Publications by authors named "Madhu Shekhar"
Purpose: To evaluate higher order aberrations (HOA) in different types of posterior capsule opacification (PCO) and analyze its changes fosllowing Nd:YAG laser posterior capsulotomy (LPC).
Settings: Tertiary care ophthalmic hospital.
Design: Prospective, comparative, observational study.
Purpose: To assess the learning curve of MSICS in three different groups of trainees with varying prior MSICS experience. To evaluate the effectiveness of ICO OSCAR for objective assessment of surgical skill transfer.
Methods: Ninety-five MSICS trainees were divided into three groups as 1st year resident, fellow and external trainee.
Purpose: To determine the incidence, risk factors and clinical outcomes in patients with nucleus drop (ND) following phacoemulsification surgery at a tertiary care ophthalmic institute.
Methods: Medical records of patients with ND during phacoemulsification between January'2019 and December'2022 were reviewed retrospectively. Incidence of ND was calculated overall, and according to surgical expertise levels and surgical steps.
Fibrotic cataracts, posterior capsular opacification (PCO), and anterior subcapsular cataracts (ASC) are mainly attributed to the transforming growth factor-β (TGFβ)-induced epithelial-to-mesenchymal transition (EMT) of lens epithelial cells (LECs). Previous investigations from our laboratory have shown the novel role of non-canonical TGFβ signaling in the progression of EMT in LECs. In this study, we have identified YAP as a critical signaling molecule involved in lens fibrosis.
View Article and Find Full Text PDFThe anterior lens epithelium has the ability to differentiate into lens fibres throughout its life. The present study aims to identify and functionally characterize the adult stem cells in the human lens epithelium. Whole mounts of lens epithelium from donor eyes (normal/cataract) were immunostained for SOX2, gap junction protein alpha 1 (GJA1), PAX6, α, β and γ-crystallins, followed by a confocal analysis.
View Article and Find Full Text PDFPurpose: To examine the visual outcomes and risk factors of uveitis cataract eyes after phacoemulsification and manual small-incision cataract surgery (MSICS).
Setting: Tertiary-care eye hospital in southern India.
Design: Retrospective interventional case series.
Purpose: To assess the accuracy of e-Paarvai, an artificial intelligence-based smartphone application (app) that detects and grades cataracts using images taken with a smartphone by comparing with slit lamp-based diagnoses by trained ophthalmologists.
Methods: In this prospective diagnostic study conducted between January and April 2022 at a large tertiary-care eye hospital in South India, two screeners were trained to use the app. Patients aged >40 years and with a best-corrected visual acuity <20/40 were recruited for the study.
Purpose: To compare the slit-lamp method and wavefront aberrometry method based on outcomes of toric realignment surgeries.
Settings: Tertiary care ophthalmic hospital.
Design: Retrospective study.
Article Synopsis
- This study evaluated the outcomes of manual small incision cataract surgery (MSICS) on 286 patients who had cataracts complicated by corneal opacity at a tertiary care eye hospital.
- It found that nebular corneal opacity was the most common type, often resulting from trauma or infection, and the intra-operative complication rate was 4.89%.
- The surgery significantly improved patients' vision, with median logMAR vision enhancing from 1.08 pre-operatively to 0.3 post-operatively, indicating that MSICS is an effective alternative for these cases.
Purpose: To study the effect of prophylactic intracameral moxifloxacin (ICM) on microbiological profile and antimicrobial sensitivity of culture-proven postoperative endophthalmitis (POE).
Methods: This study evaluated culture-proven POE diagnosed within 6 weeks of cataract surgery over two periods, period-1 (January 2010-March 2015) and period-2 (April 2015-December 2019), before and after introduction of prophylactic ICM, respectively.
Results: In period-1, 100 cases of culture-positive POE were reported (1 in 4879, 0.
Purpose: To describe the surgical technique of intraocular lens (IOL) scaffolding in hypermature/Morgagnian cataract in manual small-incision cataract surgery (MSICS).
Setting: Charitable section of the hospital through direct availed services at free/subsidized cost.
Design: Interventional study.
Purpose: To compare the clinical outcomes of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification (CP) in terms of refractive outcomes, cumulative dissipated energy, and intraoperative complications.
Methods: In this retrospective study performed in a tertiary care ophthalmic hospital, we reviewed 2124 eyes that underwent FLACS or CP. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), cumulative dissipated energy (CDE), and intraoperative complications were analyzed in the study.
