PubMed Health⌕ Search

Biomedical subjects

T Dada

Publications and source records attributed to T Dada.

At least 19 recordsLinked to original sources
PubMed2002

Risk factors for graft infection in India: a case-control study.

AIM: To study the demographic, clinical, and microbiological profile and the risk factors for graft infection following penetrating keratoplasty. METHODS: 50 eyes of 50 consecutive patients with graft infection after an optical penetrating keratoplasty were included as cases; 50 eyes of 50 patients with no graft infection were included as controls. The main variables evaluated in this study included the clinical and microbiological profile, sociodemographic status, suture related problems, persistent epithelial defects, and ocular surface disorders. RESULTS: Cultures were positive in 43 (86%) eyes and Staphylococcus epidermidis (67.4%) was the most common organism isolated. Infection could be resolved with treatment in 37 (74%) eyes. In eight (16%) eyes the graft melted and a repeat penetrating keratoplasty had to be performed. Only 6% of the cases could achieve a best corrected visual acuity of 6/18 or better after resolution of the infection. In multivariate logistic regression analysis persistent epithelial defect (OR (95% CI): 3.0 (1.17 to 8.33)), suture related problems (OR (95% CI): 3.6 (1.39 to 9.25)), and ocular surface disorders (OR (95% CI): 2.4 (0.93 to 6.03)) were found to be statistically significant risk factors for graft infection following an optical penetrating keratoplasty. CONCLUSIONS: Staphylococcus epidermidis is the commonest organism responsible for post-keratoplasty microbial keratitis. Persistent epithelial defects, suture related problems, and ocular surface disorders are the major risk factors predisposing to graft infection.

Adult↗
PubMed2002

Role of argon laser trabeculoplasty as primary and secondary therapy in open angle glaucoma in Indian patients.

AIMS: To study the efficacy of argon laser trabeculoplasty (ALT) as a primary and secondary therapy in Indian patients with primary open angle glaucoma (POAG). METHODS: ALT was performed as a primary therapy in 40 eyes of 21 patients newly diagnosed with POAG (group I) and as a secondary therapy in 39 eyes of 21 patients who had been taking topical antiglaucoma medications for more than 1 year. The best corrected visual acuity, baseline intraocular pressure (IOP), diurnal variation of IOP, anterior chamber angles, and visual fields were the various parameters evaluated before and after performing ALT. Follow up visits were scheduled at 24 hours, 1 week, 1 month, 3 months, 6 months, and 1 year after the surgery. The patients were recalled at the end of 5 years for the final follow up examination. Success of ALT was defined as IOP </=21 mm Hg without any medication with no progression of disc or visual field changes. RESULTS: The prelaser mean IOP was 25.8 (SD 3.4) mm Hg in group I and 26.1 (3.2) mm Hg in group II. The mean post-laser IOP at 5 year follow up was 18.1 (3.2) mm Hg in group I and 22.7 (3.9) mm Hg in group II (p= 0.002) while the mean reduction in IOP was 5.7 (1.8) mm Hg in group I and 3.2 (0.8) mm Hg in group II (p<0.001). The diurnal variation reduced from a preoperative value of 7.9 (1.4) mm Hg to 3.6 (1.3) mm Hg in group I and from 7.7 (1.4) mm Hg to 5.8 (1.8) mm Hg in group II (p<0.001). The success rate of ALT was 75% at 1 year and 65% at 5 years in group I and 35% at 1 year and 10% at 5 years in group II. CONCLUSION: ALT can be used as a primary therapy in pigmented eyes with POAG. ALT is less effective as a secondary therapy in controlling the IOP in eyes of patients on long term topical antiglaucoma treatment.

Follow-Up Studies↗
PubMed2001

Microkeratome-induced reduction of astigmatism after penetrating keratoplasty.

PURPOSE: To report the reduction in postpenetrating keratoplasty astigmatism with the use of the microkeratome to create a lamellar corneal flap as the first stage in a two-step laser in situ keratomileusis. METHODS: The hansatome microkeratome was used to create a lamellar corneal flap in a 24-year-old man with a net corneal astigmatism of 7.3 diopters, 2 years after penetrating keratoplasty. No laser ablation was performed. RESULTS: The net corneal astigmatism reduced to 3.9 diopters at 1 month and 2.3 diopters at 3 months of follow-up, without any laser ablation. CONCLUSION: Laser in situ keratomileusis may be performed as a two-stage procedure, because the lamellar corneal flap alone may reduce postpenetrating keratoplasty astigmatism.

