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Biomedical subjects

S S Badrinath

Publications and source records attributed to S S Badrinath.

At least 19 recordsLinked to original sources
PubMed1998

Primary vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment.

OBJECTIVE: This study aimed to report the success rate of primary vitrectomy, scleral buckling, and oral steroids in eyes with combined rhegmatogenous retinal detachment (RRD) and choroidal detachment (CD) and to compare these results with those reported in the literature for similar cases managed by scleral buckling alone. DESIGN: Consecutive case series. PARTICIPANTS: Twenty-one eyes of 21 consecutive patients with primary RRD associated with CD were examined. INTERVENTION: All patients were treated with systemic corticosteroids before surgery. Pars plana vitrectomy with scleral buckling or encircling or both were performed. MAIN OUTCOME MEASURES: Retinal reattachment rate and resolution of choroidal detachment were measured. RESULTS: At mean follow-up of 11.4 months, retinal reattachment was attained in 19 eyes (90.5%) compared to less than 53% reported in the literature for scleral buckling alone. With preoperative oral steroids, choroidal detachment regressed completely in 13 eyes (61.9%). In the remaining eyes with persistent choroidal detachment, suprachoroidal fluid was drained during vitrectomy. CONCLUSION: Aggressive treatment with oral steroids followed by pars plana vitrectomy and scleral buckling or encircling is recommended instead of scleral buckling alone in the management of combined primary rhegmatogenous retinal detachment and choroidal detachment.

Administration, Oral↗
PubMed1998

Surgical management of retinal detachments related to coloboma of the choroid.

OBJECTIVE: This study aimed to develop a rationale for the management of retinal detachments related to choroidal coloboma and to study the outcome of their management. DESIGN: The study design was a retrospective study. PARTICIPANTS: A total of 85 eyes of 81 patients with retinal detachments related to coloboma of the choroid participated. INTERVENTION: All eyes underwent pars plana vitrectomy with internal tamponade using silicone oil (80 eyes) or perfluropropane gas (5 eyes). Behavior of the retina on fluid-air exchange was used to guide the further steps of surgery. Endolaser was performed along the coloboma border. Silicone oil was removed in 80% of eyes. The main outcome measures were retinal reattachment and visual recovery. RESULTS: Recurrent retinal detachment occurred in 16.3% of silicone oil-filled eyes and 60% of gas-filled eyes. After silicone oil removal, 15.6% of eyes had recurrent retinal detachment. After a mean follow-up of 13.4 months, 81.2% of eyes had attached retina and 69.4% recovered equal to or better than 10/200 visual acuity. CONCLUSION: Retinal detachment secondary to coloboma of choroid is treated best by pars plana vitrectomy along with silicone oil tamponade. Gas tamponade has limited indications. Clinical evaluation of the extent of retinal detachment within the colobomatous area and the behavior of the retina on fluid-air exchange help the authors understand the pathogenesis of the retinal detachment and plan a rational therapy.

Adolescent↗
PubMed1998

Subretinal fibrosis and nonrhegmatogenous retinal detachment associated with multifocal central serous chorioretinopathy.

PURPOSE: To report the rare occurrence of subretinal fibrosis in patients with multifocal central serous chorioretinopathy and evaluate the role of systemic corticosteroids and the effects of laser photocoagulation on multifocal leaks. METHODS: A total of 29 patients (mean age, 37.7 years; 89.7% male) treated for subretinal fibrosis and multifocal central serous chorioretinopathy from 1983-1995 were reviewed retrospectively. Mean follow up was 26 months (range, 6.8-81 months). RESULTS: Retinal detachment involved the macula in 72.4% cases. Fluorescein angiography showed a mean of 6.7 (range, 2-22) central serous chorioretinopathy leaks and a mean of 1.8 (range, 1-5) retinal pigment epithelial detachments. The fundus pictures of 23 patients who were taking systemic corticosteroids showed no improvement. Following laser treatment, however, retinal reattachment was obtained in all eyes, and improvement in visual acuity of > 2 Snellen lines was noted in 68.9% of patients. CONCLUSIONS: The presence of subretinal fibrosis with secondary retinal detachment in otherwise healthy young patients, particularly in men, should alert the physician to look for multifocal central serous retinopathy leaks. Systemic corticosteroids did not prove effective in treating these patients, although laser treatment is recommended for each leak identified on an angiogram.

Adult↗
PubMed1998

Management of glass intraocular foreign bodies.

