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   2014| November  | Volume 62 | Issue 11  
    Online since December 10, 2014

 
 
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RESEARCH METHODOLOGY
Publish or perish: The art of scientific writing
Sabyasachi Sengupta, Dhananjay Shukla, Pradeep Ramulu, Sundaram Natarajan, Jyotirmay Biswas
November 2014, 62(11):1089-1093
DOI:10.4103/0301-4738.146760  PMID:25494253
Publishing manuscripts is the only way by which scientists communicate with each other. In recent times, there is an increasing desire to publish manuscripts from the developing world for a variety of reasons. Though, performing a research study is challenging in itself, writing it for publication is the final frontier that can be daunting, especially for the novice. Work that remains unpublished in one form or the other is essentially incomplete or undone. Hence, it is critically important for one to publish one's findings in a reputed journal. The purpose of this paper is to alleviate the mystique involved in manuscript writing and provide a blueprint where the subheadings given under each of the sections of introduction, methods, results and discussion can be expanded as per the particular study and the manuscript can be constructed in a stepwise manner. We hope that by following this approach, potential researchers and practicing ophthalmologists will develop the skill and aptitude for medical writing, and that the developing world shall do justice to its tremendous intellectual capital by making meaningful contributions to global scientific literature.
  4,229 660 -
ORIGINAL ARTICLES
Rectifying calibration error of Goldmann applanation tonometer is easy!
Nikhil S Choudhari, Krishna P Moorthy, Vinod B Tungikar, Mohan Kumar, Ronnie George, Harsha L Rao, Sirisha Senthil, Lingam Vijaya, Chandra Sekhar Garudadri
November 2014, 62(11):1082-1085
DOI:10.4103/0301-4738.146761  PMID:25494251
Purpose: Goldmann applanation tonometer (GAT) is the current Gold standard tonometer. However, its calibration error is common and can go unnoticed in clinics. Its company repair has limitations. The purpose of this report is to describe a self-taught technique of rectifying calibration error of GAT. Materials and Methods: Twenty-nine slit-lamp-mounted Haag-Streit Goldmann tonometers (Model AT 900 C/M; Haag-Streit, Switzerland) were included in this cross-sectional interventional pilot study. The technique of rectification of calibration error of the tonometer involved cleaning and lubrication of the instrument followed by alignment of weights when lubrication alone didn't suffice. We followed the South East Asia Glaucoma Interest Group's definition of calibration error tolerance (acceptable GAT calibration error within ±2, ±3 and ±4 mm Hg at the 0, 20 and 60-mm Hg testing levels, respectively). Results: Twelve out of 29 (41.3%) GATs were out of calibration. The range of positive and negative calibration error at the clinically most important 20-mm Hg testing level was 0.5 to 20 mm Hg and -0.5 to -18 mm Hg, respectively. Cleaning and lubrication alone sufficed to rectify calibration error of 11 (91.6%) faulty instruments. Only one (8.3%) faulty GAT required alignment of the counter-weight. Conclusions: Rectification of calibration error of GAT is possible in-house. Cleaning and lubrication of GAT can be carried out even by eye care professionals and may suffice to rectify calibration error in the majority of faulty instruments. Such an exercise may drastically reduce the downtime of the Gold standard tonometer.
  3,754 317 -
REVIEW ARTICLES
Scanning laser polarimetry in glaucoma
Tanuj Dada, Reetika Sharma, Dewang Angmo, Gautam Sinha, Shibal Bhartiya, Sanjay K Mishra, Anita Panda, Ramanjit Sihota
November 2014, 62(11):1045-1055
DOI:10.4103/0301-4738.146707  PMID:25494244
Glaucoma is an acquired progressive optic neuropathy which is characterized by changes in the optic nerve head and retinal nerve fiber layer (RNFL). White-on-white perimetry is the gold standard for the diagnosis of glaucoma. However, it can detect defects in the visual field only after the loss of as many as 40% of the ganglion cells. Hence, the measurement of RNFL thickness has come up. Optical coherence tomography and scanning laser polarimetry (SLP) are the techniques that utilize the evaluation of RNFL for the evaluation of glaucoma. SLP provides RNFL thickness measurements based upon the birefringence of the retinal ganglion cell axons. We have reviewed the published literature on the use of SLP in glaucoma. This review elucidates the technological principles, recent developments and the role of SLP in the diagnosis and monitoring of glaucomatous optic neuropathy, in the light of scientific evidence so far.
