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   2020| January  | Volume 68 | Issue 1  
    Online since December 19, 2019

 
 
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ORIGINAL ARTICLE
Pars-plana vitrectomy with phacofragmentation for hyperdense cataracts in eyes with severe microcornea and chorio-retinal coloboma: A novel approach
Alok C Sen, Gaurav M Kohli, Ashish Mitra, Shubhi Tripathi, Sachin B Shetty, Sonal Gupta
January 2020, 68(1):91-98
DOI:10.4103/ijo.IJO_405_19  PMID:31856479
Purpose: To report the outcomes of pars-plana approach for the management of brunescent cataract in eyes with severe microcornea and associated chorio-retinal coloboma. Methods: This was a retrospective, single center, interventional case series performed in a tertiary eyecare center in central Medical records of consecutive cases of microcornea with coloboma who underwent pars-plana vitrectomy with phacofragmentation (PF) between January 2015 and December 2017 were reviewed. Results: The study group comprised of 30 eyes of 30 patients, of which 18 (60%) were males and 12 (40%) were females. The mean age of the patients was 41.9 years (range of 17–70 years). The mean corneal diameter was 6.7 mm with a range of 4–8 mm and all the eyes had dense cataract with nuclear sclerosis of grade 4 or more. The mean preoperative visual acuity was 1.97 (+/-0.067) Log MAR and the mean postoperative vision at 1 month was 1.6 (+/-0.39) Log MAR. Postoperatively, 21 patients (70%) gained ambulatory vision. The visual gain in all the patients was maintained over a mean follow-up period of 15.5 months. Conclusion: Pars-plana vitrectomy with PF can be considered in eyes with severe microcornea and brunescent cataracts, where cataract surgery through the limbal (anterior) approach is not only difficult but at times impossible due to anatomical restraints.
  17,863 200 3
REVIEW ARTICLE
Management of corneal perforations: An update
Rashmi Deshmukh, Louis J Stevenson, Rasik Vajpayee
January 2020, 68(1):7-14
DOI:10.4103/ijo.IJO_1151_19  PMID:31856457
Corneal perforation is a potentially devastating complication that can result from numerous conditions that precipitate corneal melting. It is associated with significant morbidity and prompt intervention is necessary to prevent further complications. Causes include microbial keratitis, ocular surface disease, and autoimmune disorders and trauma. Various management options have been described in the literature to facilitate visual rehabilitation. This rview discusses the treatment options that range from temporising measures such as corneal gluing through to corneal transplantation, with decision making guided by the location, size, and underlying aetiology of the perforation.
  12,563 1,449 41
ORIGINAL ARTICLE
Evaluation of Barrett universal II formula for intraocular lens power calculation in Asian Indian population
Nikhil Kuthirummal, Murugesan Vanathi, Ritika Mukhija, Noopur Gupta, Rachna Meel, Rohit Saxena, Radhika Tandon
January 2020, 68(1):59-64
DOI:10.4103/ijo.IJO_600_19  PMID:31856468
Purpose: Barrett Universal II (BU-II) is considered as one of the most accurate intraocular lens (IOL) power calculation formulas; however, there is no literature studying the same in Indian population. The aim of this study was to evaluate the accuracy of BU-II formula in prediction of IOL power for cataract surgery in Asian Indian population. This was an institutional, prospective, observational study. Methods: Patients with senile cataract who underwent phacoemulsification with posterior chamber IOL implantation were enrolled in the study. Biometry data from Lenstar-LS900 was used and IOL power was calculated using four IOL formulas: modified SRK-II, SRK/T, Olsen, and BU-II. Primary outcome was measured as the prediction error in postoperative refraction for each formula and secondary outcome was measured as the difference in mean absolute errors between the four formulas. SPSS Version-21 with P < 0.05 considered significant. Results: A total of 244 eyes were included in the study and were divided into three groups in accordance to axial length (AL): Group 1 (AL: 22–24.5 mm; N = 135), Group 2 (AL <22 mm; N = 53), and Group 3 (AL >24.5 mm; N = 56). BU-II formula gave the lowest mean absolute error (0.37 ± 0.27D) and median absolute error (0.34) in predicted postoperative refraction in the entire study population. When compared with the other formulas, mean absolute error was significantly lower in all three groups (P < 0.0005) as well, except for Olsen formula in the normal AL group, where the results were comparable (P = 0.742). Conclusion: BU-II performed as the most accurate formula in the prediction of postoperative refraction over a wide range of ALs.
  5,545 491 10
ORIGINAL ARTICLES
Study of biofilm formation in bacterial isolates from contact lens wearers
L Raksha, Nagaraju Gangashettappa, GB Shantala, Bhavna R Nandan, Deepa Sinha
January 2020, 68(1):23-28
DOI:10.4103/ijo.IJO_947_19  PMID:31856459
Purpose: To detect biofilm forming capacity of bacterial isolates obtained from the conjunctiva, contact lens and accessories of contact lens wearers using phenotypic and genotypic methods. Methods: Bacterial strains were collected from the conjunctiva, contact lens and lens storage cases of contact lens wearers. The phenotypic detection of biofilm production was done using the tube method and congo red agar method. The biofilm-forming related genes, icaA, of Coagulase negative Staphylococcus (CONS) and Staphylococcus aureus, and pslA, of P. aeruginosa, were detected using PCR. Results: A total of 265 bacterial isolates which included S. aureus, CONS, Pseudomonas, Nil-fermenter Gram-negative bacilli (NFGNB), Bacillus spp, Diphtheroids, Micrococci, Klebsiella pneumonia, Klebsiella oxytoca, E. coli, Proteus mirabilis, Proteus vulgaris, Citrobacter koseri, Citrobacter freundii, Enterobacter cloacae, Moraxella were obtained. Of the 265 isolates, 53.5% were moderately positive, 33.2% strongly positive and 13.2% negative for biofilm production by tube method and 36.6% were moderately positive, 40% strongly positive and 23.3% negative for biofilm production by congo red agar method. Of the four S. aureus isolates, two (50%) showed the presence of icaA gene. Of the 23 CONS isolates, three (13%) showed the presence of icaA gene. All the Pseudomonas isolates were negative for presence pslA (1119 bp) gene though most of them were phenotypically positive for biofilm formation. Conclusion: Most of the bacterial isolates obtained from contact lens wearers had the potential to produce biofilms. Tube method and Congo red agar method exhibited significant statistical correlation (P-value = 0.006) and picked up a good number of biofilm-forming isolates, hence may be used for detection of biofilm production. The absence of biofilm-forming gene did not rule out the possibility for phenotypic biofilm production by bacteria.
  4,669 437 9
Intrastromal voriconazole: An adjuvant approach for recalcitrant mycotic keratitis
Piyali Konar, Shilpa Joshi, Seema J Mandhare, Rasika Thakur, Madan Deshpande, Ashutosh Dayal
January 2020, 68(1):35-38
DOI:10.4103/ijo.IJO_378_19  PMID:31856462
Purpose: To evaluate the efficacy of intrastromal voriconazole for the management of fungal keratitis not responding to conventional therapy. Methods: Patients having microbiologically proven fungal keratitis with poor response to 2 weeks of conventional topical therapy were included in the study. After obtaining informed consent, an intrastromal injection of voriconazole was administered around the ulcer. Response to treatment in the form reduction in the size of the ulcer and infiltration was recorded on regular follow-ups. Results: Out of a total of 20 patients, 14 responded to intrastromal treatment and resolved, whereas six patients progressed to perforation. Mean resolution time was 35.5 ± 9.2 days. The most common organism isolated was Fusarium in six patients while Aspergillus and Mucor were isolated in two each. The causative organism could not be isolated in eight patients. The size of the ulcer at presentation and height of hypopyon were found to be significant risk factors associated with treatment outcomes. Conclusion: Intrastromal voriconazole as an adjuvant therapy appeared to be effective in treatment of fungal keratomycosis not responding to conventional therapy, thus, reducing the need for therapeutic or tectonic keratoplasty.
  4,430 471 17
PHOTO ESSAY
Pearly white intraocular lens opacification – “Tertiary cataract”
Gaurav Gupta, Parul Goyal, Amanjit Bal, Arun Kumar Jain, Chintan Malhotra
January 2020, 68(1):188-189
DOI:10.4103/ijo.IJO_205_19  PMID:31856508
  3,658 269 1
GUEST EDITORIAL
Professional Medical Indemnity Insurance - Protection for the experts, by the experts
Manoj Chandra Mathur
January 2020, 68(1):3-5
DOI:10.4103/ijo.IJO_2279_19  PMID:31856455
  3,163 433 2
ORIGINAL ARTICLES
Outcomes of rebubbling for graft detachment after Descemet's stripping endothelial keratoplasty or Descemet's stripping automated endothelial keratoplasty
Sushank A Bhalerao, Ashik Mohamed, Pravin K Vaddavalli, Somasheila I Murthy, Jagadesh C Reddy
January 2020, 68(1):48-53
DOI:10.4103/ijo.IJO_1521_18  PMID:31856465
Purpose: To study the outcomes of rebubbling for graft detachment after Descemet's stripping endothelial keratoplasty (DSEK) or Descemet's stripping automated endothelial keratoplasty (DSAEK). Methods: From 2260 eyes that underwent DSEK or DSAEK from July 2008 to June 2015, 80 eyes of 80 patients developed graft detachment and were retrospectively reviewed. Host-related, surgery-related and donor-related factors that have a bearing on graft adhesion were looked at retrospectively, and eventual outcomes after rebubbling procedure were studied. Results: Successful attachment was observed in 77 (96.25%) eyes and clear grafts were achieved in 55 (68.75%) eyes, while 25 (31.25%) eyes had graft failure. The uncorrected and best-corrected distance visual acuities significantly improved from 1 month to 3 months post-operatively and remained stable till 12 months of follow-up. Three lenticules that failed to attach with the first rebubbling procedure underwent a second rebubbling, two underwent a repeat DSEK with good outcomes and four underwent penetrating keratoplasty. On evaluating possible risk factors for graft failure, lower donor endothelial cell density was found to be a significant factor (P = 0.03). The median graft survival following rebubbling was 30 months. Conclusion: Rebubbling procedure in detached grafts after DSEK or DSAEK can reattach the lenticule in 96% of eyes in immediate post-operative period and the majority of the grafts remained clear on long-term follow-up with a median graft survival period of 2.5 years.