PURPOSE: To describe the results of management of glass intraocular foreign bodies (IOFBs). METHODS: A total of 51 eyes of 43 patients that sustained penetrating injury with glass IOFB were studied retrospectively. A total of 23.5% had IOFB only in the anterior segment; the rest had IOFB in the posterior segment alone or in both the anterior and posterior segments. Six eyes were followed conservatively despite IOFB in a functional eye. Removal of IOFB was combined with repair of retinal detachment (where present) using internal tamponade with gas or silicone oil or buckle. RESULTS: After a mean follow-up of 16.8 months, 66.7% of eyes recovered better than 6/60 (20/200) vision and 75.6% had attached retina. On univariate analysis, scleral entry wound, posterior segment IOFB, larger size of IOFB, and retinal damage were found to be associated with poor anatomic outcome. Lower presenting visual acuity, hyphema, retinal damage, subretinal hemorrhage, detached retina, and larger IOFB were associated with a poor functional result. Multivariate analysis identified retinal damage caused by the foreign body as the only factor significantly associated with poor anatomic as well as functional outcome. CONCLUSIONS: Glass IOFBs are caused in a majority of cases by blast injury. Bilaterality is not uncommon. Presence of retinal damage is predictive of poor functional and anatomic results. Overall results are modest with modern vitreoretinal surgical techniques.

Adult↗
PubMed1997

A multivariate analysis of anatomic success of recurrent retinal detachment treated with pneumatic retinopexy.

PURPOSE: The purpose of the study is to determine the success rate of pneumatic retinopexy (PR) after failed scleral buckling and to elucidate the predictors for anatomic failure by multiple logistic regression analysis. METHODS: Thirty-six eyes with recurrent retinal detachment after failed scleral buckling underwent PR. Intraocular tamponade was attained with SF6 (20 eyes), C3F8 (13 eyes), and air (3 eyes). Median follow-up was 14 months. RESULTS: Retinal reattachment was obtained in 69.4%. Multivariate analysis identified two risk factors for failure: location of retinal break either on the posterior slope or posterior to buckle (P = 0.01) and extent of retinal detachment greater than two quadrants (P = 0.02). CONCLUSIONS: Pneumatic retinopexy is an effective alternative to revision surgical operations if the leaking retinal break is located on the buckle.

Adolescent↗
PubMed1997

Parabulbar anesthesia for primary vitreoretinal surgery.

PURPOSE: The efficacy and safety of parabulbar anesthesia was investigated prospectively in 100 patients undergoing primary vitreoretinal surgery. METHODS: The technique involved three steps: (1) orbicularis oculi injection, (2) subconjunctival injection, and (3) sub-Tenon irrigation. The effect of anesthesia was graded 0 to 5 depending on inadequate anesthesia-akinesia with or without local supplementation. Ninety-three patients underwent vitrectomy without buckling and 4 with an encircling band; 3 had scleral buckling. Mean duration of surgery was 89.38 minutes. RESULTS: In 69% of patients (grades 4 and 5), no supplementation was required and in 31% (grades 1-3), local supplementation was needed for inadequate anesthesia or akinesia or both. No ocular or systemic complication occurred. Early onset of anesthesia correlated with adequate anesthesia throughout the procedure (P < 0.04). CONCLUSIONS: Parabulbar anesthesia is a safe and effective technique of local anesthesia in patients undergoing primary vitreoretinal surgery.

Adult↗
PubMed1997

A case-control study of suprachoroidal hemorrhage during pars plana vitrectomy.

BACKGROUND AND OBJECTIVE: To investigate the risk factors associated with suprachoroidal hemorrhage (SCH) during vitrectomy. PATIENTS AND METHODS: Of 6971 pars plana vitrectomies performed between May 1988 and December 1994, SCH occurred intraoperatively in 12 (0.17%) cases. Forty-two age- and sex-matched control subjects were selected by computer-generated random numbers. Preoperative and intraoperative variables were subjected to univariate and conditional logistic regression analysis. RESULTS: Statistically significant risk factors for SCH after univariate analysis included myopia (P = .048), aphakia or pseudophakia (P = .024), rhegmatogenous retinal detachment (P = .044), scleral buckling and/or encirclage at vitrectomy (P = .029), and longer duration of surgery (P = .044). Multivariate analysis revealed independent risks associated with the absence of a lens and longer duration of the surgery. CONCLUSION: A knowledge of the risk factors involved with SCH helps the physician to identify patients who are at a greater risk for this complication.

Adult↗
PubMed1996

Optic disc in fundus coloboma.

