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Biomedical subjects

Sudarshan Khokhar

Publications and source records attributed to Sudarshan Khokhar.

At least 19 recordsLinked to original sources
PubMed2006

Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: comparative analysis.

PURPOSE: To compare the astigmatic correcting effect of paired opposite clear corneal incisions (OCCIs) on the steep axis with that of single clear corneal incisions (CCIs) in cataract patients having phacoemulsification. SETTING: Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. METHODS: This randomized prospective clinical study comprised 40 eyes of 40 patients with topographic astigmatism of more than 1.50 diopters (D). Paired 3.2 mm OCCIs were made in the steep axis in Group 1 and single CCIs in Group 2. Preoperative evaluation included uncorrected visual acuity, refraction, applanation tonometry, dilated fundoscopy, biomicroscopic examination, keratometry, and topography. The steep axis was marked before sub-Tenon's anesthesia was given and routine phacoemulsification was performed through a 3.2 mm CCI on the steep axis. An additional opposite 3-step self-sealing CCI was made in Group 1. Patients were examined 1, 4, and 12 weeks postoperatively. Visual acuity, refraction, keratometry, and topography were evaluated. RESULTS: The mean preoperative and postoperative topographic corneal astigmatism was 2.51 D +/- 0.92 (SD) and 0.91 +/- 0.54 D, respectively, in Group 1 and 2.16 +/- 0.80 D and 1.57 +/- 0.70 D, respectively, in Group 2. Mean astigmatic correction was 1.66 +/- 0.5 D and 0.85 +/- 0.75 D in Group 1 and Group 2, respectively. Mean surgically induced astigmatism, measured by a vector-corrected method, was 1.66 +/- 0.50 D and 0.85 +/- 0.75 D in Group 1 and Group 2, respectively (P = .00). The coupling ratio was -0.96 in Group 1 and -0.87 in Group 2. The spherical equivalent was +0.23 +/- 0.41 D in Group 1 and +0.11 +/- 0.17 D in Group 2 at 12 weeks. Uncorrected visual acuity was better in Group 1 than in Group 2 (P = .032). There was no difference in best corrected visual acuity between the groups. There were no incision-related complications. CONCLUSION: Paired OCCIs were predictable and effective in providing an enhanced effect for correcting preexisting corneal astigmatism in cataract surgery.

Astigmatism↗
PubMed2006

Visual outcome after intravenous dexamethasone therapy for idiopathic optic neuritis in an Indian population: a clinical case series.

PURPOSE: To evaluate the clinical profile, response to dexamethasone treatment and visual function outcome in Indian patients with acute optic neuritis. MATERIALS AND METHODS: We conducted an observational study of patients with acute optic neuritis who were treated with intravenous dexamethasone (100 mg in 250 ml of 5% dextrose over 1-2 hours daily, for three consecutive days) and had completed at least two years of follow-up. Parameters assessed included visual acuity, contrast sensitivity, color vision, visual fields, relative afferent pupillary defect (RAPD) and visually evoked potentials. Out of 40 patients studied, 26 patients (33 eyes) had all visual function parameters assessed. Twenty three patients (28 eyes) had completed two years of follow-up and were included for statistical analysis. RESULTS: Improvement in visual acuity was statistically significant for distance after 24 hours of the first dose (P = < 0.001) and for near vision after 24 hours of the second dose (P = 0.006); improvement in color and contrast sensitivity was statistically significant 24 hours after the third dose (P = < 0.001 for color vision and P = 0.013 for contrast sensitivity). Significant improvement in RAPD and visual fields were seen by 1 month (P = 0.005). Recurrence was seen in 4 eyes of 4 patients. No serious side effects were observed. At two years, 82.14% (23 out of 28) eyes had visual acuity > 20/40. CONCLUSION: Treatment with intravenous pulsed dexamethasone led to rapid recovery of vision in acute optic neuritis, without any serious side effects.

Adolescent↗
PubMed2005

Amniotic membrane transplantation in refractory neurotrophic corneal ulcers: a randomized, controlled clinical trial.

