Neurovascular structure-adjacent frozen-section examination robotic-assisted radical prostatectomy: outcomes from 500 consecutive cases in the UK.

The purpose is to report the United Kingdom's largest single-centre experience of robotically assisted laparoscopic radical prostatectomies (RALP), using the neurovascular structure-adjacent frozen-section (NeuroSAFE) technique. We describe the utilisation and outcomes of this technique. This is a retrospective study from 2012 to 2019 on 520 patients undergoing NeuroSAFE RALP at our Institution.

Endocervical Polyp With Florid "Epidermal Metaplasia": Report of a Previously Undescribed Phenomenon.

Endocervical polyps are common benign lesions which rarely result in diagnostic problems, although a variety of alterations occasionally complicate histologic interpretation. We report an unusual, and not previously described, finding of florid "epidermal" metaplasia with keratinization and extensive formation of skin appendages structures (sebaceous and sweat glands and hair follicles) within an endocervical polyp. The features closely resembled an epidermal inclusion cyst.

HLA class II-like antiidiotypic antibodies from highly sensitized patients inhibit T-cell alloresponses.

The purpose of this study is to identify factors in the sera of highly sensitized (HS) patients (pts) that inhibit T-cell alloresponses. An in vitro assay was used to measure HLA class I and class II-like antiidiotypic antibodies (anti-ids). The stimulation index (SI) was used to measure PBL and T-cell responses to alloantigens.

The efficacy of postenucleation saline wash and the effect of different antimicrobial agents on microbial contamination of donor eyes.

Objectives: To evaluate the efficacy of postenucleation saline wash and the effect of different antimicrobial agents on the microbial contamination of donor eyes.

Methods: Two hundred donor eyes were given saline wash and treated with any one of the following 5 randomly selected antimicrobial solutions: 1% povidone-iodine for 3 min, 0.3% gentamycin for 10 min, 0.

Abnormal B-cell regulation in highly sensitized patients with sustained serum levels of antibody to HLA class I antigens.

Background: There are anti-idiotypes in the sera of highly sensitized (HS) patients that stimulate B cells to produce antibody to HLA class I antigens. The purpose of this study is to determine if there is an abnormality in B cell responses to these anti-idiotypes.

Methods: Supernatants from normal and HS B cells exposed to either HLA-like anti-idiotypes or HS sera were tested for IgG and antibody to HLA class I antigens by ELISA and flow beads.

Anti-idiotypic antibodies from highly sensitized patients stimulate B cells to produce anti-HLA antibodies.

Background: Sustained allosensitization increases waiting time for transplantation and increases the risk of rejection. The purpose of this study is to examine the effect of anti-idiotypic antibodies on B-cell responses and to define their role in alloantibody production.

Methods: The Immunoglobulin G (IgG) fraction, or the sera of 19 highly sensitized (HS) patients was absorbed to remove anticlass I antibody and was incubated with B cells.

Therapeutic sclerokeratoplasty versus therapeutic penetrating keratoplasty in refractory corneal ulcers.

Purpose: To assess the efficacy of newer surgical technique of sclerokeratoplasty in cases of refractory corneal ulcers of the cornea and to compare it with therapeutic penetrating keratoplasty.

Methods: A randomized, prospective clinical trial in 20 eyes with refractory corneal ulcers was undertaken. Ten eyes each underwent sclerokeratoplasty (group I) or therapeutic penetrating keratoplasty (group II).

Animal study on the effects of catalin on aftercataract and posterior capsule opacification.

Purpose: To find out the role of Catalin in the prevention of posterior capsular opacification (PCO), we undertook this experimental study in rabbits.

Methods: Twenty rabbits (10 for the Catalin group and 10 for the placebo group) were operated on for extracapsular clear lens extraction in an aseptic environment. In all cases, capsulorrhexis of 8 mm diameter was carried out.

Sclerokeratoplasty versus penetrating keratoplasty in anterior staphyloma.

Background And Objective: To assess the efficacy of the newer surgical technique of sclerokeratoplasty in spherical anterior staphyloma of the cornea and to compare it with total penetrating keratoplasty.

Patients And Methods: A randomized, prospective clinical trial in 20 eyes with acquired spherical anterior staphylomas was undertaken. Ten eyes each underwent sclerokeratoplasty (group 1) or total penetrating keratoplasty (group 2).

Phacofracture versus phacoemulsification in eyes with age-related cataract.

Purpose: To compare manual phacofracture and phacoemulsification techniques.

Setting: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.

STUDY OF TRAUMATIC CATARACT IN OCCUPATIONAL AND ENVIRONMENTAL TRAUMA AND ITS MANAGEMENT.

Sixty cases of traumatic cataract in 5 years due to occupational and environmental hazards were studied to highlight mode of trauma, structural damage; management profile and final visual outcome. Thirty six (60%) cases had mechanical trauma whereas 18 (30%) cases had injuries due to non metalic or organic substances. Industrial accidents were responsible in 25 (41.

Cataract related blindness in India & its social implications.

The prevalence of blindness in India is 14.9 per 1000. Eighty per cent of this blindness is due to cataract alone.

Topical fluconazole therapy of Candida keratitis.

