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Biomedical subjects

S S Pandav

Publications and source records attributed to S S Pandav.

At least 19 recordsLinked to original sources
PubMed2006

Lower energy levels adequate for effective transcleral diode laser cyclophotocoagulation in Asian eyes with refractory glaucoma.

PURPOSE: To study the treatment parameters for diode laser cyclophotocoagulation (DLCP) in Asian Indian eyes using laser energy titrated to clinical response. METHODS: This prospective interventional longitudinal study included 66 eyes of 66 patients with varied aetiology refractory glaucoma, no previous cycloablation, and minimum 1 year follow-up. DLCP was performed using the Oculight Diode laser system IRIS( Medical Instruments Inc., CA, USA). Power used per spot was titrated according to the audible 'pops' indicating tissue microexplosion. The mean laser energy delivered, post-laser intraocular pressure (IOP) reduction, complications, and requirement of re-treatment in various subgroups were analyzed. Differences in energy delivered in each subgroup were assessed by analysis of variance with post hocBonferroni corrections. Linear regression analysis was used to identify possible predictive factors for failure of cyclodiode therapy. RESULTS: The mean total energy delivered per eye was 87.80+/-31.8 J (range 105.4+/-36.8 J in neovascular glaucoma (NVG) to 61.5+/-8.8 J in uveitic glaucoma (P=0.134)). Mean pre treatment IOP was 36.4+/-10.7 mmHg, which reduced to 19.4+/-9.8 mmHg (P<0.001) at 1 week, and 15.6+/-6.6 mmHg at 1 year. At 1 year, 58 of 66 patients had IOP<22.0 mmHg (response rate 87.8%), and six patients had hypotony (success rate 78.8%). The uveitic glaucoma group had 100% success rate. NVG group required maximum re-treatments. CONCLUSIONS: DLCP with a titrated energy protocol needs resulted in lower energy in Asian Indian eyes compared to that reported in literature, and different energy levels are needed for different diseases. 'Standard treatment parameters' for DLCP may be inappropriate for all diseases and all races.

Adolescent↗
PubMed2006

Ultrasound biomicroscopic quantification of the change in anterior chamber angle following laser peripheral iridotomy in early chronic primary angle closure glaucoma.

AIMS: To prospectively evaluate by ultrasound biomicroscopy (UBM) and gonioscopy the anterior chamber angle widening following laser peripheral iridotomy (LPI) in eyes with early chronic primary angle closure glaucoma (CACG). METHODS: A total of 55 eyes of 55 patients with CACG presenting with less than 180 degrees peripheral anterior synechiae (PAS) were enrolled in the study. Angles were assessed by gonioscopy (Shaffer's grading) and UBM, before and 4 weeks after LPI. The angle opening distance at 250 and 500 microm from the scleral spur (AOD 250 and AOD 500) was computed. Results were analysed using the Wilcoxon signed-rank test. RESULTS: In the quadrant with LPI, the mean gonioscopy grade increased significantly from 0.45 to 1.45 (P<0.001) and the mean AOD 250 and AOD 500 increased from 38.5+/-25.9 to 83.5+/-48.4 microm (P<0.001) and 110.2+/-80.9 to 170.6+/-83.4 microm (P<0.001), respectively. The angles widened significantly in the opposite quadrant on UBM (AOD 250: 48.8+/-31.5-82.7+/-43.9 microm, P<0.001; AOD 500:117.2+/-65.5-172.2+/-81.7 microm; P<0.001), but the median gonioscopy grade remained unchanged. CONCLUSIONS: LPI significantly widened the anterior chamber angle in the quadrant with LPI and the quadrant furthest away in patients of CACG with established glaucomatous damage. This change was much better appreciated by the UBM than gonioscopy.

Adult↗
PubMed2006

Unilateral lateral rectus muscle recession and medial rectus muscle resection with or without advancement for postoperative consecutive exotropia.

PURPOSE: To evaluate the effectiveness of unilateral lateral rectus muscle recession and medial rectus muscle resection with or without advancement in treating postoperative consecutive exotropia. METHODS: We performed a retrospective review on 31 patients with consecutive exotropia who were treated with unilateral lateral rectus muscle recession and medial rectus muscle resection (17 patients) or unilateral lateral rectus muscle recession and medial rectus muscle partial resection combined with advancement (14 patients). All patients had exotropia with a less than 10 prism diopters (PD) distance near-disparity. The characteristics studied before surgery included type of esotropia surgery, detection of amblyopia, presence of an "A" or "V" pattern, dissociated vertical deviation, limitation of adduction, deviation angle measurement, and forced duction testing. Ocular alignment and status of adduction postoperatively at the last follow-up were recorded. RESULTS: Nineteen patients (61.3%) had amblyopia, 17 patients (54.8%) had limitation of adduction, 8 patients (25.8%) had dissociated vertical deviation, and 5 patients (16.1%) had an "A" or "V" pattern. The mean preoperative exodeviation was 47.3 PD. Overall 21 (67.7%) of 31 patients achieved a successful postoperative result (alignment within 10 PD of orthophoria). There was no significant difference in successful alignment in patients treated with unilateral medial rectus muscle resection compared with those treated with unilateral medial rectus muscle partial resection combined with advancement. There was no influence of amblyopia on the result. Twelve (70.6%) of the 17 patients with limited adduction preoperatively showed normalization of adduction postoperatively. CONCLUSIONS: Unilateral lateral rectus muscle recession and medial rectus muscle resection with or without advancement is an effective alternative for treating postoperative consecutive exotropia.