PURPOSE: To categorize and describe the type of optic disc involvement and blood vessel patterns seen in patients with fundus coloboma. METHODS: This is a prospective study involving 67 eyes of 40 patients with choroidal coloboma. The evaluation included documentation of fundus details using fundus drawings or photographs, or both. RESULTS: Six types of disc involvement were identified: (1) normal disc outside fundus coloboma (27.8%); (2) disc outside the fundus coloboma and abnormal (10.4%); (3) disc outside the fundus coloboma and independently colobomatous (8.9%); (4) disc within the fundus coloboma and normal (5.0%); (5) disc within the fundus coloboma and colobomatous (44.3%); and (6) disc shape not identified but blood vessels seen emanating from the superior border of the large fundus coloboma (2.9%). Visual acuity was better in types I, II, and III compared with IV, V, and VI. Microphthalmos was more common with the more severe anomalies. High myopia was more common in the less severe anomalies. CONCLUSION: Optic disc involvement in fundus coloboma is widely variable. Of fundus colobomas, 67.2% are associated with either a frankly colobomatous or an altered disc. Of the discs located outside fundus colobomas, 41% are also abnormal. Visual acuity was better in types I, II, and III.

Adolescent↗
PubMed1996

Comparison of ciprofloxacin ophthalmic solution 0.3% to fortified tobramycin-cefazolin in treating bacterial corneal ulcers. Ciprofloxacin Bacterial Keratitis Study Group.

PURPOSE: The purpose of the study is to compare the clinical efficacy and safety of ciprofloxacin ophthalmic solution 0.3% (Ciloxan) with a standard therapy regimen (fortified tobramycin, 1.3%-cefazolin, 5.0%) for treating bacterial corneal ulcers. METHODS: This randomized, parallel group, double-masked, multicenter study was conducted in 324 patients at 28 centers in the United States, Europe, and India. Patients were randomized into 2 treatment groups: 160 to ciprofloxacin and 164 to fortified tobramycin-cefazolin. Positive microbiologic cultures were obtained in 188 (58%) of 324 patients. Of these, 176 patients met protocol criteria and were evaluated for treatment efficacy: 82 in the ciprofloxacin group and 94 in the standard therapy group. The dosing schedule for both treatment groups was 1 to 2 drops of the first study medication (ciprofloxacin or fortified tobramycin) every 30 minutes for 6 hours, then hourly for the remainder of day 1; 1 to 2 drops every hour on days 2 and 3; 1 to 2 drops every 2 hours on days 4 and 5, followed by 1 to 2 drops every 4 hours on days 6 to 14. The second medication (ciprofloxacin or cefazolin) was instilled 5 to 15 minutes after the first drug, following the same dosing frequency. Physician's judgment of clinical success, cure rate, changes in ocular sings, and symptoms and the rate of treatment failures were the primary efficacy criteria. RESULTS: Topical ciprofloxacin monotherapy is equivalent clinically and statistically to the standard therapy regimen of fortified antibiotics. No statistically significant treatment differences were found between ciprofloxacin (91.5%) and standard therapy (86.2%) in terms of overall clinical efficacy (P = 0.34). Similarly, no differences were noted in resolution of the clinical signs and symptoms (P > 0.08) or the time to cure (P = 0.55). The incidence of treatment failures was less in the ciprofloxacin group (8.5%) compared with the standard therapy group (13.8%). Significantly fewer patients treated with ciprofloxacin reported discomfort than did patients treated with the standard therapy regimen (P = 0.01). CONCLUSION: Ciprofloxacin ophthalmic solution 0.3% monotherapy is equivalent clinically and statistically to standard therapy (fortified tobramycin-cefazolin) for the treatment of bacterial corneal ulcers and produces significantly less discomfort.

Adolescent↗
PubMed1996

Linkage of blepharophimosis syndrome in a large Indian pedigree to chromosome 7p.

Blepharophimosis syndrome (BPES) is an autosomal dominant disorder involving abnormal eyelid development. Cytogenetic and linkage analyses have previously implicated the chromosome 3q23 region in multiple cases of this syndrome. However, in a few cases cytogenetic analyses have implicated other chromosomal regions in this condition. Here we report linkage of BPES in a large Indian pedigree to chromosome 7p13-p21; affected only two-point and multipoint analyses using D7S488, D7S2551 and D7S2562 both showed peak lod scores of 3.61 coincident with D7S2562. Recombinations in affected individuals placed the critical region between D7S488 and D7S629. When both affected and unaffected individuals were considered, a maximum two-point lod score of 3.38 at theta = 0.08 was obtained with D7S2551 while a peak multipoint lod score of 3.64 was obtained between D7S488 and D7S2551. Segregation analysis revealed two unaffected individuals carrying the affected haplotype accounted for the difference in peak, relative to the affected only analysis. The chromosome 7p candidate genes inhibin beta A and epidermal growth factor receptor map outside this region whereas the HOX1 gene cluster may map inside this region. Although BPES is sometimes associated with female infertility due to premature ovarian failure, in the current family affected females were fertile. The current finding together with the previous evidence implicating chromosome 3q2 provides strong evidence that BPES involves locus heterogeneity; this point should be considered when counselling affected families.