Adult↗
PubMed2001

Oversized corneal grafts for corneal opacities with iridocorneal adhesions.

OBJECTIVE: To evaluate the efficacy of 1-mm oversized corneal grafts in patients with acquired corneal opacities and extensive peripheral iridocorneal adhesions. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Twenty patients (20 eyes) aged 15 years or older with unilateral or bilateral corneal opacification and a shallow anterior chamber. INTERVENTION: Penetrating keratoplasty was performed with donor corneal buttons oversized by 1 mm. MAIN OUTCOME MEASURES: The various parameters evaluated were visual acuity, graft clarity, keratometry, anterior chamber depth, intraocular pressure, and spherical equivalent refraction 12 months after surgery. RESULTS: The keratoplasties were performed in 15 eyes with a corneo-iridic scar after infectious keratitis (75%) and 5 eyes with failed graft (25%). At the final follow-up, a clear graft was achieved in 17 eyes (85%), and 14 eyes (70%) achieved a best-corrected visual acuity of 6/12 or better. Three of the grafts failed because of rejection. The average keratometry was 44.1 +/- 1.0 diopters (D), and the mean spherical equivalent was -3.23 +/- 2.86 D. The oversized grafts provided a mean anterior chamber depth of 2.36 +/- 0.42 mm, and the mean intraocular pressure at the 12 month follow-up was 16.38 +/- 2.09 mmHg. CONCLUSIONS: Corneal grafts oversized by 1 mm provide adequate anterior chamber depth and reduce the risk of peripheral anterior synechiae and secondary glaucoma in patients with corneal opacities and extensive peripheral iridocorneal adhesions.

Adolescent↗
PubMed2001

Phacoemulsification combined with silicone oil removal through a posterior capsulorhexis.

PURPOSE: To evaluate the technique of silicone oil removal through a posterior capsulorhexis combined with phacoemulsification and intraocular lens (IOL) implantation. SETTING: Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India. METHODS: Fifteen eyes of 15 patients had phacoemulsification with removal of silicone oil, which had been used for intraocular tamponade after a previous pars plana vitrectomy. Eyes with a stable retina were included in the series. In all eyes, the silicone oil was removed through a planned posterior capsulorhexis after phacoemulsification. The parameters evaluated were the primary diagnosis, duration between silicone oil instillation and phacoemulsification, type of cataract, preoperative and postoperative best corrected visual acuities (BCVAs), and complications such as frequency of retinal redetachment and secondary cataract. RESULTS: Vitreoretinal surgery with silicone oil instillation was performed for rhegmatogenous-tractional detachment resulting from Eales' disease in 6 eyes and from proliferative diabetic retinopathy in 2 eyes, for primary rhegmatogenous retinal detachment in 6 eyes, and for traumatic rhegmatogenous detachment in 1 eye. The mean duration between the silicone oil instillation and phacoemulsification was 7.5 months +/- 3.8 (SD). Fourteen eyes had posterior subcapsular cataract, and 10 had nuclear sclerosis. Preoperative BCVA was worse than 6/60 in all eyes. The BCVA was 6/60 or better in 9 eyes after a minimum follow-up of 6 months. Two eyes had choroidal detachment in the early postoperative period. No eye had vitreous hemorrhage, retinal redetachment, secondary cataract, clinically significant endothelial decompensation or macular edema, or a dislocated IOL. CONCLUSION: The results indicate that silicone oil removal through a posterior capsulorhexis during phacoemulsification is a viable option and can be performed in selected cases of cataract with previous silicone oil instillation and a stable retina.

Adolescent↗
PubMed2001

Bimanual Sinskey hook technique to enlarge a preexisting capsulorhexis.

We describe a technique of enlarging a small primary capsulorhexis. Two Sinskey hooks are introduced through the side ports. One hook is placed above the anterior capsulorhexis margin with its tip pointing down, and the other is placed beneath the anterior capsulorhexis margin with its tip pointing up. A small nick is made between the tips of the 2 hooks, and the capsulorhexis is extended with a Utrata capsulorhexis forceps. This technique does not require additional instrumentation, impart zonular stress, or disturb wound architecture or integrity.