A prospective clinical trial of topical fluconazole solution (2 mg/ml) was undertaken in six consecutive eyes of microbiologically proven Candida keratitis with abscess formation. All eyes responded well to the medical therapy. Average duration required for healing was 22.

Capsulotomy for phacoemulsification in hypermature cataracts.

We describe a modified surgical technique of anterior capsulotomy and phacoemulsification for use in hypermature cataracts. Surgical steps included inferior linear capsulotomy with aspiration of milky cortex, inflation of the capsular sac with viscoelastic, a reverse triangular anterior capsulotomy with Vannas scissors, and in-the-bag bimanual sculpting of the nucleus. An oval 5 mm x 6 mm posterior chamber intraocular lens was used with single horizontal or no-stitch wound closure.

Lack of enhanced T-helper cell function in uremic patients with circulating alloreactive antibodies.

Some uremic patients with a history of blood transfusion, pregnancy, and previous transplantation maintain high levels of alloreactive cytotoxic antibodies in the absence of continuous exogenous allogenic stimuli and are thus considered sensitized to the major histocompatibility proteins. To differentiate into antibody-producing cells, B lymphocytes must interact with T-helper (CD4+) cells. Whether ongoing help from these cells is necessary for the B cells to continue producing cytotoxic alloreactive antibodies in these sensitized uremic patients is unknown.

Pre-existing posterior capsule breaks from perforating ocular injuries.

We analyzed the characteristic features and intraoperative behavior of pre-existing posterior capsule breaks in 12 cases of traumatic cataract caused by perforating ocular trauma. The interval between the occurrence of trauma and cataract surgery ranged from three days to one year. Two distinct types of posterior capsule breaks were found: one had thick, fibrous, opaque margins with associated posterior capsule opacification (type I); the other had thin, transparent margins (type II).

Combined keratoplasty, cataract extraction, and intraocular lens implantation after corneolenticular laceration in children.

Over a period of two years we performed combined penetrating keratoplasty, cataract extraction, and intraocular lens implantation in seven children between the ages of 2 and 12 years old. The interval between trauma and the surgery varied from six weeks to six months (3.5 +/- 1.

Protection of the iris by lamellar dissection of corneal layers. A technique in penetrating keratoplasty.

Adherent leukomatous corneal opacities constitute the bulk of cases undergoing keratoplasty in developing countries. Surgical trauma to the iris resulting in a large iris coloboma, iridodialysis, and bleeding are the imminent intraoperative complications in such cases. We have evolved a technique of lamellar separation of corneal layers and gentle separation of adherent iris after partial trephination in such cases.

Changing patterns of microbial contamination and antimicrobial sensitivity in donor eyes.

Contaminating microbial flora and their in vitro antibiotic sensitivity pattern was determined for 1557 eyes from donor cadavers collected during five years. Positive cultures were obtained in 42.77% of the eyes; bacterial growth was observed in 39.

Nd:YAG "sweeping"--an indirect technique for clearing intraocular lens deposits.

Corticosteroid-resistant deposits on the anterior surface of intraocular lenses (IOLs) in 11 patients who had complained of poor vision were "swept" with a Neodymium:YAG laser beam. As contrasted with previous "direct hit" methods, our method is indirect, using a low-power, defocused beam to generate an acoustic shock-wave, which then sweeps the lens surface clear of deposits. The deposits were cleared in all 11 patients, with no damage to the IOL or any other postlaser complications.

Laboratory diagnosis of keratomycosis: comparative evaluation of direct microscopy and culture results.

In a prospective study, we evaluated the sensitivities of direct microscopy using potassium hydroxide 10% wet-mount preparations and culture for definitive diagnosis of keratomycosis in 171 clinically suspected fungal corneal ulcers. Although cultures were positive in 88 eyes (51.46%), the fungus could be demonstrated by KOH preparation in 94.

Efficacy of cryotherapy in vernal catarrh.

Cryotherapy of the palpebral conjunctiva with oral aspirin has been evaluated in mixed-type active vernal keratoconjunctivitis. The symptoms and signs were recorded on a four-point scale. In 15 patients, we used cryotherapy of the palpebral conjunctiva in 30 eyes (-60 degrees C to -80 degrees C for 30 seconds, repeating the freeze-thaw cycle 2-3 times).

Direct scleral fixation of posterior chamber intraocular lenses using a special needle-holder.

We report a modified technique of direct scleral fixation of a posterior chamber intraocular lens (PC-IOL) using a specially designed intraocular needle-holder. The procedure was carried out in three eyes with posttraumatic subluxated cataracts; one with aphakic bullous keratopathy and with an accidental posterior capsular rent, and one with a superior zonulodialysis. The needle-holder greatly facilitated the procedure, enabling us to place the PC-IOL precisely in the ciliary sulcus with no subsequent decentration.

Management of secondary pupillary membrane in aphakia (YAG discission vs parsplana membranectomy).

Forty aphakic eyes, with secondary pupillary membranes, underwent pars plana membranectomy and YAG laser discission randomly. Visual improvement was similar in both the groups. IOP remained low for a week in pars-plana membranectomy while it transiently increased following YAG laser discission Complications like anterior chamber reaction, corneal edema and CME were more after pars plana membranectomy than in YAG laser discission.