  3,206 233 9
LETTERS TO THE EDITOR
Effectiveness of combined dichoptic therapy, binocular vision therapy, and part-time patching for the management of amblyopia in adults
Faiza Bhombal, Mihir Kothari, Mohammad Oliullah Abdal, Shruti Lad, Gul Nankani
January 2020, 68(1):257-258
DOI:10.4103/ijo.IJO_1184_19  PMID:31856546
  2,804 281 5
ORIGINAL ARTICLE
Corneal endothelial cell changes in diabetics versus age group matched nondiabetics after manual small incision cataract surgery
Ajay A Kudva, Adeline S Lasrado, Sudhir Hegde, Rajani Kadri, P Devika, Akansha Shetty
January 2020, 68(1):72-76
DOI:10.4103/ijo.IJO_406_19  PMID:31856472
Purpose: To assess and compare the endothelial cell changes after manual small incision cataract surgery (SICS) in diabetic patients versus age group matched non-diabetic patients. Methods: This comparative prospective observational follow-up study included 54 diabetic patients and 52 control patients without diabetes who underwent manual SICS. Preoperative, one day, one week, one month and three months post-surgery assessments of corneal endothelial cell changes were done using specular microscopy. Data analysis was performed using SPSS software (version 20.0, SPSS, Inc.). Mann–Whitney U test was used to compare the data between the test group and control group. Results: There was drop in the endothelial density in both the groups postoperatively, with the mean percentage of endothelial loss at three months post- surgery being 27.5% in diabetics and 18.3% in controls. There was also a significant increase in central corneal thickness and coefficient of variance in diabetics as compared to controls at every follow up one day, one week, one month and three months. The percentage of hexagonality was statistically significant at post-operative three months. Conclusion: The diabetic endothelium was found to be under greater metabolic stress and had less functional reserve after manual SICS than the normal corneal endothelium.
  2,669 384 12
ORIGINAL ARTICLES
Association between serum 25-hydroxyvitamin D levels and myopia in general Korean adults
Byung J Jung, Donghyun Jee
January 2020, 68(1):15-22
DOI:10.4103/ijo.IJO_760_19  PMID:31856458
Purpose: We performed this study to determine the association between serum 25-hydroxyvitamin D [25(OH) D] level and myopia in adults. Methods: A total of 25,199 subjects aged ≥20 years were included from the National Health and Nutrition Examination Survey 2008–2012. Blood 25(OH)D levels were evaluated from blood samples. Refractive error was measured without cycloplegia. Myopia and high myopia were defined as ≥-0.50 diopters (D) and ≥-6.0 D, respectively. Other covariates such as education, physical activity, and economic status were obtained from interviews. Results: Linear regression analysis showed that as 25(OH) D level increased by 1 ng/mL, myopic refractive error significantly decreased by 0.01 D (P < 0.001) after adjusting for potential confounders including sex, age, height, education level, economic status, physical activity, and sunlight exposure time. The odds ratios for myopia was 0.75 (95% Confidence interval [CI]; 0.67–0.84, P < 0.001) in the highest 25(OH) D quintile compared to the lowest quintile. The odds ratios for high myopia was 0.63 (95% CI; 0.47–0.85, P < 0.001) in the highest 25(OH)D quintile compared to the lowest quintile. Conclusion: Serum 25(OH)D level was inversely associated with myopia in Korean adults.
  2,630 326 8
Subretinal hyperreflective material in central serous chorioretinopathy
Niroj K Sahoo, Vishal Govindhari, Rumneek Bedi, Abhilash Goud, Rishi Singh, Lihteh Wu, Jay Chhablani
January 2020, 68(1):126-129
DOI:10.4103/ijo.IJO_265_19  PMID:31856489
Purpose: To describe the the appearance and behavior of subretinal hyperreflective material (SHRM) in eyes with central serous chorioretinopathy (CSCR). Methods: This retrospective study included 20 eyes of 20 patients with CSCR presenting with SHRM, defined as sub-retinal deposits that appear hyper-reflective on OCT The eyes underwent either laser (15 eyes) or observation (5 eyes). Optical coherence tomography and fundus fluorescein angiography (FFA) characteristics were analyzed at baseline and resolution of neurosensory detachment, which were then co-related with the visual acuity at resolution. Results: Improvement in vision was seen in 16 eyes. Ellipsoid zone damage (P = 0.03) and external limiting membrane (ELM) damage (P = 0.000) at resolution; diffuse retinal pigment epithelium (RPE) abnormalities on FFA (P = 0.04), and the presence of scar (P = 0.000), were associated with poor visual outcome in univariate analysis. ELM damage at resolution was statistically significant (P = 0.001) in multivariate analysis. Conclusion: CSCR with SHRM have a good visual prognosis. ELM damage at resolution corelates with a poor visual acuity at resolution.
  2,549 337 7
A comparative study of tarsorrhaphy and amniotic membrane transplantation in the healing of persistent corneal epithelial defects
Hennaav K Dhillon, Harsh Bahadur, Anuradha Raj
January 2020, 68(1):29-33
DOI:10.4103/ijo.IJO_617_19  PMID:31856460
Purpose: To compare and study the clinical outcome of tarsorrhaphy and amniotic membrane transplant in the healing of persistent corneal epithelial defects in terms of clinical improvement and symptomatic relief. Methods: This was an interventional, prospective study in which a total of 60 patients with persistent epithelial defects (PED's), randomly divided into two groups of 30 patients each who underwent tarsorrhaphy (Group A) or amniotic membrane transplantation (Group B) with a 4-week-follow-up period, were included. The main parameters studied were the size of an epithelial defect, total healing time, pain score, and complications. Results: The study included 60 eyes of 60 patients with PED. The healing time was 9.83 ± 6.51 days in Group A (median = 9.50 days, IQR = 1–7 days) vs. 18.33 ± 13.46 days (median = 19.50 days, IQR = 1–21 days) in Group B. A total of ten eyes (16.7%) did not heal at the end of 4 weeks. Conclusion: There was a significant reduction in the area of epithelial defect at the end of the 1 week and 2 week follow up postoperatively, in both the treatment forms. The mean healing time in patients of Group A was less as compared to that of the patients in Group B.
  2,329 503 6
ORIGINAL ARTICLE
Comparison of posterior optic capture of intraocular lens without vitrectomy vs endocapsular implantation with anterior vitrectomy in congenital cataract surgery: A randomized prospective study
Savleen Kaur, Jaspreet Sukhija, Jagat Ram
January 2020, 68(1):84-88
DOI:10.4103/ijo.IJO_522_19  PMID:31856476
Purpose: To compare surgical outcome of two procedures in pediatric cataract surgery. Methods: Prospective randomised interventional study. Consecutive patients with bilateral congenital cataract who were operated during January 2016 to October 2016 at a tertiary care referral institute were included. One eye of all patients underwent Intraocular lens (IOL) implantation with optic capture through a primary posterior continuous curvilinear capsulorhexis (PPC) without vitrectomy while in the other eye endocapsular IOL implantation was performed along with PPC and anterior vitrectomy. Intraoperative challenges and postoperative complications were noted. Results: 15/18 children who fulfilled the inclusion criteria were included for follow up analysis. Mean age at the time of surgery was 21 ± 14.7 months. At a mean follow up of 25.69 ± 1.06 months; all eyes in both groups maintained a clinically centred IOL with clear visual axis. One patient with endocapsular IOL implantation developed anterior capsular phimosis. The rate of fibrinous complications (IOL deposits and synechiae) were more in the eyes with IOL in the bag (6 eyes) vs eyes where posterior optic capture was done (1 eye); P = 0.039. Conclusion: Posterior optic capture is a safer alternative to conventional pediatric cataract surgery in terms of inflammatory sequelae and lens epithelial cell proliferation. However the two methods work equally well in preventing visual axis obscuration over a long follow-up.
  2,418 364 16
ORIGINAL ARTICLES
Can subthreshold micropulse yellow laser treatment change the anti-vascular endothelial growth factor algorithm in diabetic macular edema? A randomized clinical trial
Hatice Selen Kanar, Aysu Arsan, Ahmet Altun, Suat Fazıl Akı, Aynur Hacısalihoglu
January 2020, 68(1):145-151
DOI:10.4103/ijo.IJO_350_19  PMID:31856493
Purpose: To compare the efficacy of subthreshold micropulse yellow laser (SMYL) and intravitreal aflibercept injection (IAI) combination therapy with IAI monotherapy in the treatment of diabetic macular edema (DME) and to evaluate the number of injections and SMYL sessions required. Methods: This prospective study compared a group of 28 patients treated with a combination of SMYL and IAI with a group of 28 patients treated only with IAI. All patients initially received 3 monthly IAIs, and the monotherapy group was given additional injections as needed. The combination therapy patients additionally received SMYL after the loading phase. The primary outcome measures were the change in the best-corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline to month 12; the secondary outcomes were the mean number of required injections and SMYL sessions. Results: In the monotherapy group, the BCVA improved from 0.38 ± 0.10 to 0.20 ± 0.10 logMAR; in the combination group, BCVA improved from 0.40 ± 0.09 to 0.17 ± 0.06 logMAR at the end of the 12th month. The CMT was reduced from 451.28 ± 44.85 to 328.8 ± 49.69 μm in the monotherapy group and from 466.07 ± 71.79 to 312.0 ± 39.29 μm in the combination group. Improvement of the mean BCVA and reduction of the mean CMT were similar in each group. The combination group required significantly fewer injections (3.21 ± 0.41 vs 5.39 ± 1.54; P < 0.001). By month 12, 75% of patients in the monotherapy group had required additional IAIs when compared with 16% in the combination group (P < 0.001). Conclusion: SMYL combination therapy demonstrated significant visual improvements in patients with DME. In the combination group, the retreatment rate and number of required injections were significantly lower compared with the IAI monotherapy group.