  2,722 344 -
ORIGINAL ARTICLES
Choroidal thickness profi le in healthy Indian subjects
Jay Chhablani, P Srinivasa Rao, Amarnath Venkata, Harsha L Rao, B Siva Koteswar Rao, Uday Kumar, Raja Narayanan, Rajeev Reddy Pappuru
November 2014, 62(11):1060-1063
DOI:10.4103/0301-4738.146711  PMID:25494246
Purpose: The aim was to study choroidal thickness (CT) and its profile based on location in healthy Indian subjects using Cirrus high definition (HD) optical coherence tomography. Materials and Methods: A total of 211 eyes of 115 healthy subjects with no retinal or choroidal disease were consecutively scanned using Cirrus HD 1 line raster scan mode without pupillary dilation. Eyes with any ocular disease or axial length (AXL) >24 mm or <20 mm were excluded. Experienced technician measured CT from the lower border of the retinal pigment epithelium (RPE) to the lower border of choroid. CT was measured from the posterior edge of the RPE to the choroid/sclera junction at 500-μm intervals up to 3000 μm temporal and nasal to the fovea. Generalized estimating equations were used to evaluate the correlation between CT at various locations and age, AXL, spherical equivalent, and macular thickness. Results: Mean age was 42.8 ± 13.6 years. Mean AXL was 22.84 ± 0.78 mm. Median spherical equivalent was 0.16 ± 0.64 D. Mean central macular thickness was 216.4 ± 30.03 μm. Choroidal was thinnest nasally and thickest subfoveally. On multivariate regression, age was the most significant factor affecting subfoveal CT (P = 0.000). Regression analysis showed an approximate decrease in CT of 1.18 μm every year. Conclusions: Our study provides CT profile in Indian healthy subjects in various age groups. CT depends on its location, subfoveal being the thickest and nasal being the thinnest. Age is a critical factor, which is negatively correlated with CT.
  1,739 293 -
BRIEF COMMUNICATIONS
Novel surgical technique for the management of partial cryptophthalmos
Ramesh Murthy, Himika Gupta
November 2014, 62(11):1096-1098
DOI:10.4103/0301-4738.146754  PMID:25494255
We report a case of a 2-month-old baby with bilateral nonsyndromic partial cryptophthalmos presenting with upper eyelid incomplete development and fusion to the cornea with resultant inability to close the eyes. He was managed successfully with bilateral upper lid reconstruction with composite graft using maternal skin and oral mucous membrane, amniotic membrane, and donor scleral graft. After this one stage surgery, lids were well-formed, and the patient was able to close both eyes, thus achieving good anatomical, functional, and cosmetic outcome.
  1,654 201 -
ORIGINAL ARTICLES
Augmented surgical amounts for intermittent exotropia to prevent recurrence
Hatice Arda, Hatice Tuba Atalay, Faruk H Orge
November 2014, 62(11):1056-1059
DOI:10.4103/0301-4738.146710  PMID:25494245
Purpose: The purpose was to evaluate the results of bilateral lateral rectus (BLR) recession which is based on augmented surgical amounts of classical surgical table of Parks' for basic and pseudo-divergence excess type intermittent exotropia [X(T)]. Materials and Methods: Patients with X(T) operated by the same surgeon and followed-up for at least 6 months were included. Patients with prior surgery, neurobehavioral and musculoskeletal conditions, strabismus different from that mentioned above X(T) were excluded. All the patients received BLR only. The amount of the recession was increased by the amount needed to correct 5 prism diopters (PD) more X(T) than what was measured. After the operation, 1 st week, 2 nd and 6 months measurements were recorded. The patients were grouped according to their 1 st week (3-7 days) postoperative examination as: >10 PD esotropia (Group 1), ≤10 PD esotropia (Group 2), exotropia (Group 3), and orthotropic (Group 4), respectively. Final surgical outcomes were classified as "good" (≤10 PD exotropia and ≤5 PD esotropia), "recurrence" (>10 PD exotropia) and "overcorrected" (>5 esotropia). Results: Thirty-seven patients were included. The mean age was 6.78 ± 2.87 years (range: 2-12 years). Mean preoperative deviation was 29.72 ± 8.07 PD (range: 15-45 PD) at distance and 20.94 ± 11.65 PD (range: 10-45 PD) at near (P < 0.0001). There were 21 (56.8%) patients in Group 1, 9 (24.3%) patients in Group 2, 1 (2.7%) patient in Group 3 and 6 (16.2%) patients in Group 4. Initial esotropia was achieved in 30 (30/37) of the patients. Twenty-eight of them had good results at the end of the 6 months. Overall "motor surgical" success rate was found to be 89.2% (33/37 patients), with 1 (2.7%) overcorrection and 3 (8.1%) recurrences at the end of the 6 months. Conclusion: This study demonstrated that early overcorrection of 10-20 PD after X(T) surgery can achieve acceptable motor outcomes in the first 6 months postoperative period.