Purpose: The purpose of this study was to evaluate trainee performance across six modules of a virtual reality (VR) simulator.
Methods: A retrospective observational study was conducted on 10 manual small-incision cataract surgery (MSICS) trainees who practiced cataract surgery on an MSICS VR simulator for one month. They were assessed in six major steps which included scleral groove, tunnel dissection, keratome entry, capsulorhexis, nucleus delivery, and intraocular lens (IOL) insertion under a trainer's supervision.
Purpose: To report the outcomes of cataract surgery in patients with Human Immunodeficiency Virus (HIV) infection. Setting Tertiary care ophthalmic hospital DESIGN: Retrospective study METHODS: This study included all eyes of patients with known HIV infection undergoing cataract surgery with a minimum follow-up of 6 months between January 2017 and December 2020. Patients who underwent combined surgeries and pediatric patients were excluded from analysis.
View Article and Find Full Text PDF"Stay Back Technique" of scleral fixation of decentred intraocular lensbag complex.
Indian J Ophthalmol
July 2022
Background: Even though rare, posterior chamber intraocular lens (IOL)-bag complex dislocation is a serious complication following cataract surgery. Preoperative trauma or zonular weakness, capsule contraction syndrome, and surgical or postoperative trauma to the zonules have been proposed as the causative mechanism. Various risk factors have been described such as pseudoexfoliation (PXF), aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, and connective tissue disorders, among which PXF is the most common risk factor.
View Article and Find Full Text PDFPurpose: To study the intraoperative complications and postoperative clinical outcomes in different types of posterior polar cataract (PPC) following phacoemulsification, based on morphological classification.
Methods: All consecutive patients with PPC who underwent phacoemulsification during the study period from 2016 to 2019 were included and sub-grouped based on the morphological characteristics according to Daljit Singh's classification. Intraoperative complications such as posterior capsular rupture (PCR), vitreous loss, nucleus drop, and Postoperative best-corrected visual acuity (BCVA) at day 1 and day 30 were documented.
Purpose: To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic.
Methods: This was a prospective, cross-sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID-19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed.
Purpose: To study the risk factors, clinical features, management, and outcomes of intraoperative expulsive choroidal hemorrhage (ECH) during cataract surgery.
Setting: Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Design: Retrospective hospital-based study.
Background: Iris root is the thinnest and weakest portion of the iris stroma. It can detach easily due to blunt trauma or accidental engagement of the iris during intraocular surgery resulting in glare, photophobia and monocular diplopia. Multiple techniques described for iridodialysis repair such as hang back technique, stroke and dock technique and sewing machine technique are technically challenging.
View Article and Find Full Text PDFBackground: Cataract surgeries are challenging in colobomatous eyes as they are associated with features such as microphthalmia, microcornea, zonular deficit, etc. These factors predispose to capsulorhexis extension, posterior capsular rent, zonular dialysis and result in unfavourable visual outcomes. The most critical step of cataract surgery in such cases is the capsulorhexis as the chances of extension are high in the colobomatous area.
View Article and Find Full Text PDFPurpose: To evaluate a system that objectively assesses the risk of cataract surgery complications performed with phacoemulsification and manual small incision cataract surgery (MSICS) techniques.
Methods: The study was a retrospective comparative interventional case series. Electronic medical records of consecutive eyes that underwent cataract surgery from January 2019 to December 2019 were evaluated.
Purpose: To evaluate outcomes of manual small-incision cataract surgery (MSICS) and phacoemulsification in eyes with chorioretinal coloboma.
Setting: Tertiary eye center, South India.
Design: Retrospective study.
Article Synopsis
- The study aimed to compare the safety and effectiveness of the Active Sentry handpiece versus the Ozil handpiece for cataract surgery using the Centurion phacoemulsification system in a South Indian eye center.
- A total of 204 patients with uncomplicated cataracts were randomly assigned to undergo surgery with either handpiece, evaluating factors like patient pain, surgeon comfort, energy use, and postoperative outcomes.
- Results showed no significant differences in patient pain, visual acuity, or corneal edema between the two groups, but surgeons preferred the Ozil handpiece for certain tasks; however, the Active Sentry operated at lower intraocular pressure levels, indicating it was equally safe and effective.