  2,290 288 25
ORIGINAL ARTICLE
Surgical management of Helveston syndrome (triad of A- pattern exotropia, superior oblique overaction and dissociated vertical deviation) using 'Four Oblique' procedure
Prachi Agashe, Ashish Doshi
January 2020, 68(1):170-173
DOI:10.4103/ijo.IJO_196_19  PMID:31856501
Purpose: To report the surgical outcomes in six patients of Helveston syndrome using a “four oblique” procedure. The popular methods for surgical management include superior rectus recessions alone or combined with superior oblique tenectomy. However, large angle exotropia correction would entail a higher risk of anterior segment ischemia when the superior rectus needs to be operated along with the horizontal recti. Hence, we evaluated the long-term results of this uncommon procedure. Methods: This was a retrospective review of six patients diagnosed to have manifest dissociated vertical deviation (DVD) with A pattern exotropia with bilateral superior oblique over action. All patients underwent horizontal muscle recessions/resections for exotropia along with bilateral posterior tenectomy of the superior oblique with inferior oblique anterior transpositioning. Results: The median age was 10 years (Range 5–26 years). The mean postoperative follow-up was 26 ± 14.02 months (Range 12–48 months). The mean reduction in exotropia was from 36.5 ± 21.06 PD (Range 15–65 PD) to 6.1 ± 3.06 PD (Range 3–10 PD). The procedure corrected the A pattern from a mean 23 ± 7 PD (Range 15–35 PD) to 7.6 ± 3.2 PD (Range 3–10 PD). The average DVD in the right eye reduced from 14 ± 4.3 PD (Range 8–20 PD) to 5.3 ± 1.2 PD and in the left eye from 14.33 ± 3.6 PD (Range 10–18 PD) to 4.1 ± 1.1 PD. The DVD asymmetry reduced from 6.33 ± 3.4 PD to 1.5 ± 1.3 PD. Conclusion:”Four oblique” procedure with horizontal muscle surgery seems to be an effective method for significantly correcting the A pattern as well as reducing the DVD with good long-term outcome in our case series.
  2,239 235 4
Seroprevalence of Lymes disease in the Nagarahole and Bandipur forest areas of South India
Kalpana Babu, Krishna R Murthy, M Bhagya, Praveen R Murthy, Vinuth N Puttamallesh, V Ravi
January 2020, 68(1):100-103
DOI:10.4103/ijo.IJO_943_19  PMID:31856481
Purpose: The aim of this study was to determine the seroprevalence of Lymes disease in a population at risk in south India. Methods: Prospective ongoing study and included screening of forest workers and staff of Nagarahole and Bandipur forest ranges in South India for Lymes disease. Screening included a detailed questionnaire for Lymes disease, complete ocular and systemic examination by an ophthalmologist and infectious disease specialist and blood collection. ELISA for IgM and IgG antibodies for Borrelia burgdorferi were performed on the collected sera samples. Western blot confirmation was done on the seropositive samples. Ticks were also collected from these forest areas for future studies to detect if they harbor B. burgdorferi. Results: Seroprevalence of 19.9% was noted by ELISA. Western blot confirmation was seen in 15.6% of the seropositive samples. There was significant correlation between seropositivity and exposure to tick bites (P = 0.023). Conclusion: There is a high seroprevalence of infection with B. burgdorferi in the forest areas of Nagarahole and Bandipur ranges in south India.
  2,245 224 11
ORIGINAL ARTICLES
Analysis of differentially expressed genes in bacterial and fungal keratitis
Rui Tian, He Zou, Lufei Wang, Lu Liu, Meijiao Song, Hui Zhang
January 2020, 68(1):39-46
DOI:10.4103/ijo.IJO_65_19  PMID:31856463
Purpose: This study was aimed at identifying differentially expressed genes (DEGs) in bacterial and fungal keratitis. The candidate genes can be selected and quantified to distinguish between causative agents of infectious keratitis to improve therapeutic outcomes. Methods: The expression profile of bacterial or fungal infection, and normal corneal tissues were downloaded from the Gene Expression Omnibus. The limma package in R was used to screen DEGs in bacterial and fungal keratitis. The Co-Express tool was used to calculate correlation coefficients of co-expressed genes. The "Advanced network merge" function of Cytoscape tool was applied to obtain a fusional co-expression network based on bacterial and fungal keratitis DEGs. Finally, functional enrichment analysis by DAVID software and KEGG analysis by KOBAS of DEGs in fusion network were performed. Results: In total, 451 DEGs in bacterial keratitis and 353 DEGs in fungal keratitis were screened, among which 148 DEGs were found only in bacterial keratitis and 50 DEGs only in fungal keratitis. Besides, 117 co-expressed gene pairs were identified among bacterial keratitis DEGs and 87 pairs among fungal keratitis DEGs. In total, nine biological pathways and seven KEGG pathways were screened by analyzing DEGs in the fusional co-expression network. Conclusion: TLR4 is the representative DEG specific to bacterial keratitis, and SOD2 is the representative DEG specific to fungal keratitis, both of which are promising candidate genes to distinguish between bacterial and fungal keratitis.
  2,133 263 5
COMMENTARY
Commentary: Barrett's Universal II formula: Time to change the old trends?
Partha Biswas, Sneha Batra
January 2020, 68(1):64-65
DOI:10.4103/ijo.IJO_2262_19  PMID:31856469
  2,130 236 1
ONE MINUTE OPHTHALMOLOGY
The complementary image
Md Shahid Alam, Bhuvaneshwaran Vedapuri Eswaran
January 2020, 68(1):6-6
DOI:10.4103/ijo.IJO_902_19  PMID:31856456
  1,876 445 -
CASE REPORTS
Prenatal diagnosis of bilateral congenital microphthalmia in two fetuses from the same parents
Dongyu Song, Hongxin Song, Lixia Zhou, Congxin Sun, Qingqing Wu, Dongmei Li
January 2020, 68(1):216-218
DOI:10.4103/ijo.IJO_750_19  PMID:31856529
Congenital microphthalmia (CM) is a rare anomaly of the fetal orbit, results from developmental defects of the primary optic vesicle, and is characterized by a reduced eyeball volume and axial diameter. Fetal CM cases have rarely been reported. Herein, we present a case of two fetuses with bilateral CM from the same parents, diagnosed using ultrasonography (US) and magnetic resonance imaging (MRI). We found that the antepartum US and MRI measurements were smaller than the postpartum ones. Genetic testing of the parents and fetuses revealed that GL12 gene mutation may be associated with CM.
  2,092 165 2
An unusual case of orbitocranial wooden foreign body with amazing outcome: A case report
Shyam Sundar Das Mohapatra, Jayanta Das, Harsha Bhattacharjee
January 2020, 68(1):219-221
DOI:10.4103/ijo.IJO_569_19  PMID:31856530
Penetrating orbitocranial injuries can present with foreign body/bodies (FBs) lodged in eye, orbit, and/or brain. But limited literatures are available about FBs lodged partly in orbit and partly intracranially. Here, we present a rare case of orbitocranial wooden FB impacted in right palpebral aperture extending intracranially following accidental fall from height. Unexpectedly, the patient himself removed the FB in fully conscious and oriented state while waiting for neurosurgical intervention, later completely recovered under observation and antibiotic prophylaxis. Therefore, it is important to have high suspicion of intracranial extension in impacted orbital FBs and a team approach for managing such cases.
  2,039 193 4
ORIGINAL ARTICLES
Etiological causes and epidemiological characteristics of patients with occupational corneal foreign bodies: A prospective study in a hospital-based setting in India
Charu Agrawal, Shenouda Girgis, Aditya Sethi, Vaibhav Sethi, Manisha Konale, Parul Lokwani, Reena Sethi
January 2020, 68(1):54-57
DOI:10.4103/ijo.IJO_623_19  PMID:31856466
Purpose: Corneal foreign bodies (CFBs) due to occupational exposure have been largely ignored in Indian literature, especially nonmetal workers. Our study looks at a broad range of occupations and settings that contribute to CFB in our local Indian population. The study objective was to determine the occupations, level of education and demographics of patients presenting with CFB acquired during occupational work. Methods: Prospective hospital-based study at a tertiary eye hospital in Gurgaon, Haryana, India, within duration of 9 months. Patients presenting with CFB were asked a set of questions relating to their occupation, level of education, understanding of the potential complications of CFB, and demographics. Results: A total of 83 patients were included in the study. CFB were attributed only to males. 66% of patients were in the age group of 14--29 years. 30% of patients were in the age group 30--44 years and 4% of patients were between 45 and 60 years old. The metal work industry was responsible for 47% of presentations. The construction industry was responsible for 27% of presentations. Electricians and carpenters combined were responsible for 10% of presentations and 17% of presentations occurred in other sectors. Conclusion: CFB occur across a number of occupations in the construction industry, not just metallic workers. Among a population that is generally poorly educated and have nominal understanding of the impact that CFB can have on vision, occupational hazard education is necessary to address this problem.
  1,855 250 2
EDITORIAL
Indian Journal of Ophthalmology - Promises kept, objectives met
Santosh G Honavar
January 2020, 68(1):1-2
DOI:10.4103/ijo.IJO_2323_19  PMID:31856454
  1,684 394 1
ORIGINAL ARTICLES
Comparison of wide-field swept source optical coherence tomography angiography and fundus autofluorescence in tubercular serpiginous-like choroiditis
Manpreet Brar, Mansi Sharma, S P S Grewal, Dilraj S Grewal
January 2020, 68(1):106-111
DOI:10.4103/ijo.IJO_78_19  PMID:31856483
Purpose: To evaluate the potential clinical utility of wide-field swept source optical coherence tomography angiography (SS-OCTA) using a prototype device compared to a wide-field fundus autofluorescence (FAF) for analysis of the disease activity in eyes with tubercular serpiginous-like choroiditis (TBSLC). Methods: Using a prototype SS-OCTA device (PLEX Elite, Carl Zeiss Meditec, Dublin, CA), 17 eyes of 12 consecutive patients with TBSLC were imaged and multiple 12 mm × 12 mm OCTA scans were captured, which were montaged to create wide-field montage OCTA images scans. A wide- FAF (Eidon, CenterVue, Padova, Italy) was performed in the same sitting. Two masked graders independently analyzed OCTA and FAF images for the presence of choroidal lesions, recorded the number of lesions identifiable, and provided a subjective grading for the activity of individual lesion, which were then compared. Results: The total number of lesions identified on FAF were 282 (posterior pole lesions, n = 129 and peripheral lesions n = 153) and on wide-field SS-OCTA were 230 (posterior pole lesions, n = 108 and peripheral lesions n = 122). Active choroidal lesions were comparable on the two machines (n = 28 on FAF and n = 28 on SS-OCTA, respectively); whereas numerous healed lesions were identified on FAF (n = 219) as compared to SS-OCTA (n = 170). There was good correlation among the devices for healed lesions (Pearson correlation, r = 0.82) and active lesions (r = 0.88). Conclusion: There was good correlation between FAF and wide-field SS-OCTA for detection of disease activity in TBSLC; however, FAF depicted greater number of healed lesions compared to wide-field SS-OCTA.
