Future of anti-VEGF: biosimilars and biobetters.

The advent of Anti- VEGFs like Lucentis (Ranibizumab), Eylea (Aflibercept) and off-label Avastin (Bevacizumab) have radically improved visual outcomes in patients of neovascular Age Related Macular Degeneration (nARMD), Diabetic Macular Edema (DME) and Retinal Vein Occlusion (RVO). It is a matter of great concern that the US patents for Ranibizumab and Aflibercept expired in 2020 with European patents to expire in 2022 and 2025, respectively. With the expiry of these biologics, Biosimilars can prove to be saviours in the posterior segment pharmacotherapy owing to their cost effectiveness and availability of various options.

Topical vs Peribulbar Anesthesia: Comparison of Anterior Chamber Depth and the Resultant Visual Outcome After Phacoemulsification.

Purpose: To compare anterior chamber depth and postoperative visual outcome in patients undergoing phacoemulsification under topical vs peribulbar anesthesia.

Materials And Methods: Prospective, randomized, comparative observational study.Sample size: 110 eyes with 55 eyes each.

Modified bandage-contact-lens used as a guide-marker for performing continuous-curvilinear-capsulorhexis by a first-year-post-graduate-ophthalmology-resident.

Purpose: To define the use of modified bandage-contact-lens as a guide-marker for performing continuous-curvilinear-capsulorhexis by a first-year-post-graduate-ophthalmology-resident.

Observation: Phacoemulsification has now become the standard cataract surgery in which anterior capsulorhexis is the first and most crucial step. A perfect capsulorhexis is difficult to learn and even more difficult to master with a steep learning curve when performed free-hand especially by a first-year post-graduate ophthalmology-resident.

Topical steroid alone vs a combination with a posterior segment NSAID after Nd-YAG capsulotomy: Is the posterior segment NSAID really necessary?

Purpose: To compare the effect of topical 1% prednisolone acetate and 0.09% bromfenac versus topical 1% prednisolone acetate alone on macular thickness following Nd: YAG laser capsulotomy.

Materials And Methods: About 150 eyes with posterior capsule opacification following were included.

Effect of Uncomplicated Cataract Surgery on Central Macular Thickness in Diabetic and Non-diabetic Subjects.

Purpose: To assess the quantitative changes of macula in diabetic and non-diabetic eyes after uncomplicated cataract surgery.

Methods: In this prospective interventional study being performed in a tertiary healthcare hospital, a total of 660 eyes were divided into two groups. Group 1 included 330 eyes from healthy subjects and group 2 included 330 eyes from well-controlled diabetic subjects with no diabetic retinopathy planned for phacoemulsification with foldable IOL implantation by the same surgeon under similar settings.

Intraoperative capsular marking for toric intraocular lens placement.

Preoperatively, the surgeon instills two drops of 0.5% proparacaine and then marks the 0° and 180° points at the limbus using a Gentian violet marker and 26G needle edge. Intraoperatively, after phacoemulsification and irrigation and aspiration of the cortex are complete, the surgeon inspects the previously marked 0°-180° points on the limbus.

Effect of intravitreal anti-vascular endothelial growth factor on corneal endothelial cell count and central corneal thickness in Indian population.

Purpose: To evaluate the effect of intravitreal anti-VEGF on corneal endothelial cell count and central corneal thickness as well as to compare these in phakic and pseudophakic eyes.

Material And Methods: The study was conducted in 102 eyes selected, as per selection criteria, over a time period of 18 months. At first patient visit, examination included: 1.

BKC and CME: Is benzalkonium chloride hindering our efforts to achieve the desired postoperative visual acuity?

Purpose: To evaluate and compare the change in postoperative central macular thickness in patients receiving benzalkonium chloride (BKC)-preserved and BKC-free medications after uneventful phacoemulsification.

Setting: V.M.

Association of the severity of meibomian gland dysfunction with dyslipidemia in Indian population.

Purpose: To correlate the severity of meibomian gland dysfunction (MGD) with the serum lipoprotein levels.

Methods: The study was conducted as a prospective observational study over a period of 18 months. Ninety patients diagnosed with MGD were enrolled after they gave their informed consent according to the inclusion-exclusion criteria.

Role of trabeculectomy in advanced glaucoma: Whether we stand to consider it a bane or a boon today?

Purpose: To elucidate the role of trabeculectomy in advanced glaucoma.

Materials And Methods: Only patients with primary open-angle glaucoma were selected. All patients who had cup-disc ratio of 0.

Spontaneous levitation of dropped nucleus on first post-operative day.

A 60-year-old male patient presenting with gradual painless progressive diminution of vision was diagnosed with nuclear sclerosis grade III (LOCS). Intra-operatively, there was a nuclear drop into the vitreous cavity. The patient was left aphakic and was deferred for further vitreoretinal procedure the next day.

Suture-guided sulcus implantation of a single-piece foldable acrylic intraocular lens after posterior capsule rupture.

We describe a technique for suture-guided sulcus implantation of a foldable acrylic posterior chamber IOL (PC IOL). A 10-0 monofilament nylon suture is used to control insertion of the PC IOL over the ciliary sulcus and enable safe retrieval if the PC IOL drops during insertion, stabilization, or centration. In this technique, the 10-0 monofilament nylon suture acts as a guy rope to hold onto the PC IOL, enabling the surgeon to inject the IOL into the sulcus, unfold it in the iris plane, dial it in the appropriate meridian, and stabilize it.

Comparative analysis of coaxial phacoemulsification with 2.2- and 2.8-mm clear corneal incisions.

Purpose: To compare the intraoperative efficiency and postoperative visual outcome of coaxial phacoemulsification using 2.2- and 2.8-mm clear corneal incision coaxial phacoemulsification.

Topical 5% 5-fluorouracil in the treatment of multifocal basal cell carcinoma of the face: A novel chemotherapeutic approach.

To determine the safety and efficacy of topical 5-fluorouracil (5-FU) 5% ointment in treatment of non-syndromic multifocal basal cell carcinoma. A 55-year-old male patient, with 8 hours of daily sun exposure, having histologically proven and radiologically non-syndromic, multifocal basal cell carcinoma with involvement of 6 sites on the face, was treated with topical 5-FU 5% ointment twice daily over all sites except the site involving lid margin to prevent corneal toxicity. Left lid lesion underwent wide surgical excision with 5-mm clear margins and reconstruction with nasal septal mucoperichondrium and local skin mobilization.

26-G needle-assisted sutureless glueless intrascleral haptic fixation for secondary ciliary sulcus implantation of three-piece polymethylmethacrylate intraocular lens during penetrating keratoplasty.

After tenotomy adjoining 3 o'clock and 9 o'clock limbus, 3-mm-wide partial-thickness scleral tunnels are created at these two diametrically opposite points 3 mm from the limbus such that they reach up to a distance of 1.5 mm from the limbus. Two sclerotomies are created using 26-G needles on the bed of these partial-thickness scleral tunnels.