Capsulorhexis↗
PubMed2001

Diode laser trans-scleral cyclophotocoagulation for glaucoma following silicone oil removal.

PURPOSE: To evaluate the effect of trans-scleral cyclophotocoagulation (TSCP) on intraocular pressure (IOP) in eyes with medically uncontrolled secondary glaucoma persisting after intravitreal silicone oil removal. METHODS: Clinical records of 21 eyes of 21 patients who underwentTSCP for medically uncontrolled glaucoma persisting after the removal of intravitreal silicone oil, injected during vitreoretinal surgery for proliferative vitreoretinopathy (PVR), were reviewed retrospectively. Diode laser contactTSCP was applied at a power setting of 1.5-2.5 W, for a maximum duration of 2 s, and a total of 40 spots (10 spots each quadrant). All the patients were evaluated for visual acuity, IOP and number of medications used. RESULTS: The patients were followed up for a mean +/- SD period of 39.9 +/- 4.27 weeks (range 36-48 weeks). The IOP was found to have decreased significantly from a pretreatment value of 34.5 +/- 5.37 mmHg (range 24-44 mmHg) to 20.47 +/- 4.49 mmHg at 6 months of follow up (range 12-30 mmHg, P < 0.01, Student's paired t-test). The total number of glaucoma medications being used reduced from 3.38 +/- 0.5 to 1.08 +/- 0.80 postoperatively (P < 0.01, Wilcoxon's rank sum test). There was no significant difference in the visual acuity before and after the procedure. Thirteen eyes required a second sitting of TSCP, and five of these required a third sitting. For a successful outcome (IOP < 24 mmHg), a mean of 1.56 sittings (range 1-3 sittings) per eye were needed. CONCLUSION: Patients with medically uncontrolled glaucoma persisting after intravitreal silicone oil removal can be treated with TSCP; however, the reduction of IOP is variable. The IOP usually falls after a mean of 2-3 sittings of

Adult↗
PubMed2001

Influence of body mass index and self-administration of hCG on the outcome of IVF cycles: a prospective cohort study.

Final maturation of the oocyte in in vitro fertilization (IVF) cycles is achieved through the administration of a timed injection of human chorionic gonadotrophin (hCG). The success of mature oocyte retrieval is dependent on serum concentrations of the hormone reaching values capable of initiating meiosis and triggering the release of the cumulus-oocyte complex into the follicular fluid. The objective of this prospective cohort study was to examine the effect of adiposity, as measured by body mass index (BMI), on serum concentrations of hCG and gonadotrophins and to relate this to IVF outcome. A comparison was also made between professionally and non-professionally administered hCG to assess any possible effect on cycle parameters. A total of 50 patients with a high BMI (> or = 26 kg m(-2)) who underwent IVF treatment at the Assisted Conception Unit, St James's University Hospital, Leeds, was recruited prospectively into the study. They were matched with 50 patients with a normal BMI (18-25 kg m(-2)) who acted as a control group. The two groups were matched for age (mean of 32 years and range of 22-42 years) and cause of infertility. Serum gonadotrophins, oestradiol and hCG concentrations, measured at the time of oocyte retrieval, and the clinical outcome of the two groups were compared. Patients with a high BMI had a significantly lower mean serum hCG concentration compared with controls (63.9 versus 99.6 iu l(-1), P < 0.0003). They also required a higher dosage of gonadotrophin (3660 versus 3007 iu) to achieve follicular maturation than the controls. Similarly, the high BMI group of patients had higher serum concentrations of follicle-stimulating hormone (FSH) (12.3 versus 11.2 iu l(-1)) and lower oestradiol (3499 versus 3506 pmol l(-1)) compared with controls. Patients with a high BMI had significantly fewer oocytes aspirated, resulting in a significant decrease in the oocyte:follicle ratio compared with controls (33.9 versus 41.7, P < 0.05). The fertilization rate (46.2 versus 61.3%, P < 0.05) and clinical pregnancy rate per cycle (26.6 versus 37.1%, P < 0.05) were also lower in the patients with high BMI compared with those with normal BMI. The administration of hCG by the patient or her partner did not have a significant effect on clinical outcome. The mean serum hCG at the time of oocyte recovery was equivalent in both groups (87.1 versus 89.7 iu l(-1)). Furthermore, the oocyte:follicle ratio (0.73 versus 0.72), fertilization rate (46.2 versus 54.2%) and clinical pregnancy rate (38.9 versus 36.5%) were similar. These findings indicate that high BMI is detrimental to the success of IVF treatment and has an important influence on the distribution and metabolism of hCG. The results also indicate that non-professional administration of hCG does not compromise cycle outcome.