  1,836 237 15
Choroidal hyper-reflective foci and vascularity in retinal dystrophy
Daren Hanumunthadu, Mohammed Abdul Rasheed, Abhilash Goud, Arushi Gupta, Kiran Kumar Vupparaboina, Jay Chhablani
January 2020, 68(1):130-133
DOI:10.4103/ijo.IJO_148_19  PMID:31856490
Purpose: To investigate choroidal hyper-reflective foci (HRF) in subjects with retinal dystrophy [Stargardt's disease (SGD) and retinitis pigmentosa (RP)] and their association with demographics, visual acuity, choroidal thickness (CT), and choroidal vascularity index (CVI). Methods: Single center retrospective study of subjects with previously diagnosed SGD or RP. Swept-source optical coherence tomography images were analyzed for the presence of choroidal HRFs and CVI using previously validated automated algorithm. A Spearman's rank correlation coefficient was used to evaluate the correlation between the number of HRF and various baseline parameters including age, visual acuity, intraocular pressure, and other optical coherence tomography (OCT) parameters (CT, choroidal area, and CVI) were evaluated in these subjects. Results: This study included 46 eyes (23 subjects) and 55 eyes (28 subjects) with previously diagnosed RP and SGD, respectively. In the RP group, the mean number of HRFs was 247.9 ± 57.1 and mean CVI was 0.56 ± 0.04. In SGD group, mean HRF was 192.5 ± 44.3 and mean CVI was 0.41 ± 0.04. Mean HRF was significantly greater in the RP group (0.02), however, the mean CVI was not statistically different. In RP, mean HRF were correlated only with CVI (r = 0.49; P = 0.001), however, in SGD, it correlated with only choroidal area (r = 0.27; P = 0.04). Conclusion: Choroidal HRF were present in both RP and SGD subjects with more HRFs in those with RP. These HRFs were associated with alteration in choroidal vascularity, which further adds into the pathogenesis of these diseases.
  1,860 193 5
CASE REPORTS
Pediatric idiopathic macular hole – A case report and review of literature
Nawazish Shaikh, Vinod Kumar, Nitesh Salunkhe, Shreya Nayak, Shoryavardhan Azad
January 2020, 68(1):241-244
DOI:10.4103/ijo.IJO_354_19  PMID:31856539
Macular hole in the pediatric age group is usually post-traumatic unlike, the adult counterpart. Herein we describe a case of idiopathic macular hole occurring in a 9-year-old male who presented to us with complaints of diminution of vision in OD (oculus dextrus) for 2 months. The child underwent 25-gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. On follow-up his best-corrected visual acuity improved with type 1 closure of macular hole.
  1,822 192 3
ORIGINAL ARTICLE
The effects of vıtal dyes on mechanıcal propertıes of the human anterıor lens capsule
Cem Simsek, Onur Gokmen
January 2020, 68(1):66-70
DOI:10.4103/ijo.IJO_285_19  PMID:31856470
Purpose: The purpose of this study was to evaluate the mechanical effects of vital dyes on the anterior lens capsule via the nanoindentation method. Methods: Twenty anterior lens capsules of 20 different patients were dissected into four equal fragments. Each fragment was stained separately with dyes for intraocular surgeries, such as trypan blue 0.06% (TB), brilliant blue 0.025% (BB), and indocyanine green 0.05% (ICG), for 1 min. The remaining fragment was assessed as an untreated control group. The alterations on the mechanical characteristics of the anterior lens capsule were evaluated using a nanoindentation testing device with Oliver–Pharr and Martens hardness methods. Results: The mean values of elasticity were 7.842 ± 0.55 GPa for capsules fragments stained with TB (P < 0.05), 8.407 ± 0.82 GPa for capsules fragments stained with BB (P < 0.05), 8.557 ± 0.60 GPa for ICG (P < 0.05), and 6.09 ± 0.57 GPa for the untreated control group. The mean values of stiffness were 299.7 ± 47 MPa for TB (P < 0.05), 317.9 ± 34 MPa for BB (P < 0.05), 331.8 ± 48 MPa for ICG (P < 0.05), and 229.85 ± 44 MPa for the untreated control group. The elasticity of the capsules statistically decreased in comparison to the control group, and the capsule stiffness showed a statistically significant increase in comparison to the untreated controls. Conclusion: The mechanical characteristics of the human anterior lens capsule were affected in association with the alterations in the elasticity and stiffness properties of the capsule as a result of exposure to three different dyes.
  1,685 318 7
SURGICAL TECHNIQUE
Intraoperative optical coherence tomography and proportional reflux hydrodissection-guided pars plana vitrectomy for complex severe proliferative diabetic retinopathy
Aniruddha Agarwal, Vishali Gupta
January 2020, 68(1):177-181
DOI:10.4103/ijo.IJO_978_19  PMID:31856503
The study describes the technique of combining microscope-integrated optical coherence tomography (mi-OCT) and proportional reflux hydrodissection (PRH) during pars plana vitrectomy (PPV) in eyes with complex proliferative diabetic retinopathy (PDR) including tractional retinal detachment (TRD), combined retinal detachment (CRD), and taut posterior hyaloid membrane (TPHM). In this technique, PRH is used to create tissue planes between fibrovascular adhesions in areas identified using mi-OCT for insinuating the vitrector, enabling tissue dissection and release of traction. About 46 patients were operated using this technique. 34 eyes had TRD, 9 eyes had CRD, and 3 eyes were diagnosed with TPHM. A second instrument was used only in nine eyes. None of the eyes required use of intraocular scissors. Iatrogenic breaks occurred in six eyes. All patients had successful reattachment at 3-month follow-up. Thus, combination of mi-OCT and PRH is useful incomplete fibrovascular tissue dissection during PPV for complex PDR cases.
  1,805 197 5
ORIGINAL ARTICLES
Lateral elongation of flat irregular pigment epithelial detachment: A novel optical coherence tomography biomarker in polypoidal choroidal vasculopathy
Divya Alex, Anantharaman Giridhar, Mahesh Gopalakrishnan, VP Indu
January 2020, 68(1):134-140
DOI:10.4103/ijo.IJO_236_19  PMID:31856491
Purpose: To explore novel Optical Coherence Tomography (OCT) biomarkers and precursor lesions in Polypoidal Choroidal Vasculopathy (PCV). Methods: This retrospective cohort study included 76 treatment naïve fellow eyes of PCV. Focus was given to analyse the various morphological changes in the clinically unaffected fellow retina during the follow-up period. Results: 11 fellow eyes (14.47%) developed disease activity in the form of Sub Retinal Fluid (SRF) or Intra Retinal Fluid (IRF) within a mean follow-up of 17 months. All 11 eyes (100%) showed the presence of flat irregular pigment epithelial detachment (FIPED) and a peculiar property of lateral elongation of FIPED during disease activity. A positive correlation with the disease progression was found for the same (P < 0.0001). The mean horizontal dimension of the flat irregular PED at the enrolment was 1984 ± 376u and the mean expansion of FIPED at SRF formation was 461 ± 152u. ICG taken at the time of disease activity in the fellow eye revealed branching vascular network (BVN) in 9 (81.8%) eyes, polyps in 7 (63.6%) eyes, a combination of both in 5 (45.4%) eyes. Type one BVN with interconnecting channels showed faster disease progression than type two BVN. Eye tracking ICG illustrated that BVN corresponded to the FIPED in OCT and polypoidal lesions developed at the end of expanding FIPED. Conclusion: Flat irregular pigment epithelial detachment with its characteristic property of lateral elongation may be considered as a precursor lesion for PCV and as a novel OCT biomarker for the disease activity. Fellow eyes with FIPED need close monitoring to identify development of disease activity at the earliest.
  1,741 258 1
Correlation of multicolor images and conventional color fundus photographs with foveal autofluorescence patterns in diabetic macular edema
Kumar Saurabh, Rupak Roy, Sugandha Goel
January 2020, 68(1):141-144
DOI:10.4103/ijo.IJO_608_19  PMID:31856492
Purpose: The aim of this study is to assess the ability of multicolour imaging (MCI) to detect foveal cysts in diabetic macular edema (DME) and compare it with conventional color fundus photography (CFP) and foveal autofluorescence (FAF) pattern. Methods: It was a retrospective review of 112 eyes of 84 DME patients with central foveal thickness ≥250 μ who underwent MCI, CFP and shortwave autofluorescence imaging. MCI was performed with Sepctralis spectral domain optical coherence tomography (SDOCT) (Heidelberg Engineering, Germany). Results: 97 (86.6%) eyes had cystoid increased autofluorescence (cystoid iFAF), 9 (8%) had spot iFAF and 6 (5.35%) had irregular decreased FAF (dFAF). Among eyes with cystoid iFAF, OCT detected DME cysts in 93 (95.6%) eyes, MCI in 75 (77.3%) and CFP in 5 (5.15%) eyes. In all these eyes, the location of cysts on OCT and MCI corresponded with the location of cystoid iFAF, whereas none of the eyes with cyst seen on CFP correlated with the location of cystoid iFAF. Conclusion: MCI was superior to CFP in detecting DME cysts at fovea. It also correlated with hyperautofluorescence pattern in these eyes. MCI may have a potential role in diabetic retinopathy screening by segregating eyes with DME which would require treatment. Our findings need to be further validated in a larger and prospective study design.