Adolescent↗
PubMed2001

Fungal endophthalmitis following cataract surgery: clinical presentation, microbiological spectrum, and outcome.

PURPOSE: To determine the clinical presentation, microbiological spectrum, and outcome in cases of fungal endophthalmitis following cataract surgery. DESIGN: Observational case series. METHODS SETTING: Tertiary referral hospital. PATIENTS: Retrospective analysis of 27 cases of smear- and culture-proven fungal endophthalmitis. INTERVENTION: Pars plana vitrectomy in 18 eyes, where the corneal condition did not preclude the same. All eyes received intravitreal amphotericin B and dexamethasone along with systemic antifungal agents. MAIN OUTCOME MEASURES: Functional success: Final visual acuity of 3/60 or better with attached retina. Anatomical success: Final visual acuity of better than light perception with preserved anatomy of globe. RESULTS: The majority of the eyes (22 of the 27) had early onset and diffuse presentation (that is, anterior segment as well as posterior vitreous exudates). Substantial corneal involvement was seen in 14 eyes (51.85%). Aspergillus sp. was the most common isolate. Multivariate analysis using forward stepwise logistic regression showed corneal involvement as the single most important risk factor in determining final visual outcome (P =.0429). CONCLUSIONS: Early onset and diffuse presentation, which mimics bacterial endophthalmitis, stresses the importance of both bacterial and fungal cultures from intraocular fluids to reach a diagnosis apart from the clinical judgment. Corneal involvement was the most important predictor of outcome in cases of fungal endophthalmitis.

Adult↗
PubMed2001

Vogt-Koyanagi-Harada syndrome following injury-induced progressive vitiligo.

We report a case of Vogt-Koyanagi-Harada (VKH), Syndrome wherein the patient developed ocular symptoms following injury-induced progressive vitiligo with immunologic evidence from the skin biopsy specimen of the vitiligo. This case supports the hypothesis that the cell-mediated immune process against a common melanocyte antigen plays an important role in the development and progression of the disease.

Accidents, Traffic↗
PubMed1998

Cataract surgery in patients with dry eyes.

PURPOSE: To evaluate the potential causes of postoperative complications and the visual outcome after surgery for age-related cataract in dry eyes. SETTING: Tertiary-care multidisciplinary referral medical institution. METHODS: The records of 15 patients (21 eyes) with age-related cataract, a Schirmer value of 5.0 mm or less in 5 minutes, and a tear-film breakup time of 5 seconds or less having complications after cataract surgery were reviewed. Patients were assigned to 1 of 2 groups: dry eye with probable secondary Sjögren's syndrome (Group 1); dry eye without connective tissue disorders (Group 2). The surgical procedure, preoperative and postoperative medications, postoperative complications, and final visual outcome were analyzed. RESULTS: Ten eyes (8 patients) in Group 1 and 11 (7 patients) in Group 2 had cataract surgery. In Group 1, postoperative endophthalmitis developed in 3 eyes and peripheral keratolysis in 4; 5 eyes attained a visual acuity between 6/60 and 6/18 2 years after surgery. In Group 2, filamentary keratitis developed in 6 eyes and peripheral keratolysis in 2 eyes; 6 eyes achieved a visual acuity of 6/12 or better 2 year after surgery. A significant decrease in visual acuity occurred between 3 months and 2 years postoperatively in both Group 1 (P = .010) and Group 2 (P = .0005). CONCLUSION: Cataract surgery in dry eyes had fewer complications and better visual outcome in patients who did not have connective tissue disease than in those who did.

Adult↗
PubMed1996

Risk factors influencing the treatment outcome in diabetic macular oedema.

A multivariate analysis was done on 96 eyes to evaluate the effect of various risk factors on the final visual outcome after laser photocoagulation for clinically significant macular oedema (CSME) in diabetic retinopathy. Advanced age of the patient, large size of CSME and poor baseline visual acuity were found to be significantly associated with poorer outcome (p < 0.05). The association of nephropathy and hypertension with poorer visual outcome was of boderline significance (p = 0.054 and 0.07, respectively). Wavelength of the laser (argon or krypton) used for treatment did not significantly influence the outcome.

Diabetic Retinopathy↗
PubMed1995

Postoperative complications of intraocular lens implantation in patients with Fuchs' heterochromic cyclitis.