Blepharophimosis↗
PubMed1996

Removal of silicone oil and epimacular proliferation from eyes following vitrectomy.

BACKGROUND AND OBJECTIVES: Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The significance of EMP in eyes that have undergone vitrectomy is still not clear. This study investigated the redetachment rate following silicone oil removal when combined with removal of EMP. PATIENTS AND METHODS: Twenty-two consecutive eyes underwent removal of silicone oil and EMP These eyes had attached retinas following silicone oil injection used as an adjunct to complex vitreoretinal surgery. RESULTS: The retina remained attached in 19 (86.4%) of the eyes, with functional improvement it vision in 81.8% of the eyes. Visual acuity of 6/60 (20/200) or better was obtained in 12 (54.5%*) of the eyes. The mean follow-up time was 6.3 months. CONCLUSION: These results suggest that removal of EMP and silicone oil does not increase the risk of redetachment.

Adolescent↗
PubMed1996

A case control study of senile cataract in a hospital based population.

A case-control study (244 cases and 264 controls) was done during 1986-89 on a hospital based population to evaluate the risk factors associated with the etiology of senile cataract. Patient with age between 40-60 years, visual acuity of 6/9 or less, and presence of lenticular opacity of senile origin were included as cases. Age matched individuals with absence of lenticular opacity made up the controls. Multivariate logistic regression analysis revealed that higher systolic BP and number of meals were significantly (P < or = 0.05) associated with presence of senile cataract; whereas higher weight, education and income, and utilization of cooking water had a significant protective effect against senile cataract. The present study helps the clinician to understand the possible risk factors associated with the development of senile cataract and could be helpful in designing a intervention strategy in future.

Adult↗
PubMed1995

Pattern of retinal breaks and retinal detachments in eyes with choroidal coloboma.

PURPOSE: To describe the type of breaks that occur in the diaphanous tissue within the coloboma of the choroid and the types of retinal detachment that are associated with these breaks. METHODS: This is a retrospective study of 36 eyes of 36 patients with retinal detachments that extended into the choroidal coloboma. Preoperative findings were documented using detailed fundus drawings and color photographs. Intraoperative identification of retinal breaks was possible using high magnification of the operating microscope. RESULTS: Based on the identifiable breaks inside the coloboma and the extent of retinal detachment, these patients were divided into five subgroups. Three distinct types of breaks were identified within the coloboma: (1) breaks at the edge of the detachment inside the coloboma; (2) oval atrophic breaks; and (3) breaks in anatomic macula that was involved in the coloboma. Multiple breaks were common. CONCLUSIONS: Retinal detachments that extend into the colobomatous area always are associated with breaks in the diaphanous tissue. Intraoperative identification of these breaks is relatively easy. Commonly, the breaks are seen at the edge of the retinal detachment inside the coloboma or as oval breaks within the detached diaphanous tissue. Macula, if involved in the coloboma, occasionally can harbor a retinal break.

Adolescent↗
PubMed1995

Retinal detachment secondary to ocular perforation during retrobulbar anaesthesia.

The clinical characteristics and the retinal breaks associated with rhegmatogenous retinal detachments secondary to accidental globe perforation during local infiltration anaesthesia in five highly myopic eyes are presented. Retinal detachment was total with variable proliferative vitreoretinopathy. The pattern of retinal breaks was rather typical and predictable. Management involved vitreous surgery with internal tamponade by silicone oil in four eyes and perfluoropropane gas in one eye. At the last follow-up, all eyes had attached retina. One eye did not recover useful vision due to possible concurrent optic nerve damage.

Anesthesia, Local↗
PubMed1995

Endophthalmitis caused by anaerobic bacteria.

A retrospective analysis of 22 patients who underwent pars plana vitrectomy for endophthalmitis and had culture-proven anaerobic bacteria, was done. Elimination of infection with attached retina and recovery of ambulatory vision > or = 2/60 were considered as anatomic success and functional success, respectively. Mean follow-up period was 12.7 months (range, 2 to 48 months). Anatomic success was attained in 14 (63.6%) eyes and functional success in 12 (54.6%) eyes. A poor preoperative visual acuity was found to be associated with poor functional outcome (p < 0.046). In endophthalmitis, a routine anaerobic culture of intraocular specimen is recommended.

Adolescent↗