  1,751 224 8
OPHTHALMIC IMAGES
Lenticular opacities in vitiligo iridis
Deepa A Kumar, Rekha R Khandelwal, Sonali Bawankar
January 2020, 68(1):213-213
DOI:10.4103/ijo.IJO_800_19  PMID:31856526
  1,740 184 -
SURGICAL TECHNIQUE
Surgical management of post-Descemet stripping automated endothelial keratoplasty interface haze associated with interface deposits
George D Kymionis, Nafsika Voulgari, George A Kontadakis, Dimitrios Mikropoulos, Aleksandra Petrovic, Konstantinos Droutsas
January 2020, 68(1):174-176
DOI:10.4103/ijo.IJO_883_19  PMID:31856502
We describe an effective technique for the management of graft–host interface haze associated with interface deposits after Descemet-stripping automated endothelial keratoplasty (DSAEK) with bimanual irrigation/aspiration. A Tan marginal dissector was used to separate the graft from the stroma in the nasal two-thirds of the graft–host interface. The aspiration handpiece was inserted in the interface through the nasal side-port corneal incision and a separate irrigation tip was placed in the anterior chamber (AC) through the temporal corneal paracentesis. Meticulous rinsing of the two-thirds of the interface area and the AC was performed. At the end of the procedure, air was injected into the AC to float the donor graft against the host stromal bed and facilitate graft adherence. Postoperative anterior segment optical coherence tomography and slit-lamp examination confirmed elimination of the interface haze–deposits and a well-attached graft. An improvement in visual acuity was noted.
  1,724 166 -
ORIGINAL ARTICLE
Low incidence of pachydrusen in central serous chorioretinopathy in an Indian cohort
Sumit Randhir Singh, Renuka Chakurkar, Abhilash Goud, Jay Chhablani
January 2020, 68(1):118-122
DOI:10.4103/ijo.IJO_528_19  PMID:31856486
Purpose: The aim of this study is to report the prevalence, clinical and swept-source optical coherence tomography (SS-OCT) characteristics of pachydrusen in eyes with central serous chorioretinopathy (CSCR) and their fellow eyes. Methods: A total of 264 eyes of 132 patients with a diagnosis of CSCR (acute/persistent/recurrent/chronic/inactive) in atleast one eye, were analyzed in this retrospective, cross-sectional study. SS-OCT parameters including choroidal thickness (CT), large choroidal vessel layer thickness (LCVT) at fovea and the site of pachydrusen were recorded. Paired t test and analysis of variance (ANOVA) was used to compare CT in eyes with CSCR (subfoveal and site of pachydrusen) and multiple groups respectively. Results: The mean age of the study patients was 42.9 ± 9.5 years with 119 males (90.15%). Bilateral CSCR was present in 31 patients. Nine eyes (chronic, 4; persistent, 2; and inactive/resolved CSCR, 3) showed presence of pachydrusen with an overall prevalence of 6.82% (9 eyes of 9 patients out of 132 patients). There was no significant difference of subfoveal CT (SFCT) in eyes with CSCR (422.4 ± 107.8 μ) vs fellow eyes (407.0 ± 96.5 μ) and eyes with CSCR associated with pachydrusen (413.7 ± 101.5 μ) vs fellow eyes of CSCR eyes with pachydrusen (431.6 ± 188.8 μ) (P = 0.71). LCVT as a percentage of CT was higher at the site of pachydrusen compared to SFCT (69.8% vs. 50.8%). Conclusion: CSCR can be associated with pachydrusen with a lower prevalence rate than previously reported. Whether the thickened large choroidal vessels at site of pachydrusen play any role in formation in pachydrusen needs further evaluation.
  1,658 196 4
CASE REPORTS
Severe focal stromal degeneration up to Descemet membrane after corneal collagen cross-linking
GV Prabhakar, N Panickar, JK Reddy, SK Sivasubramaniam, A Singh
January 2020, 68(1):224-226
DOI:10.4103/ijo.IJO_475_19  PMID:31856532
Corneal collagen cross-linking (CXL) is an effective treatment for arresting progression in keratoconus cases. It is considered safe despite a few complications that have been recorded earlier. In this case series, we report a rare and late complication caused due to severe stromal thinning up to Descemet's membrane in three patients who underwent CXL 3 to 6 years back for keratoconus. Deep anterior lamellar keratoplasty (DALK) was then done for the affected eye with good outcomes. This case series highlights the possible late effects of UVA irradiation post CXL.
  1,687 162 1
Rheumatoid factor versus anti - cyclic citrullinated peptide antibody as screening tool for rheumatoid arthritis in an ophthalmic clinic
Prabhakar Singh, Arvind Kumar, Prakash Chandra
January 2020, 68(1):236-238
DOI:10.4103/ijo.IJO_526_19  PMID:31856537
Patients with moderate to severe dry eyes are often screened at the Dry Eye Clinic to rule out connective tissue diseases. Rheumatoid factor (RF) is one of the screening tools to rule out rheumatoid arthritis (RA). Patients who turn out positive for the RF are often subjected to anti-CCP antibody evaluation for confirmation of disease. This article tries to highlight 3 cases of negative and anti-CCP antibody positive cases which presented to the ophthalmic clinic, unaware of their systemic status. Though RF is the cheapest modality to screen for RA, it is not always a reliable marker. One should order anti-CCP antibody for patients where suspicion is high, despite RF being normal.
  1,658 174 -
PHOTO ESSAY
Phacoemulsification tip fracture
Sudarshan Khokhar, Chirakshi Dhull, Sourabh Verma, Yogita Gupta
January 2020, 68(1):187-188
DOI:10.4103/ijo.IJO_419_19  PMID:31856507
  1,620 195 2
CASE REPORTS
Outer retinal tubulation and inner retinal pseudocysts in a patient with maternally inherited diabetes and deafness evaluated with optical coherence tomography angiogram
Koushik Tripathy, Barsha Sarma, Shahana Mazumdar
January 2020, 68(1):250-253
DOI:10.4103/ijo.IJO_577_19  PMID:31856543
A 47-year-old lady (index case) with diabetes and deafness showed multiple oval circumferential areas of perifoveal atrophy in both eyes. Autofluorescence revealed areas of hypoautofluorescence. Optical coherence tomography (OCT) showed depression of inner retinal surface, inner retinal hyporeflective spaces (pseudocysts), disorganization/thinning of outer retina, outer retinal tubulation, loss of external limiting membrane, ellipsoid and interdigitation zone, and thinning of the retinal pigment epithelium and choriocapillaris. The patient was evaluated using OCT angiogram. Retinal lesions of her mother (68-year-old) were very obvious on autofluorescence imaging. The result of A3243G mutation in MTTL1 gene was positive in the index case confirming the diagnosis of maternally inherited diabetes and deafness (MIDD).
  1,637 175 7
PHOTO ESSAY
Management of pseudophakic bullous keratopathy with ultrathin Descemet stripping automated endothelial keratoplasty and modified Yamanes' technique of scleral fixation
Jai Kelkar, Aditya Kelkar, Yogesh Chougule
January 2020, 68(1):185-186
DOI:10.4103/ijo.IJO_321_19  PMID:31856506
  1,607 178 4
ORIGINAL ARTICLES
A prospective comparison of the efficacy of 0.5% bupivacaine vs 0.75% ropivacaine in peribulbar anesthesia for vitreoretinal surgery
VV Jaichandran, Sangeetha Srinivasan, Sonali Raman, V Jagadeesh, Rajiv Raman
January 2020, 68(1):153-156
DOI:10.4103/ijo.IJO_239_19  PMID:31856495
Purpose: To date, there is no information on the comparison of the effect of 0.5% bupivacaine with 0.75% ropivacaine solution for vitreoretinal surgery. The aim of the study was to compare the efficacy of 0.5% bupivacaine with 0.75% ropivacaine in peribulbar anesthesia for vitreoretinal surgery. This was a prospective randomized double-blinded observational study in a hospital setting. Sixty patients planned for vitreoretinal surgery were randomized into two groups based on the peribulbar injection administered either with 0.5% bupivacaine or 0.75% ropivacaine solution, as Group B (n = 30) and Group R (n = 30), respectively. Time of onset of analgesia, akinesia, and the need for supplemental anesthesia were noted. Student's t-test or Mann-Whitney U test were used for comparing continuous variables and Chi-square or a Fischer exact test were used as appropriate for comparing two proportions. Results: The patients in Group R showed an earlier onset of both, analgesia (1.97 min vs. 2.10 min, P = 0.002) and akinesia (2.77 min vs. 4.20 min, P < 0.001) compared with the patients in Group B. The efficacy of the block attained was Grade 5 (adequate anesthesia and akinesia without supplementation) in about 97% of the patients in Group R while only 90% in Group B. However, the differences between the groups for the efficacy of the block were not statistically significant (P = 0.301) neither for Grades 5 nor for Grade 4 and 3 (P = 1.00 for both). The onset of postoperative pain was similar for both groups (P = 1.00). Conclusion: We concluded that 0.75% ropivacaine is a better choice of local anesthetic solution for patients undergoing primary vitreoretinal surgery compared with 0.5% bupivacaine.
  1,570 190 5
OPHTHALMIC IMAGES
Spinning top cataract
Harsha Bhattacharjee, Henal Javeri, Saurabh Deshmukh, Isha Agarwalla
January 2020, 68(1):212-212
DOI:10.4103/ijo.IJO_1404_19  PMID:31856525
  1,631 123 -
COMMENTARY
Commentary: Heteroplasmy in maternally inherited diabetes and deafness
Bhavik Panchal, Ketan Saoji
January 2020, 68(1):253-253
DOI:10.4103/ijo.IJO_1296_19  PMID:31856544
  1,591 157 -
Commentary: Tarsorrhaphy: A stitch in time
Manisha Acharya, Abha Gour, Abhishek Dave
January 2020, 68(1):33-34
DOI:10.4103/ijo.IJO_1824_19  PMID:31856461
  1,531 203 4
CASE REPORTS
Post cataract Pseudomonas stutzeri endophthalmitis: Report of a case and review of literature
Ankit Shah, Deepak Senger, Barun Garg, Samarth Mishra, Sugandha Goel, Kumar Saurabh, Rupak Roy
January 2020, 68(1):232-233
DOI:10.4103/ijo.IJO_334_19  PMID:31856535
We report a rare case of Pseudomonas stutzeri endophthalmitis in an immunocompetent individual along with the review of the literature. A 39-year-old healthy lady presented with sudden painful loss of vision in her right eye. She was diagnosed with postcataract surgery acute endophthalmitis and underwent vitrectomy, intraocular lens explantation and intravitreal antibiotics. P. stutzeri was isolated from vitreous. Though the infection was controlled, the anatomy of the eye could not be salvaged and the right eye became phthisical. P. stutzeri is a rare cause of endophthalmitis with usually poor outcomes.
