisections, the phacoprobe is plunged into the inferior hemisection to create a sinus within its dense wall. The chopper/second instrument is placed into the sinus and force is applied along the lateral walls of the sinus. The phacoemulsification probe breaks it and splits the inferior hemisection into two quadrants. A similar method is employed for the superior-nuclear hemisection.

Cataract↗

Posterior keratoconus due to iron nail injury--a case report.

A case of post-traumatic keratoconus is presented. This is an unusual variant of an uncommon disorder. Posterior keratoconus is a very rare ectatic dystrophy of the cornea. Since its first description in 1927, only a few cases have been described in the literature. Posttraumatic posterior keratoconus is a much rarer entity. We are reporting a case of posterior keratoconus caused by iron nail injury.

Adult↗

A simple accurate method of cataract classification. Cataract-I.

A simple and accurate system of cataract classification using slit lamp and direct ophthalmoscope is reported. Lens opacities are classified into cortical (anterior and posterior), nuclear and posterior sub-capsular and each sub-type of opacity is graded, extent and density wise, using both slit lamp and direct ophthalmoscope. A circle representing enface view of opacity divided into 100 equal parts is used in calculating the area of each opacity. This classification takes into account both the area and depth of opacity in arriving at the total extent of sub-type of each opacity. For density determination, we do not recommend the use of a resolution target projection ophthalmoscope. Intra-observer and inter-observer variability studies using this classification system indicated that the classification system is fairly reliable.

Cataract↗

Methodology for studies on medical therapy of cataracts: cataract-II.

The methodology for testing any possible effect of potential anti-cataract agents is described. This is based on slit lamp and ophthalmoscopic cataract classification and on visual acuity. The difficulties encountered in such studies are highlighted. The presented methodology is suggested to be fairly adequate in assessing usefulness of any possible medical therapy of cataracts.

Adult↗

Topical glutathione therapy in senile cataracts. Cataract-III.

We undertook a prospective study in 66 cataract patients to study if topical glutathione has any effects on the progression of cataracts. The eye with more advanced cataract received topical glutathione drops q.i.d. and contralateral eye served as control. Only 32 patients completed the follow-up of three months or more. Data analysis revealed no beneficial effect of topical glutathione drops on any of the parameters studied. PSC opacity density in eyes treated with topical glutathione showed significant increase as compared to control eyes.

Administration, Topical↗

Topical sulindac therapy in diabetic senile cataracts: cataract-IV.

Sulindac, a non-steroidal anti-inflammatory drug has been found to be a potent inhibitor of enzyme aldose reductase. We used sulindac topically in diabetic senile cataract patients to note if it effects the progression of cataracts. More of sulindac treated eyes maintained initial vision and fewer eyes had visual loss of up to two lines or more as compared to control eyes. The extent and density of different opacities showed less progression in sulindac treated eyes but it was not statistically significant except that the ophthalmoscopically observed density of opacity showed statistically very significant lesser mean increase in sulindac treated eyes. We suggest that sulindac is a potential drug which should be further evaluated in large double blind photodocumented studies in diabetic senile cataracts.

Administration, Topical↗

Systemic aspirin and systemic vitamin E in senile cataracts: cataract V.

We undertook a prospective study in senile cataract patients using systemic aspirin and systemic vitamin E. Vitamin E treated eyes did show less progression of PSC opacities extent and less new nuclear opacities during the follow-up, but overall vitamin E treated eyes did no better than the control group eyes. More eyes in systemic aspirin treated group maintained the initial vision and loss of vision in the aspirin group was also less marked. Aspirin also caused a significant less mean increase in cortical opacity extent, nuclear/opacity and density and PSC opacity extent and density as well as in ophthalmoscopically graded opacity extent and density. We suggest that aspirin is a potential drug which should be further evaluated in large double blind photodocumentated studies. The present data does not justify the recommendation that aspirin be prescribed for slowing down cataract progression. This must await large studies and confirmation.

Administration, Oral↗

Anterior synechiolysis after keratoplasty.

Anterior synechiae that develop following keratoplasty may induce immunological graft rejection or graft failure. Current surgical techniques designed to remove the synechiae early on are quite cumbersome. We describe a simple technique of anterior synechiolysis, performed 1 to 4 weeks postoperatively, using a bent 26-gauge needle, that proved safe and effective in seven cases. The only complication was a hyphema in one case. None of the synechiae had recurred at the final follow up at 3 months.

Adolescent↗