  1,501 281 -
BRIEF COMMUNICATIONS
An intraorbital metallic foreign body
Jawaad Ahmed Asif, Abdullah Pohchi, Mohammad Khursheed Alam, Yousuf Athar, Rayees Ahmad Shiekh
November 2014, 62(11):1098-1100
DOI:10.4103/0301-4738.146756  PMID:25494256
  1,525 181 -
ORIGINAL ARTICLES
Maximizing the visual outcome in traumatic cataract cases: The value of a primary posterior capsulotomy and anterior vitrectomy
Mehul A Shah, Shreya M Shah, Krunal D Patel, Ashit H Shah, Jaimini S Pandya
November 2014, 62(11):1077-1081
DOI:10.4103/0301-4738.146757  PMID:25494250
Objective: The objective was to provide evidence-based care for patients with traumatic cataracts, we assessed whether a posterior capsulotomy and anterior vitrectomy, as part of the primary surgical procedure, could be a positive predictor of final visual outcome. Materials and Methods: This is a prospective randomized control trial. Patients presenting at our hospital between January 2010 and December 2012 having ocular trauma and traumatic cataracts were enrolled, according to the inclusion criteria. We enrolled two groups: Those with and without primary posterior capsulotomy and vitrectomy. Information regarding demographic and ocular trauma were collected using the World Eye Trauma Registry form at the first visit and follow-up, and specific information was collected for both the group who underwent posterior capsulectomies and vitrectomies as a part of the primary procedure, and the control group. Data were analyzed to evaluate the predictive value of primary posterior capsulectomy and anterior vitrectomy. Results: We enrolled 120 cases, 60 in each group, comprising 31 females and 89 males. When all other variables were controlled for, the visual outcome (best corrected visual acuity) differed significantly (P < 0.001) between the groups. Conclusion: Performance of posterior capsulectomy and anterior vitrectomy as part of the primary procedure improves the final visual outcome.
  1,223 282 -
LETTERS TO THE EDITOR
Repeat fluid- gas exchange for failed primary macular hole surgery
Neha Goel, Abhinav Prakash, AK Gupta
November 2014, 62(11):1104-1105
DOI:10.4103/0301-4738.146736  PMID:25494261
  1,328 157 -
BRIEF COMMUNICATIONS
Preoperative corneal astigmatism among adult patients with cataract in Northern Nigeria
Mohammed Isyaku, Syed A Ali, Sadiq Hassan
November 2014, 62(11):1094-1095
DOI:10.4103/0301-4738.146751  PMID:25494254
The prevalence and nature of corneal astigmatism among patients with cataract has not been well-documented in the resident African population. This retrospective study was undertaken to investigate preexisting corneal astigmatism in adult patients with cataract. We analyzed keratometric readings acquired by manual Javal-Schiotz keratometry before surgery between January 1, 2011 and December 31, 2011. There were 3,169 patients (3286 eyes) aged between 16 and 110 years involved with a Male to female ratio of 1.4:1. Mean keratometry in diopters was K1 = 43.99 and K2 = 43.80. Mean corneal astigmatism was 1.16 diopter and a majority (45.92%) of eyes had astigmatism between 1.00 and 1.99 diopters. Two-thirds of the eyes (66.9%) in this study had preoperative corneal astigmatism equal to or above 1.00 diopter. Findings will help local cataract surgeons to estimate the potential demand for toric intraocular lenses.