  1,553 174 6
PHOTO ESSAY
Late onset DCR surgical site herpes zoster in an immunocompetent patient: A rare presentation
E Vivek Chaitanya, TV Shruthi, Neeraj A Shah
January 2020, 68(1):202-203
DOI:10.4103/ijo.IJO_1007_19  PMID:31856516
  1,555 156 -
LETTERS TO THE EDITOR
Comments on: Ocular surface status in patients with hemifacial spasm under long-lasting treatment with botulinum A toxin: A comparative fellow eye study
Manisha Singh, Sima Das, Virender Sangwan
January 2020, 68(1):264-265
DOI:10.4103/ijo.IJO_1645_19  PMID:31856551
  1,526 179 2
Response to comments on: Ocular surface status in patients with hemifacial spasm under long-lasting treatment with botulinum A toxin: A comparative fellow eye study
Marco Pellegrini, Costantino Schiavi, Leonardo Taroni, Stefano Sebastiani, Federico Bernabei, Matilde Roda, Fabiana Moscardelli, Giuseppe Giannaccare
January 2020, 68(1):265-265
DOI:10.4103/ijo.IJO_2025_19  PMID:31856552
  1,496 201 -
CASE REPORTS
Pars plana placement of Ahmed glaucoma valve tube through sclerotomy port in refractory glaucoma: A novel surgical technique
Richa Gupta, Abhishek Varshney
January 2020, 68(1):234-236
DOI:10.4103/ijo.IJO_870_19  PMID:31856536
We describe a case of 34-year-old male with post penetrating keratoplasty glaucoma, post trabeculectomy with aphakia in the only seeing eye, in which a modified surgical technique of inserting Ahmed glaucoma valve (AGV) tube in vitreous cavity was done to reduce the risks associated with pars plana incision during pars plana vitrectomy (PPV). A hybrid 20-25 gauge PPV was done concurrently, implant fixed to sclera, and tube inserted through the 25 gauge sclerotomy port in supero-temporal quadrant. Visual acuity and intraocular pressure remained stable during 1-year follow-up.
  1,506 181 2
Oral mucosa for reconstructive surgery in a case of severe inflammatory necrotizing sclero-uveitis
José Lamarca-Mateu, Borja Salvador-Culla, Alba Gómez-Benlloch, Rafael I Barraquer
January 2020, 68(1):221-223
DOI:10.4103/ijo.IJO_671_19  PMID:31856531
The purpose of this case is to show the efficacy of buccal mucosa as an alternative to treat a case of severe necrotizing sclero-uveitis (NSU) associated with ocular perforation. We show a severe inflammatory NSU case that did not improve with topical treatment and scleral patch. We performed a buccal mucosa graft taken from the lower lip with excellent functional and anatomical result, with no signs of relapse of the NSU after 2 years of follow-up. Buccal mucosa can be a safe, useful, and effective alternative for the reconstruction of the scleral wall.
  1,503 176 3
LETTERS TO THE EDITOR
Imaging the ora serrata with the 3Nethra Neo camera – Importance in screening and treatment in retinopathy of prematurity
Anand Vinekar, Mangat Ram Dogra, Bhujang Shetty
January 2020, 68(1):270-271
DOI:10.4103/ijo.IJO_1232_19  PMID:31856558
  1,483 182 4
ORIGINAL ARTICLE
Morphological assessment of lamina cribrosa in idiopathic intracranial hypertension
Ipek Tanir Tatar, Banu Solmaz, Zeynep Gizem Erdem, Isıl Pasaoglu, Ali Demircan, Beril Tülü Aygün, Abdullah Ozkaya
January 2020, 68(1):164-167
DOI:10.4103/ijo.IJO_142_19  PMID:31856499
Purpose: Technological development of optic coherence tomography has enabled a detailed assessment of the optic nerve and deeper structures and in vivo measurements. The aim of this study was to compare the lamina cribrosa morphology of the optic nerve in idiopathic intracranial hypertension (IIH) and healthy individuals. Methods: The lamina cribrosa morphology of optic nerve in 15 eyes with IIH and 17 eyes of healthy individuals were compared. Four parameters such as Bruch membrane opening (BMO), lamina cribrosa thickness (LCT), prelaminar tissue thickness (PTT), and anterior lamina cribrosa surface depth (ALCSD) were retrospectively evaluated. Results: By enhanced depth imaging-optic coherence tomography (EDI-OCT), PTT and BMO were found to be significantly greater (574,35 ± 169,20 μm and 1787,40 ± 140,87 μm, respectively) in IIH patients than healthy individuals (187,18 ± 132,15 μm and 1632,65 ± 162,58 μm, respectively), whereas ALSCD was found to be significantly less in IIH patients (234,49 ± 49,31 μm) than healthy individuals (425,65 ± 65,23 μm). There was not a statistically significant difference regarding LCT between the IIH patients (238,59 ± 17,31 μm) and healthy individuals (244,96 ± 15,32 μm). Conclusion: Increased intracranial pressure causes morphological changes in lamina cribrosa. Assessment of lamina cribrosa with EDI-OCT is important for diagnosis and follow-up of patients with IIH. EDI-OCT is objective, reproducible, and cost-effective assistive imaging tool in IIH patients.
  1,439 208 1
Surgical outcomes, complications and learning curve of glued intraocular lens of a vitreo retinal fellow in training
Avadhesh Oli, Divya Balakrishnan
January 2020, 68(1):78-82
DOI:10.4103/ijo.IJO_524_19  PMID:31856474
Purpose: To evaluate surgical outcomes, complications and learning curve of glued intraocular lens surgery by a vitreoretinal (VR) fellow in training. Methods: Analysis of 50 eyes requiring glued intraocular lens (GIOL) surgery for various indications was done. Both the consultant VR surgeon (Group 1) and VR fellow in training (Group 2) operated 25 eyes each. The primary outcome measures were visual acuity at 3 months, and time taken for completion of surgery. Secondary outcome measures were refractive correction, intraocular pressure and intraoperative or postoperative complications. Results: The uncorrected visual acuity (UCVA) improved from log MAR 1.54±0.56 (Snellen 20/693) to 0.45±0.26 (Snellen 20/56) and from 1.64±0.53 (Snellen 20/873) to 0.56±0.45 (Snellen 20/72) in group 1 and 2, respectively. The best corrected visual acuity (BCVA) improved from log MAR 0.74±0.61 (Snellen 20/109) to 0.33±0.26 (Snellen 20/42) and from 1±0.68 (Snellen 20/200) to 0.40±0.50 (Snellen 20/50) in group 1 and 2, respectively (P > 0.05). The surgical time was significantly less in group 1 when compared to that of group 2 (64.26 vs 107.16 minutes) P value <0.05). The mean time taken for the initial 10 cases and later 15 cases in group 2 were 131.9 and 91.2 minutes, which was statistically significant. The complication rates in both groups were comparable. Transient hypotony (IOP < 11) was seen in 56% (14/25) of eyes in group 2 and 44% (11/25) in group 1 (P = 0.39). Conclusion: The study results are encouraging for a VR fellow with good short-term visual outcomes and comparable surgical complications. The procedure gives promising results and the learning curve is overcome by a desire to learn and with increasing number of procedures done under supervision.
  1,482 160 4
ORIGINAL ARTICLES
Enterobacter endophthalmitis: Clinical settings, susceptibility profile, and management outcomes across two decades
Vivek Pravin Dave, Avinash Pathengay, Shashwat Behera, Joveeta Joseph, Savitri Sharma, Rajeev Reddy Pappuru, Taraprasad Das
January 2020, 68(1):112-116
DOI:10.4103/ijo.IJO_693_19  PMID:31856484
Purpose: To describe the clinical presentation and management of Enterobacter endophthalmitis and compare with previous in-house published literature. Methods: This was a retrospective interventional comparative case series involving 44 cases with culture proven Enterobacter endophthalmitis from April 2006 to August 2018 who underwent vitrectomy/vitreous biopsy, intravitreal antibiotics with or without additional procedures as appropriate. The current outcomes were compared to the outcomes previously reported a decade back from our center. The mean age at presentation, predisposing factor, number of interventions, interval between inciting event and presentation, type of intravitreal antibiotic used, anatomic, and the functional outcomes were analyzed and compared to the previous series. Results: There were 30 males. Mean age was 22.73 ± 21.35 years (median 14 years). Inciting event was open globe injury in 34 (77.27%) eyes, 4 (9.09%) eyes following cataract surgery, 3 (6.81%) eyes with endogenous endophthalmitis, 2 (4.54%) eyes following keratoplasty, and 1 eye (2.27%) following trabeculectomy. Presenting visual acuity was favorable (≥20/400) in 2 eyes (4.54%), at the final visit it was in 11 eyes (25%). The organisms were most sensitive to ciprofloxacin (95.12%), amikacin (90.47%), and ceftazidime (85.36%). A comparison of the current study with previous in-house study showed that number of eyes with presenting vision ≥20/400 as well as final vision ≥20/400 were comparable. Susceptibility was highest to ciprofloxacin 39 (95.12%) (previous series) and 33 (92%) (current series). Conclusion: Enterobacter organisms show susceptibility to ciprofloxacin, amikacin, and ceftazidime. Susceptibility profile, clinical presentations, and management remain largely similar over many years. Final outcome is unfavorable.
