Polymeric hydrogels for soft contact lenses.
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Biomedical subjects
Publications and source records attributed to V K Dada.
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We prospectively studied 40 eyes with intraocular lenses and astigmatism of 4 or more diopters to evaluate the efficacy and safety of argon laser suture ablation as contrasted with surgical suture removal. Two groups of 10 eyes underwent argon laser suturotomy (ALS) 4 and 6 weeks, respectively, after surgery. Sutures were removed surgically in a third group of 10 eyes 6 weeks after surgery. The final group of 10 eyes served as controls. Serial keratometry and refraction demonstrated that ALS was as effective as surgical suture removal in reducing postoperative astigmatism, and complications associated with the procedure were negligible.
In a prospective, randomized, double-blind trial, we evaluated the relative efficacy of indomethacin and flurbiprofen when used as adjuvants to routinely used mydriatics for maintenance of pupillary dilatation in patients with heavily pigmented iris undergoing extracapsular cataract extraction. The drugs were administered orally as well as topically according to a fixed regimen. The pupillary diameters, measured with calipers at various surgical steps, were significantly larger at every step in the study groups in which either of the adjuvants had been used than they were in the control group (P less than .001). Flurbiprofen tended to help maintain a larger pupillary diameter in the later stages of surgery than indomethacin, but this difference was not statistically significant. We conclude that it is important to use prostaglandin synthetase inhibitors as adjuvants to routine mydriatics, and that flurbiprofen may be somewhat more effective than indomethacin in this capacity.
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A case of bilateral cornea plana with high hypermetropia is reported in a 20-year-old woman. Neither routine spectacles nor polymethylmethacrylate (PMMA) contact lenses could achieve satisfactory visual and cosmetic results. Comprehensive visual and cosmetic rehabilitation was accomplished with a high-plus, low-water-content, lenticular soft lens. This new concept of management of cornea plana appears promising in cases not amenable to routine spectacles or hard contact lenses.
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Recurrent pseudomonal conjunctivitis, caused by poor soft contact lens care and the use of contaminated saline, is described. This problem can easily be avoided by proper sterilization, with boiling being the method of choice.
The vision of 190 eyes of 130 patients with corneal scars was tested with contact lenses, of which 166 eyes subsequently were fitted with contact lenses. Over 75% of all eyes with corneal scars showed a visual acuity improvement to 6/12 or better. All eyes with a nebular or macular corneal scar and an initial visual acuity of 6/60 or better improved to 6/12 or better. The visual acuity of 77% of the eyes fitted with contact lenses, compared to the visual acuity of 36% of the same eyes obtained with spectacle lenses, improved to 6/12 or better.
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A prospective randomized clinical trial was carried out to compare the intercapsular or the endocapsular technique of IOL insertion and conventional posterior chamber IOL insertion after can opener capsulotomy. Age and sex matched groups of 76 patients each underwent surgery by the two techniques. The corneal and the uveal reaction was evaluated on the first day after the surgery and specular counts were done at six weeks. Though the difference between the two groups was not statistically significant, a trend in favour of intercapsular technique emerged strongly.
A case of destructive ocular myiasis resulting in complete loss of the globe in two days time is documented. To the best of our knowledge this is the first report of such a severe involvement in a healthy and non-compromised host. Mechanical removal and good local hygiene helped heal the wound. The larvae were isolated to be that of Chrysomyia bezziana (screwworm fly). This is possibly the first report of destructive ocular myiasis caused by Chrysomyia bezziana from the Indian subcontinent and the second in world literature. Infestation of human eyes with larvae of flies (myiasis) has been reported. Serious consequences of destructive myiasis are seen in emaciated and diseased patients. Only one report of total destruction of the globe by maggots of Chrysomyia bezziana exists in the literature. As in previous communications, the patient in this report had no predisposing factors both systemic and local. We here in document a case of orbital myiasis leading to rapid destruction of the globe within two days in a healthy and a non-compromised patient.
We examined 23 consecutive cases of unilateral aphakia reporting to the contact lens office for endothelial count and morphology, corneal thickness and toricity. The fellow eye served as a control in all the cases. It was found that there is a significant drop in the central endothelial cell density, and change in the size and shape of the cells. These observations indicate a thermodynamically unstable state. The aphakic corneas were thicker than the controls but not to a significant extent. The cell count and pachymetry had no statistical correlation. Toricity of the aphakic corneas make successful fitting of a lens difficult. Since prolonged use of extended wear gas permeable as well as hydrogel lenses have a deleterious effect on the endothelium it is suggested that a careful case selection be made and strict monitoting carried out at follow up. These corneas are liable for decompensation with only mild noxious stimuli. This article is intended to acquaint the ophthalmologist with the pitfalls in aphakic contact lens fitting so that a cautious follow up may be planned.
The effects of long term wear of PMMA contact lenses on the corneal endothelium used on a daily wear basis were determined by examining 8 patients who had been prescribed lenses in one eye only. The patients excluded unilateral aphakes. It was found that a significant reduction in the cell density and a change in the cell size and shape was induced by PMMA lenses. These changes reflect an endothelial metabolic stress and emphasize the need to find newer lens materials that are more oxygen permeable and produce little interference with the corneal metabolism.
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