  1,241 226 -
ORIGINAL ARTICLES
High-risk histomorphological features in retinoblastoma and their association with p53 expression: An Indian experience
Rao Seema, Sobti Parul, Khurana Nita, Kamlesh
November 2014, 62(11):1069-1071
DOI:10.4103/0301-4738.146747  PMID:25494248
Introduction: Histopathological features in retinoblastoma are considered high-risk factors (HRF) for tumor progression and metastasis, thus their presence becomes an indication for adjuvant chemotherapy. Present study was undertaken to evaluate the incidence of HRF in retinoblastoma and to correlate them with p53 expression. Materials and Methods: This was a retrospective study where 17 diagnosed cases of retinoblastoma were included. Cases were re-evaluated for various histomorphological parameters. Immuno-histochemical analysis was done with p53 antibody by Streptavidin biotin method. Results: The patients were in the age range of 1.5-50 years. Common histological features included necrosis (70.5%), calcification (64.7%), and retinal detachment (58.8%). Incidence of various morphological parameters was anterior chamber seeding (47.2%), ciliary body involvement (29.4%), iris involvement (29.4%), choroid involvement (58.8%), scleral invasion (29.4%), extrascleral invasion (11.8%), and optic nerve infiltration (23.5%). p53 expression was present in four cases out of 13 cases (30.7%) and showed a significant association with choroid invasion (P = 0.02). Discussion: The presence of HRF should alert the physician for a possible metastasis, and such patients should be kept on regular follow-up to detect an early recurrence. p53 expression, a known poor prognostic indicator, showed significant association with choroid invasion, however, no association was seen with other HRF. Conclusion: Histopathological HRF have significant therapeutic and prognostic implications. The incidence of HRF is higher in developing countries as patients present with a more advanced stage of disease. p53 expression is significantly associated with choroid invasion out of all HRF.
  1,228 213 -
Diurnal variation in central corneal thickness and intraocular pressure in eyes with pseudoexfoliation syndrome without glaucoma
Stuart Keel, Linda Malesic, Siew-Pang Chan
November 2014, 62(11):1072-1076
DOI:10.4103/0301-4738.146755  PMID:25494249
Aim: The aim was to ascertain if any differences exist in diurnal central corneal thickness (CCT) and intra-ocular pressure (IOP) between eyes with pseudoexfoliation (PXF) syndrome without glaucoma and eyes with no ocular pathology. A secondary aim was to determine whether there was a significant relationship between CCT and IOP. Settings and Design: This study was a prospective design conducted within a hospital setting. Materials and Methods: The experimental group consisted of seven participants with bilateral PXF (14 eyes) and the control group comprised of 15 participants (30 eyes). Testing included CCT and IOP measured at four different times on one given day (8.00 a.m.; 11 a.m.; 2 p.m. and 5 p.m.). Statistical Analysis: The data were analyzed with the generalized linear latent mixed model. Results: PXF eyes displayed a significantly thinner overall mean CCT (520 μm) compared to controls (530 μm). Furthermore, a significant reduction in CCT and IOP occurred in the PXF group from 8 a.m. to 5 p.m. The mean overall IOP in PXF eyes was significantly lower than the control group. A significant association between IOP and CCT was also found in PXF eyes. Conclusions: Displaying a significantly thinner mean CCT highlights the importance of measuring CCT in an ophthalmic clinical setting as to avoid falsely underestimated IOP measurements in such a high-risk glaucoma population. Furthermore, a statistically significant correlation between IOP and CCT in PXF eyes suggests that the reduction in CCT that occurred in PXF eyes between 8 a.m. and 5 p.m. may be partly responsible for the reduction in IOP measurements.
  1,188 247 -
OPHTHALMOLOGY PRACTICE
Anterior migration of dexamethasone implant in a pseudophakic patient with intact posterior capsule
Nilufer Kocak, Taylan Ozturk, Eyyup Karahan, Suleyman Kaynak
November 2014, 62(11):1086-1088
DOI:10.4103/0301-4738.146763  PMID:25494252
Intravitreal application of Ozurdex ® (Allergan, Inc., Irvine, CA, USA) which is a biodegradable, sustained-release dexamethasone implant has been reported to be effective in the treatment of macular edema. Migration of such implant into the anterior chamber has been recently described in cases without perfect zonular or the posterior capsular integrity. Herein, we report the first case with anterior migration of Ozurdex ® implant that mislocated just behind the intraocular lens (IOL) in an intact capsular bag. It is thought that such implant migrated anteriorly towards into the posterior chamber through weak zonules as the present case had a medical history of uneventful phacoemulsification surgery with the implantation of posterior chamber IOL. However, the migrated implant was well tolerated since there was no sign of the corneal complication, rise in intraocular pressure, and anterior chamber reaction. Close follow-up was scheduled to find out any signs of anterior segment pathology. Meanwhile dexamethasone implant completely degraded at the 4 th month of postoperative follow-up.