  1,401 207 7
CASE REPORTS
Combined brilliant blue G and xenon light induced outer retinal layer damage following macular hole surgery
Ramesh Venkatesh, Aditya Aseem, Kushagra Jain, Naresh Kumar Yadav
January 2020, 68(1):247-249
DOI:10.4103/ijo.IJO_1386_19  PMID:31856542
We report a case of combined brilliant blue G and endoilluminator retinal toxicity in a patient who has undergone macular hole surgery. The patient developed extensive degeneration of the retinal pigment epithelium as early as 1 week following surgery that eventually lead to poor visual outcome. We look into the pathogenesis of BBG and endoilluminator causing retinal toxicity and also suggest measures to avoid this irreversible retinal damage.
  1,394 179 13
PHOTO ESSAY
A rare case of ruptured optic disc retinal arterial macroaneurysm and its successful management with intravitreal ranibizumab
Joash Rijey, Sugandha Goel, Kumar Saurabh, Rupak Roy
January 2020, 68(1):200-201
DOI:10.4103/ijo.IJO_1127_19  PMID:31856515
  1,406 157 -
CASE REPORT
Simultanagnosia as a cause of visual disturbance following Posterior Reversible Encephalopathy Syndrome (PRES): A case report
Niranjan K Pehere, Gordon N Dutton, Kshitij Mankad
January 2020, 68(1):254-256
DOI:10.4103/ijo.IJO_807_19  PMID:31856545
Simultanagnosia resulting from dorsal stream dysfunction is an under recognized condition. In this case report we describe the case of a young woman who developed posterior reversible encephalopathy syndrome (PRES), and who recovered visual acuities of 20/20 in each eye, along with normal visual fields and contrast sensitivities, yet experienced persistent symptoms of perceptual dysfunction. Detailed and systematic history taking revealed consistent visual difficulties typical of dorsal stream dysfunction. After a detailed explanation of her symptomatology and training in a range of strategies to cope, the patient experienced a great improvement in her day-to-day functioning.
  1,379 169 3
ORIGINAL ARTICLES
A novel standardized reproducible method to calculate the area of internal limiting membrane peeled intra-operatively in macular hole surgery by using a video overlay—A long-term study in cases of idiopathic macular holes
Subhendu K Boral, Arnab Das, Tushar K Sinha
January 2020, 68(1):157-161
DOI:10.4103/ijo.IJO_589_19  PMID:31856496
Purpose: To calculate AIP and to find correlation between hole closure pattern with AIP in idiopathic full thickness macular hole (FTMH) cases. Methods: In this prospective, non-randomized, interventional single blind study, 105 eyes of symptomatic FTMH (<6 month duration) were operated. Minimal diameter of macular hole (MDMH) was calculated on OCT, divided into Group I (>400μ, n = 75) and Group II (<400μ, n = 30). 23G vitrectomy with ILM peeling and gas injection were done in all and recorded. Final area of ILM peeled (AIP) was calculated using Adobe Photoshop CS2 (PSD format) in disc diameters (DD) from still frame. Follow up was done at 6 monthly interval up to a maximum of 5 years after surgery. Results: Macular holes were closed in 92.38% eyes. In Group I, mean pre-operative BCVA was 1.14 ± 0.39 log MAR and was improved to 0.79 ± 0.26 log MAR post-operatively at 6 months. In Group II, mean pre-operative BCVA was 0.95 ± 0.44 log MAR and was improved to 0.60 ± 0.24 log MAR after surgery. When AIP was more than 3DD, Type I and Type II closure were 72.77% and 27.27% in Group I (P value <0.01) and 84.21% and 15.79% in Group II (P value <0.01). Conclusion: AIP can be calculated using Adobe Photoshop CS2. Type I closure was significantly high with AIP >3DD in both groups. Intra-operatively using video overlay, surgeons can increase the diameter of AIP to get better closure pattern.
  1,383 162 4
PHOTO ESSAY
Choroidal caverns in pachychoroid neovasculopathy
Apoorva Ayachit, Shrinivas Joshi, SV Kathyayini, Guruprasad Ayachit
January 2020, 68(1):199-200
DOI:10.4103/ijo.IJO_395_19  PMID:31856514
  1,339 206 4
OPHTHALMIC IMAGES
Risperidone-induced cataract in a young female
R Balamurugan, PC Gupta, H Kashyap, Jagat Ram
January 2020, 68(1):214-214
DOI:10.4103/ijo.IJO_1517_19  PMID:31856527
  1,305 232 -
PHOTO ESSAY
A rare case of diabetic macular edema with a central serous chorioretinopathy presenting as pseudohypopyon over macula
Santosh K Mahapatra, Anuja Mohanty
January 2020, 68(1):194-196
DOI:10.4103/ijo.IJO_483_19  PMID:31856512
  1,352 160 -
CASE REPORTS
Curvularia infection of corneoscleral tunnel
Manisha Singh, Abhishek Dave, Arpan Gandhi, Nikunj Patel, Neha Kapoor, Manisha Acharya
January 2020, 68(1):229-231
DOI:10.4103/ijo.IJO_424_19  PMID:31856534
Corneoscleral tunnel infection is a potentially sight threatening complication of cataract surgery. Microbiological investigations are mandatory and early surgical intervention helps in achieving favourable outcomes. Fungal infection of tunnel incisions can pose a diagnostic and therapeutic challenge. We report a case of post-operative tunnel infection with curvularia. Prompt surgical intervention and intensive topical therapy helped attain a good tectonic as well as visual recovery.
  1,372 138 1
COMMENTARY
Commentary: Cataract surgery in small eyes: Choosing between complications
Bhavana Sharma, Brijesh Takkar
January 2020, 68(1):98-99
DOI:10.4103/ijo.IJO_1568_19  PMID:31856480
  1,339 160 -
OPHTHALMIC IMAGES
X-linked retinoschisis
Devashish Dubey, Shorya Vardhan Azad
January 2020, 68(1):215-215
DOI:10.4103/ijo.IJO_1521_19  PMID:31856528
  1,274 220 -
PHOTO ESSAY
Branch retinal artery occlusion – Finding the culprit!
B Poornachandra, Karen Sharma, Neha Peraka Sudhakar, Santosh Gopi Krishna Gadde, Chaitra Jayadev
January 2020, 68(1):196-198
DOI:10.4103/ijo.IJO_1222_19  PMID:31856513
  1,274 216 -
CASE REPORTS
Near full thickness macular hole with an intact overlying internal limiting membrane following resolution of fulminant acquired toxoplasma retinitis -A unique finding
Kalpana Babu, Dhwani Shah, M Bhagya, Krishna R Murthy
January 2020, 68(1):244-246
DOI:10.4103/ijo.IJO_924_19  PMID:31856540
A 43-year-old immunocompetent male presented with focal macular retinitis with overlying vitritis in the right eye. His BCVA was counting fingers close to face. OCT showed increased intraretinal thickness at the area of retinitis with adjacent hypo reflectivity of the choroid. Serology was positive for IgM and IgG antibodies for toxoplasma. He received oral clindamycin 300 mg 4 times/day for 8 weeks. At 6 weeks, his BCVA was CF 2 metres. Fundus showed complete resolution of retinitis with formation of near, full thickness macular hole with intact overlying ILM. A small hyper reflective scar was seen at the base of the macular hole.
  1,345 143 3
Novel ultrawide field fundus fluorescein angiographic findings in a patient of Takayasu arteritis on immunosuppression
Srikanta Kumar Padhy, Rohan Chawla
January 2020, 68(1):238-240
DOI:10.4103/ijo.IJO_455_19  PMID:31856538
A 35-year-old male, a case of Takayasu arteritis on treatment with oral prednisolone and methotrexate, revealed novel ultrawide field fluorescein angiographic features in bilateral eyes. The typical features of delayed arm-retina circulation time, lobulated areas of nonperfusion in choroid, cattle trucking of red blood cells in veins, and delayed arteriovenous transit time were nicely captured. Additionally, we noted peripheral perivascular hyperfluorescence and disc hyperfluorescence. We believe these findings could possibly be used as markers of disease activity. Lack of marked capillary nonperfusion areas and marked perivascular leakage probably signifies modulation of disease activity by the immunosuppressants.
  1,307 167 1
COMMENTARIES
Commentary: Low incidence of pachydrusen in central serous chorioretinopathy in an Indian cohort
Jay U Sheth
January 2020, 68(1):124-125
DOI:10.4103/ijo.IJO_1581_19  PMID:31856488
  1,337 132 -
COMMENTARY
Commentary: Optimizing surgical training
Manavi D Sindal, Kanika Chhabra
January 2020, 68(1):82-83
DOI:10.4103/ijo.IJO_1791_19  PMID:31856475
  1,323 143 1
Commentary: Subthreshold micropulse yellow laser in diabetic macular edema
Mayank Bansal
January 2020, 68(1):151-152
DOI:10.4103/ijo.IJO_1543_19  PMID:31856494
  1,278 173 -
PHOTO ESSAY
The “stung” cornea - Retained insect sting on the corneal endothelium
Sujata Das, Sonali Sahoo
January 2020, 68(1):182-182
DOI:10.4103/ijo.IJO_840_19  PMID:31856504
  1,230 220 -
Multicolour imaging in isolated foveal hypoplasia
Ramesh Venkatesh, Kushagra Jain, Naresh Kumar Yadav
January 2020, 68(1):191-192
DOI:10.4103/ijo.IJO_1017_19  PMID:31856510
  1,272 176 2
COMMENTARY
Commentary: Capsule staining and its aftermath
Priya Narang
January 2020, 68(1):71-71
DOI:10.4103/ijo.IJO_1574_19  PMID:31856471
  1,254 192 -
OPHTHALMIC IMAGES
Petaloid cataract
Gaurav Gupta, Jitender Jinagal
January 2020, 68(1):210-210
DOI:10.4103/ijo.IJO_1214_19  PMID:31856523
  1,280 152 -
PHOTO ESSAY
Inflammatory deposits on the foldable intraocular lens
Amravi Shah, Chetan Rao, Krishna Kumar, Ronnie Jacob George, Parthopratim Dutta Majumder
January 2020, 68(1):190-191
DOI:10.4103/ijo.IJO_1359_19  PMID:31856509
  1,237 167 1
LETTERS TO THE EDITOR
Comments on: Using Brückner's test for gross keratometry screening
Mihir Kothari, Shairin Jahan, Meghna Solanki
January 2020, 68(1):262-262
DOI:10.4103/ijo.IJO_1240_19  PMID:31856549
  1,256 143 1
CASE REPORTS
Using corneal graft from keratoconic donor for lamellar and penetrating keratoplasties
George D Kymionis, David Tabibian, Nafsika Voulgari, Filippo Fabro, Michael A Grentzelos
January 2020, 68(1):226-229
DOI:10.4103/ijo.IJO_1118_19  PMID:31856533
We report the use of two corneal grafts derived from a donor, with a history of early stage keratoconus, for lamellar and penetrating keratoplasty. The first graft was used to perform Descemet stripping automated endothelial keratoplasty (DSAEK) in a patient with endothelial dysfunction and advanced pseudoexfoliative glaucoma. The second graft was used for an emergency penetrating keratoplasty in a patient with corneal perforation secondary to uncontrolled herpes keratitis. In the first case, 1 year postoperatively, the graft was clear and attached with no signs of rejection or failure. In the second case, the perforation did not relapse after keratoplasty and the globe retained its structural integrity during the 1-year follow-up.