Adult↗
PubMed2001

Utero-ovarian blood flow characteristics of pituitary desensitization.

BACKGROUND: Down-regulation in assisted reproduction treatment cycles is monitored by suppression of ovarian/pituitary hormones and/or measurement of endometrial thickness. METHODS: This prospective longitudinal study reports on utero-ovarian characteristics of pituitary desensitization. A total of 75 patients were recruited; 32 had IVF treatment, 20 frozen--thawed embryo transfer cycles and 23 patients were recipients of donated oocytes. All received early follicular-phase down-regulation and had colour flow Doppler velocimetry of the utero-ovarian arteries < or =3 days before the start of menses and after 21 days of gonadotrophin-releasing hormone (GnRH) analogue treatment. Ovarian volume, endometrial thickness, pituitary and ovarian hormone concentrations were recorded at each scan. RESULTS: Significant changes (P < 0.05) were noted in these and utero-ovarian vasculature during the down-regulation period, with good correlation between resistance index and oestradiol estimations. Neither the type of GnRH analogue nor age influenced the changes in utero-ovarian blood flow. Ovarian artery resistance index was the best Doppler predictor for pituitary suppression and a mean discriminatory cut-off value of 0.867 +/- 0.025 was found to have the highest specificity and positive predictive value. CONCLUSIONS: This study has, for the first time, defined cut-off values for satisfactory pituitary suppression with high positive predictive value and specificity in an early follicular phase long protocol of GnRH analogue down-regulation using colour flow Doppler.

Adult↗
PubMed2001

Indications for lamellar keratoplasty in India.

PURPOSE: To study the indications for lamellar keratoplasty (LK) in a tertiary eye care hospital in northern India. METHODS: A retrospective analysis of 71 eyes that had undergone LK between January 1995 and December 1999 was performed. The parameters evaluated included demographic data, the diagnosis at admission, the laterality of involvement, and the graft size. RESULTS: The mean age of the patients was 31 +/- 21.8 years (range, 1-73 years). Forty-one male patients and 30 female patients underwent LK. Thirty-three patients (47%) lived in rural areas, and 38 patients (53%) were urban dwellers. LK was performed for optical indications in 63 eyes (88.7%), for tectonic purposes in six eyes (8.4%), and for therapeutic purposes in two eyes (2.8%). Chemical injuries (18%) were the most common indication for LK and were followed by trachomatous keratopathy (14%) and dermoids (14%). CONCLUSION: Chemical injuries, trachomatous keratopathy, and dermoids constitute the major indications for LK in India.

Adolescent↗
PubMed2001

Neurotrophic keratopathy.

PURPOSE: To review the causes, clinical features, course, histopathological and biochemical changes, diagnosis, andtreatmentof neurotrophic keratopathy. METHODS: We reviewed the literature on neurotrophic keratopathy. RESULTS AND CONCLUSIONS: Neurotrophic keratopathy is a clinical entity which involves all degrees of degenerative corneal and conjunctival changes secondary to loss of sensory function in the nasociliary branch of the trigeminal nerve with or without decreased tear production. One of the commonest causes of loss of corneal sensation is herpes virus infection. The clinical course of neurotrophic keratopathy varies considerably. The corneal epithelium becomes diseased and breakdown occurs even in the absence of dessication, infection, and trauma. This stage, if not treated aggressively with ocular lubricants, tarsorrhaphy, or a bandage soft contact lens, will result in stromal lysis with or without perforation. Depending on the size and location of corneal perforation, procedures like the application of cyanoacrylate glue, penetrating keratoplasty, or conjunctival flap may be required.

Cornea↗