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Biomedical subjects

V Agrawal

Publications and source records attributed to V Agrawal.

36 records · Page 2Linked to original sources
PubMed1995

Traumatic wound dehiscence after penetrating keratoplasty.

Eighteen eyes with wound dehiscence after penetrating keratoplasty were studied. Keratoplasty was performed for corneal scarring (n = 8), dystrophies (n = 6), graft failure (n = 2), and corneal edema (n = 2). The mean duration between keratoplasty and wound dehiscence was 6.54 months. All eyes underwent wound repair with or without iris excision, lensectomy, and vitrectomy. Grafts remained clear in eight eyes. Five eyes developed phthisis bulbi. Visual acuity was better than 20/200 in seven eyes. There was no site (quadrant) specificity for dehiscence. Trivial trauma resulted in dehiscence in 10 of the 18 eyes. The major determinants of visual outcome were the force of trauma and status of the posterior segment. Dehiscence of the graft-host junction in all cases reflects its persistent weakness after surgery.

Adolescent↗
PubMed1994

Single injection, low volume periocular anesthesia in 1,000 cases.

Periocular anesthesia is a proven alternative to retrobulbar anesthesia. A prospective evaluation of 1,000 cases was done to study the advantages of single point, low volume periocular anesthesia. This method is efficacious and has an excellent safety profile. The small needle length and the low volume of injected anesthetic enhance the safety. Supplemental anesthesia was needed in only 0.2% of cases. Chemosis was noted in 12.7%. In no case did surgery have to be postponed because of anesthesia-related complications. We believe this method is superior to other multipoint high volume methods of periocular anesthesia.

Anesthesia, Local↗
PubMed1994

Donor corneoscleral rim contamination by gentamicin-resistant organisms.

Gentamicin is the most widely used antibiotic in the decontamination of donor cornea for penetrating keratoplasty. However, the incidence of resistance to gentamicin is on the rise. Bacterial isolates from 178 donor corneal rims were studied for gentamicin sensitivity. The overall rate of gentamicin resistance was 63.4%. At 86.2% the Pseudomonas. species had the highest rate of resistance, followed by Streptococci at 84.6%. The high rate of gentamicin resistance encountered by us and others suggest that either addition of a second antibiotic to corneal storage media or replacement of gentamicin by an antibiotic with a broader spectrum of activity may help reduce the risk of endophthalmitis following penetrating keratoplasty.

Bacteria↗
PubMed1994

Penetrating keratoplasty for pseudophakic bullous keratopathy.

Penetrating keratoplasty (PK) is the only definitive treatment for the visual rehabilitation of eyes with pseudophakic bullous keratopathy (PBK). Management of the intraocular lens (IOL) at the time of PK is dependent on lens-related factors and anterior segment abnormalities. We reviewed the results of PK in 81 cases of PBK done at our institute between November 1987 and May 1993. The original lens was an anterior chamber IOL in 26 (32.1%) eyes, iris claw lens in 38 (41.9%) eyes, and a posterior chamber IOL in 17 (20.98%) eyes. IOL explanation alone was done in 24 (29.6%) eyes. The original IOL was retained in 12 (14.9%) eyes and IOL exchange was done in 45 (55.5%) eyes. With a minimum follow-up period of 6 months, the graft remained clear in 54 (66.6%) and the commonest cause of graft failure was graft rejection (17.2%). The best-corrected visual acuity in our series was 20/40 or more in 11 (20.3%) eyes and 20/50 to 20/100 in 30 (55.5%) eyes. We recommend explantation of all closed-loop anterior chamber and iris claw IOLs, and that, anterior chamber reconstruction during PK IOL exchange should be done using a posterior chamber IOL or open-loop Kelman type AC IOL.

Adolescent↗
PubMed1993

The efficacy of acetone in the sterilisation of ophthalmic instruments.

Acetone has been considered a quick, effective and less expensive chemical sterilising agent and continues to be used by ophthalmic surgeons, at least in developing countries. Its utility however has been questioned recently. This study was designed to assess the efficacy of acetone against Pseudomonas aeruginosa, Bacillus subtilis and Aspergillus flavus present on ophthalmic surgical instruments (forceps, sutures). The instruments were contaminated by immersion in standard suspensions of the organisms and thereafter were either unwashed (group-I), washed and dried (group-II) or only washed (group-III) before immersion in acetone. The exposure to acetone was kept at 3, 10 and 20 minutes in each group. The results showed that acetone could eliminate Pseudomonas (vegetative bacteria) after 10 minutes exposure in unwashed group and 3 minutes exposure in washed groups. It was ineffective against spore bearing bacteria (B. subtilis) and fungus (Aspergillus flavus) even after 20 minutes of exposure.

Acetone↗
PubMedDate not supplied

Transdeltoid palpation (the rent test) in the diagnosis of rotator cuff tears.

The purpose of this study was to assess the diagnostic accuracy of transdeltoid palpation (the rent test) for the diagnosis of full thickness rotator cuff tear. Clinical and arthroscopic findings were documented prospectively for 109 consecutive patients undergoing shoulder arthroscopy by the senior author. A retrospective analysis was then performed on these data to assess the accuracy of transdeltoid palpation in the diagnosis of full thickness rotator cuff tear. Transdeltoid palpation was found to have a sensitivity of 95.7% and specificity of 96.8% for the diagnosis of full thickness rotator cuff tear. The positive and negative predictive values for transdeltoid palpation were 95.7% and 96.8%, respectively. Overall, the diagnostic accuracy of transdeltoid palpation was 96.3%. We conclude that transdeltoid palpation is highly accurate for the clinical diagnosis of full thickness rotator cuff tear.

Adult↗