  1,256 139 3
LETTERS TO THE EDITOR
Comments on: Changes in pattern electroretinogram after application of 0.01% atropine eye drops
Jitendra Jethani, Sonu Memon
January 2020, 68(1):259-261
DOI:10.4103/ijo.IJO_1938_19  PMID:31856547
  1,265 124 4
PHOTO ESSAY
Brown-McLean syndrome revisited
Samrat Chatterjee, Swapnil M Parchand, Debashish Dash, Deepshikha Agrawal
January 2020, 68(1):183-184
DOI:10.4103/ijo.IJO_1124_19  PMID:31856505
  1,211 168 1
COMMENTARY
Commentary: Tackling the corneal foreign body
Abhishek Onkar
January 2020, 68(1):57-58
DOI:10.4103/ijo.IJO_1625_19  PMID:31856467
  1,166 189 1
OPHTHALMIC IMAGES
Precipitation of herpetic stromal keratitis after collagen cross-linking for keratoconus
Sudhakar Potti, Parag Anil Bagad, Nadim Khatib, Akhil Bevara
January 2020, 68(1):207-207
DOI:10.4103/ijo.IJO_1236_19  PMID:31856520
  1,181 172 2
COMMENTARY
Commentary: Corneal endothelial cell changes in diabetics versus age-group matched nondiabetics after manual small incision cataract surgery (SICS)
Parikshit Gogate
January 2020, 68(1):77-77
DOI:10.4103/ijo.IJO_2196_19  PMID:31856473
  1,150 192 1
OPHTHALMIC IMAGES
Evanescent gas-induced reversible lenticular opacity
Harsha Bhattacharjee, Henal Javeri
January 2020, 68(1):208-208
DOI:10.4103/ijo.IJO_789_19  PMID:31856521
  1,224 111 -
PHOTO ESSAY
Role of microscope-integrated optical coherence tomography in detecting myopic choroidal neovascularization intraoperatively in a case of myopic rhegmatogenous retinal detachment
Atul Kumar, Nasiq Hasan, Surbhi Agrawal, Dheepak Sundar
January 2020, 68(1):193-194
DOI:10.4103/ijo.IJO_391_19  PMID:31856511
  1,159 150 -
LETTERS TO THE EDITOR
Response to comments on: Changes in pattern electroretinogram after application of 0.01% atropine eye drops
Mihir Kothari, Deepak Bhat, Nitu Khadse, Rishika Jain, Vivek Rathod
January 2020, 68(1):261-261
DOI:10.4103/ijo.IJO_2086_19  PMID:31856548
  1,157 133 -
OPHTHALMIC IMAGES
Butter like brittle cornea
Kavya Reddy Katta, Arjun Srirampur
January 2020, 68(1):206-206
DOI:10.4103/ijo.IJO_520_19  PMID:31856519
  1,127 158 -
Cilium incarnatum externum
Sushrut S Dongargaonkar, Surendra P Wadgaonkar, Preeti A Patil, Suhas V Dongargaonkar, Vasudha S Dongargaonkar, Sanjay Waghmare
January 2020, 68(1):204-204
DOI:10.4103/ijo.IJO_1437_19  PMID:31856517
  1,119 165 2
COMMENTARY
Commentary: Assessing the lamina cribrosa in idiopathic intracranial hypertension
Padmaja Sudhakar
January 2020, 68(1):168-169
DOI:10.4103/ijo.IJO_1435_19  PMID:31856500
  1,109 173 -
OPHTHALMIC IMAGES
Characterizing supernumerary lacrimal punctum by anterior segment optical coherence tomography imaging
Joyeeta Das, Nibedita Das
January 2020, 68(1):205-205
DOI:10.4103/ijo.IJO_576_19  PMID:31856518
  1,118 163 2
Cystinuria in association with cataract
Prabhakar Singh, Richa Gupta, Abhishek Gupta
January 2020, 68(1):209-209
DOI:10.4103/ijo.IJO_1330_19  PMID:31856522
  1,124 157 1
Starfish cataract
Surbhi Khurana, Parul C Gupta, Jagat Ram
January 2020, 68(1):211-211
DOI:10.4103/ijo.IJO_1717_19  PMID:31856524
  1,107 174 -
COMMENTARY
Commentary: Tick talk: A glimpse into the literature
Parthopratim Dutta Majumder
January 2020, 68(1):104-105
DOI:10.4103/ijo.IJO_1539_19  PMID:31856482
  1,086 162 -
Commentary: Analysis of differentially expressed genes in bacterial and fungal keratitis
Lalitha Prajna
January 2020, 68(1):47-47
DOI:10.4103/ijo.IJO_2180_19  PMID:31856464
  1,093 137 -
COMMENTARIES
Commentary: A novel, standardized, reproducible method to calculate the area of internal limiting membrane peeled intraoperatively in macular hole surgery using a video overlay: A long-term study in cases of idiopathic macular holes
Chitaranjan Mishra, Kim Ramasamy
January 2020, 68(1):163-163
DOI:10.4103/ijo.IJO_1526_19  PMID:31856498
  1,090 136 -
Commentary: To capture or not in pediatric cataract surgery?
Ramesh Kekunnaya
January 2020, 68(1):89-89
DOI:10.4103/ijo.IJO_1561_19  PMID:31856477
  1,007 171 -
Commentary: Pachydrusen: A tell-tale sign of pachychoroid phenotype
Kumar Saurabh, Rupak Roy
January 2020, 68(1):123-123
DOI:10.4103/ijo.IJO_1534_19  PMID:31856487
  984 175 -
Commentary: Comparison of posterior optic capture of intraocular lens without vitrectomy versus endocapsular implantation with anterior vitrectomy in congenital cataract surgery – A randomized prospective study
Lav Kochgaway, Merina Mandal, Sneha Jain, Rupak Roy, Sagar Bhargava, Maneesh Singh
January 2020, 68(1):90-90
DOI:10.4103/ijo.IJO_2157_19  PMID:31856478
  998 154 -
COMMENTARY
Commentary: Internal limiting membrane sparing in necrotizing focal retinitis
Mohit Dogra, Simar Rajan Singh
January 2020, 68(1):246-247
DOI:10.4103/ijo.IJO_2204_19  PMID:31856541
  1,013 129 -
COMMENTARIES
Commentary: Considerations regarding area of internal limiting membrane peeling during macular hole surgery
Atul Kumar, Divya Agarwal
January 2020, 68(1):162-162
DOI:10.4103/ijo.IJO_1607_19  PMID:31856497
  1,035 100 1
LETTERS TO THE EDITOR
Response to comments on: Midterm outcome of mitomycin C augmented trabeculectomy in open angle glaucoma versus angle-closure glaucoma
Devendra Maheshwari, Swathi Kanduri, Mohideen A Kadar, Rengappa Ramakrishnan, Madhavi R Pillai
January 2020, 68(1):268-269
DOI:10.4103/ijo.IJO_1532_19  PMID:31856556
  962 133 1
Response to comments on: Keratoprosthesis optic and carrier corneal graft “noncontact” as a cause of sterile stromal necrosis in a case of Auro KPro implantation
Chintan Malhotra, Deepika Dhingra, Arun K Jain
January 2020, 68(1):267-267
DOI:10.4103/ijo.IJO_1888_19  PMID:31856555
  1,001 91 -
Response to comments on: Clinical profile of uveitis patients developing central serous chorioretinopathy - An experience at a tertiary eye care center in India
Parthopratim Dutta Majumder, Nitin Menia, Sridharan Sudharshan, Chetan Rao, Sudha K Ganesh, Jyotirmay Biswas
January 2020, 68(1):269-270
DOI:10.4103/ijo.IJO_1267_19  PMID:31856557
  929 141 1
Response to comments on: Using Brückner's test for gross keratometry screening
Amber Amar Bhayana
January 2020, 68(1):263-263
DOI:10.4103/ijo.IJO_1611_19  PMID:31856550
  904 129 2
Comments on: Keratoprosthesis optic and carrier corneal graft “noncontact” as a cause of sterile stromal necrosis in a case of Auro KPro implantation
Mona Harissi-Dagher, Yasmin Awad
January 2020, 68(1):266-266
DOI:10.4103/ijo.IJO_1201_19  PMID:31856553
  871 135 1
COMMENTARY
Commentary: Enterobacter endophthalmitis: Clinical settings, susceptibility profile, and management outcomes across two decades
Chitaranjan Mishra, Kim Ramasamy
January 2020, 68(1):116-117
DOI:10.4103/ijo.IJO_1527_19  PMID:31856485
  849 128 -
LETTERS TO THE EDITOR
Comments on: Mid-term outcome of mitomycin C-augmented trabeculectomy in open-angle glaucoma versus angle-closure glaucoma
Vanita Pathak-Ray
January 2020, 68(1):267-268
DOI:10.4103/ijo.IJO_1446_19  PMID:31856554
  818 132 1