PURPOSE: This study was designed to compare and evaluate the efficacy of amniotic membrane transplantation with the conventional management (tarsorrhaphy and bandage contact lens) in eyes with refractory neurotrophic corneal ulcers. METHODS: Thirty eyes of 30 patients (14 females and 16 males) with neurotrophic corneal ulcers refractory to medical management were included and divided randomly into group 1 (n = 15), who received conventional management with a tarsorrhaphy (n = 11) or bandage contact lens (n = 4), and group 2 (n = 15), who underwent Amniotic Membrane Transplantation. The outcome parameters evaluated were epithelialization time, duration of healing of corneal ulcers, and improvement in best corrected visual acuity. RESULTS: The mean age in our study was 37 +/- 14.71 years. At the end of 3 months follow-up, 10 of 15 patients (66.67%) in group 1 showed complete epithelialization and subsequent healing and 11 of 15 patients (73.33%) in group 2 showed complete epithelialization and healing (P > 0.05). The median time for complete epithelialization was 21 days in both groups. Both groups showed an improvement in the best-corrected visual acuity. CONCLUSIONS: Both amniotic membrane transplantation and conventional management (tarsorrhaphy or bandage contact lens) are effective treatment modalities for refractory neurotrophic corneal ulcers.

Adolescent↗
PubMed2005

Traumatic lenticele.

A 55-year-old woman presented with sudden diminution of vision in her left eye following trauma with her own finger. Examination revealed a firm subconjunctival swelling superiorly with aphakia and hypotony. Lens spike was absent on B-scan. Ultrasonic biomicroscopy showed thickened conjunctiva, a subconjunctival mass lesion with an underlying uveoscleral discontinuity. A surgical repair was performed with successful restoration of globe integrity. This case demonstrates that ultrasonic biomicroscopy may reveal the site and the extent of occult scleral rupture and help in precise surgical planning.

Cataract↗
PubMed2003

Painting technique for staining the anterior lens capsule.

We describe a technique of capsule staining called capsule painting. Using a Khokhar capsule painting cannula, the dye is spread directly over the anterior capsule but to no other part of the anterior chamber. There is minimal turbulence in the anterior chamber as there is no need to replace the injected viscoelastic material. The use of minimal dye and viscoelastic material reduces the cost of surgery.

Capsulorhexis↗
PubMed2003

Phacoemulsification in a case of microspherophakia.

Phacoemulsification with implantation of an acrylic foldable intraocular lens in a 14-year-old girl with microspherophakia is described. The associated lenticular myopia was disabling in terms of quality of life. With the help of nylon iris hooks, the procedure was uneventful and the outcome successful

Acrylic Resins↗
PubMed2003

Comparative evaluation of Teller and Cardiff acuity tests in normals and unilateral amblyopes in under-two-year-olds.

PURPOSE: To compare and evaluate Teller Acuity Cards (TAC) and Cardiff Acuity Cards (CAC) to assess vision in children below the age of two. METHODS: The study evaluated TAC and CAC to assess visual acuity in 90 normal children divided into three age groups, 0-6 months (group I), 6-12 months (group II) and 12-24 months (group III). 30 cases of unilateral amblyopiogenic conditions, 10 cases each of unilateral refractive error, unilateral esotropia, and unilateral cataract, were also examined. Trained optometrists carried out binocular testing followed by monocular testing, and recorded the test time in each case. RESULTS: The mean visual acuity (in Snellen units) and standard deviation (in octaves) in the three age groups of normal children, I, II, III respectively were 6/44 +/- 0.54, 6/21 +/- 0.37 and 6/21 +/- 0.41 (binocularly by TAC) and 6/46 +/- 0.80, 6/21 +/- 0.59 and 6/14.5 +/- 0.84 (binocularly by CAC). Although the time taken for testing with CAC was less, its coefficient of variance was greater for all age groups as compared to TAC. Diminution of visual acuity could be assessed correctly by both the tests in cases of strabismus and cataract, but not in some cases of refractive error. CONCLUSION: CAC is a useful and child-friendly test. It can be used clinically but may miss some cases of visually significant refractive errors. TAC is a more dependable test to assess amblyopiogenic conditions despite the use of gratings.

Amblyopia↗
PubMed2002

Pseudophakic pupillary block caused by pupillary capture after phacoemulsification and in-the-bag AcrySof lens implantation.

We describe a 50-year-old patient who developed pupillary block caused by pupillary capture 1 week after uneventful phacoemulsification and implantation of an AcrySof foldable intraocular lens (IOL). The patient had a large but intact capsulorhexis with the haptics lying in the bag; the optic lay in the pupillary area anterior to the capsulorhexis. This case was successfully managed by a neodymium: YAG laser iridotomy, IOL explantation, and subsequent implantation of a poly(methyl methacrylate) posterior chamber IOL. To prevent this complication, we suggest the optic be larger than the capsulorhexis and advocate correct, gentle insertion of the foldable IOL.

Acrylic Resins↗