  1,019 163 -
ORIGINAL ARTICLES
Effect of the color of the intraocular lens on optical and visual quality
Mª Amparo Díez-Ajenjo, Mª Carmen García-Domene, Cristina Peris-Martínez, José Mª Artigas, Adelina Felipe
November 2014, 62(11):1064-1068
DOI:10.4103/0301-4738.146741  PMID:25494247
Purpose: To analyze the optical quality of intraocular lenses (IOL) with an orange (PC440Y) and a yellow (SN60AT) filter, and correlate these results with the visual quality of patients with these implants. Setting: Fisabio Oftalmologνa Mιdica, Valencia, Spain. Design: Randomized prospective study. Materials and Methods: The IOL optical quality was determined using the modulation transfer function (MTF) and the spectral transmission. The visual quality of 87 eyes with cataract (51 with orange filter and 36 with yellow filter) was determined by best corrected visual acuity (BCVA) and contrast sensitivity function (CSF) under photopic and mesopic conditions. To analyze the results, we use a Student's t-test. Results: Orange lens filtered more of the blue spectrum (cut-off wavelength of 370 nm) than the yellow lens (390 nm). The MTF of the yellow lens was better than the orange lens (average modulation of 0.676 for natural and 0.672 for orange). The patients' BCVA was 0.02 + 0.10 logMAR for both lenses. The CSF obtained with the yellow lens was slightly better, although without statistically significant differences (P > 0.05). Conclusions: Both lenses are of good optical quality. The patients' visual quality was similar with both lenses, and optical quality was also similar. The color of the lens does not affect the visual quality of the patient.
  807 199 -
EDITORIAL
Innovative ophthalmology
Sundaram Natarajan
November 2014, 62(11):1043-1044
DOI:10.4103/0301-4738.146706  PMID:25494243
  730 200 -
LETTERS TO THE EDITOR
Improving the outcome of prosthetic rehabilitation following orbital exenteration
Pradeep Kumar, Himanshi Aggarwal, Pooran Chand, E Prashanti
November 2014, 62(11):1102-1102
DOI:10.4103/0301-4738.146731  PMID:25494258
  648 132 -
0.5% Proparacain hydrochloride for clear corneal phacoemulsification in patients with co-morbid conditions
Rajesh Subhash Joshi
November 2014, 62(11):1101-1101
DOI:10.4103/0301-4738.146729  PMID:25494257
  660 113 -
Glaucoma caused by isolated microspherophakia: A long story
Cagatay Caglar, Tekin Yasar
November 2014, 62(11):1106-1106
DOI:10.4103/0301-4738.146738  PMID:25494262
  616 139 -
Author reply to comment on photodynamic therapy and polypoidal choroidal vasculopathy
Gwyn Samuel Williams, Luke Anderson, David J Eddyshaw
November 2014, 62(11):1108-1108
DOI:10.4103/0301-4738.146746  PMID:25494264
  638 103 -
Post traumatic horseshoe-shaped macular tear
Neha Goel, Ravi Sharma, Madhullika Mandal, Reena M Choudhry
November 2014, 62(11):1103-1104
DOI:10.4103/0301-4738.146735  PMID:25494260
  593 129 -
Multimedia interventions on the informed consent process for cataract surgery
Milton C Chew, Louis W Lim, Colin S Tan
November 2014, 62(11):1102-1103
DOI:10.4103/0301-4738.146732  PMID:25494259
  478 106 -
Comment on choroidal thickness in high-altitude sickness
Wei Kiong Ngo, Colin S H Tan
November 2014, 62(11):1106-1107
DOI:10.4103/0301-4738.146742  PMID:25494263
  479 93 -
Author's reply
Kyoko Hirukawa-Nakayama, Akito Hirakarta, Kaoru Tomita, Tomoyuki Hiraoka, Makoto Inoue
November 2014, 62(11):1107-1108
  355 78 -