We studied 29 eyes of 24 patients with Fuchs' heterochromic cyclitis who had extracapsular cataract extraction and posterior chamber intraocular lens implantation. Follow-up ranged from one to four years (mean two years). Intraoperative complications included mild hyphema (n = 4). Early postoperative complications included uveitis (n = 9), glaucoma (n = 7), pigment deposits on the lens surface (n = 8), vitreous opacities (n = 8), and cystoid macular edema (n = 1). Late postoperative complications included posterior capsule opacification (n = 6), recurrent uveitis (n = 4), and persistent glaucoma (n = 3). Best corrected visual acuity of 20/40 or better was achieved in 24 eyes (82.8%).

Adolescent↗
PubMed1994

Systemic diseases in age related cataract patients.

Age related cataract is the most common cause of blindness in the world. Most of these patients are elderly and are likely to have various associated systemic diseases. Higher mortality has been reported in patients undergoing cataract surgery. In order to determine the prevalence of associated systemic disease, we carried out a large eye camp based study in 6103 age related cataract patients. Seventeen percent of our patients had systemic problems. Pulmonary disease was seen in 4.3%, cardiovascular disease and hypertension in 4.1%, diabetes mellitus in 3.8%, skin disorder in 1.4%, orodental disease requiring tooth extraction in 3%, and other diseases were seen in 0.4% of the cases. Seventy eight patients (1.27%) had significant systemic complications post-operatively, 46% of whom required hospitalization in a tertiary care center. Thus, all patients undergoing cataract surgery should be evaluated for associated systemic diseases to prevent morbidity and mortality in the preoperative, operative and postoperative period.

Adult↗
PubMed1994

Metastatic tumour of the iris: a rare presentation.

Metastasis to the iris is less frequent than that to the ciliary body and choroid. This might be the presenting feature. We report a 40 years male patient, a chronic smoker, who presented with pain, redenss and photophobia in the right eye. On detailed examination and investigations it turned out to be a case of primary squamous cell carcinoma of the bronchus metastasising to the iris. The presentation, difficulty in the diagnosis and management is discussed with review of the relavent literature.

Adult↗
PubMed1993

Reversal of lipaemia retinalis with dietary control.

Lipaemia retinalis occurs as the result of a marked elevation of serum lipids. Combined hyperlipidaemia may occur as a primary familial or secondary acquired abnormality. A case of lipaemia retinalis is described, documented by fundus photographs. A complete lipid profile of the patient revealed marked hyperlipidaemia. The lipoprotein lipase level was found to be reduced 0.3 cu (normal 0.5-2.0 cu). The patient was put on a low-fat diet, after which serial fundus photographs showed an improvement in the fundus appearance. Follow-up lipid profile estimations showed a decrease in triglyceride and cholesterol levels. After 6 months of follow-up complete reversal of lipaemia retinalis was documented. In this case, reversal of lipaemia retinalis occurred with dietary therapy alone.

Adolescent↗
PubMed1993

Antioxidant enzymes in RBCs as a biological index of age related macular degeneration.

The present study was undertaken to assess the levels of antioxidant enzymes in red blood cells of subjects with age-related macular degeneration and age-matched controls. The results obtained show a significant decrease in activities of superoxide dismutase (p < 0.001) and glutathione peroxidase (p < 0.001) as compared to the controls. A good correlation (r = -0.99) was also observed between age and decreased activity of antioxidant enzymes in controls, and also correlated well with age-related macular degeneration. In conclusion, oxidative stress as assessed by antioxidant enzymes is more pronounced in subjects with age-related macular degeneration as compared to age-matched controls.

Aged↗
PubMedDate not supplied

The effect of different doses of ketamine on intraocular pressure in anesthetized children.

BACKGROUND: When used for induction of anesthesia, ketamine usually increases intraocular pressure (IOP). However, the effect of low doses of ketamine, which are used for parental separation in children, is unknown. We studied the effect of two different doses of ketamine on IOP in anesthetized children. METHODS: Forty children age 1 to 6 years who met American Society of Anesthesiologists physical status I criteria scheduled to undergo surgery were randomly selected to receive either an induction dose (6 mg/kg) or a low dose (3 mg/kg) of ketamine intramuscularly. Anesthesia was induced and maintained with halothane, and ketamine was injected 10 minutes after induction. Intraocular pressure was measured using a Perkins applanation tonometer before ketamine administration and every 5 minutes thereafter for 20 minutes by an observer who was unaware of the ketamine dose used. 10.8 +/- 2.2 mm Hg to 12.6 +/- 2.8 mm Hg at 5 minutes and 11.9 +/- 2.5 mm Hg at 10 minutes after administration of ketamine in the induction-dose group. There was no significant change in IOP after administration of ketamine in the low-dose group. Intraocular pressure was significantly higher in the induction-dose group compared to the low-dose group at 5 minutes after administration of ketamine. More patients in the induction-dose group had postoperative airway obstruction and sedation than in the low-dose group. CONCLUSIONS: In children anesthetized with halothane, ketamine had a dose-dependent effect on IOP, with 6 mg/kg of the drug causing a small increase in IOP at 5 to 10 minutes and 3 mg/kg not altering the IOP. The higher dose of ketamine also was associated with an increased incidence of postoperative complications.

Anesthesia, Inhalation↗