Comparative Evaluation of Topical Monotherapy (Natamycin or Natasol) and Combination Therapy (Natamycin and Voriconazole) in Mild-Moderate Fungal Keratitis.

Purpose: To compare the efficacy of monotherapy (natamycin 5% or Natasol 1%) versus combination therapy (natamycin 5% and voriconazole 1%) in the treatment of mild-moderate fungal keratitis.

Methods: In a prospective, comparative, interventional study, 60 eyes of 60 patients with mild-moderate fungal keratitis were included and randomized in 3 groups based on the topical antifungal therapy received: group 1, natamycin 5%; group 2, Natasol 1% (1% w/v aqueous natamycin); and group 3, combination of natamycin 5% and voriconazole 1%.

Results: 51 of 60 cases (85%) resolved with medical management only.

Comparative evaluation of biomechanical changes and aberration profile following accelerated collagen cross-linking using hypo-osmolar and iso-osmolar riboflavin: A prospective study.

Purpose: To compare the changes encountered in corneal biomechanics and aberration profile following accelerated corneal collagen cross-linking (CXL) using hypo-osmolar and iso-osmolar riboflavin in corneal thicknesses of <400 and >400 microns, respectively.

Methods: This is a prospective, interventional, comparative study involving 100 eyes of 75 patients with progressive keratoconus. Eyes were divided into two groups based on corneal thickness: group 1 included eyes with a corneal thickness of <400 microns who underwent hypo-osmolar CXL, and group 2 included eyes with a corneal thickness of >400 microns who underwent iso-osmolar CXL.

Management of acute corneal hydrops - Current perspectives.

Acute corneal hydrops (ACH) is a rare but sight-threatening complication of corneal ectasias. We aim to review the current literature on etiopathogenesis, histology, role of ancillary investigations, management, and outcomes of ACH by classifying the various management strategies based on their site of action and the underlying mechanism. A review of the literature was conducted by searching the following databases: PubMed (United States National Library of Medicine), Embase (Reed Elsevier Properties SA), Web of Science (Thomson Reuters), and Scopus (Elsevier BV) till April 2023.

Connective tissue disorders and eye: A review and recent updates.

Collagen vascular disorders (CVDs), also known as connective tissue diseases (CTDs), are a heterogeneous group of entities that affect the connective tissues and are capable of causing end-organ damage to multiple systems, primarily cardiopulmonary and musculoskeletal. However, the occurrence and severity are highly variable among patients. Ocular involvement occurs in a significant number of these disorders and may precede the onset of other extraocular features, thereby serving as an important marker in the diagnosis of these diseases.

Immunopathogenesis of corneal graft rejection.

The most common cause of corneal graft failure is corneal graft rejection (CGR). Although cornea is one of the immune-privileged sites, it can still get a rejection episode due to a breach in its natural protective mechanism. Both anatomical and structural properties of cornea and anterior chamber contribute toward its immune tolerance.

A review of techniques and outcomes of endothelial keratoplasty in congenital hereditary endothelial dystrophy.

Congenital hereditary endothelial dystrophy affects the Descemet membrane and endothelium, resulting in corneal decompensation. Penetrating keratoplasty (PKP) has been the gold-standard surgical management until recently; however, at present, endothelial keratoplasty (DSEK/DSAEK/n-DSEK: Descemet-stripping or non-Descemet stripping endothelial keratoplasty and DMEK/n-DMEK: Descemet membrane endothelial keratoplasty) is being preferred due to lesser intraoperative and postoperative complications, early visual recovery, and comparable visual outcomes. Endothelial keratoplasty (EK) can be challenging, especially in pediatric eyes with CHED due to smaller eyeballs, shallow anterior chambers, phakic status, and poor intraoperative visibility due to thick and hazy corneas.

A novel low-cost indigenous goggle design for oxygen delivery in oxygen supplemented accelerated corneal collagen cross-linking.

Purpose: Our study aims to describe a novel low-cost indigenous design of goggles for delivery of oxygen during oxygen supplemented accelerated corneal collagen cross-linking (CXL).

Methods: The goggles were prepared by modifying the safety goggles available in personal protective equipment (PPE) kit. The goggle has two side openings covered with plugs.

Premium intraocular lenses in children.

Multifocal and toric intraocular lenses (IOLs) or the so-called premium IOLs are currently widely used in adult patients as a one-step refractive solution following cataract surgery. However, the decision to implant a premium IOL in a pediatric patient involves multiple factors affecting the child's visual development and is associated with several dilemmas and surgical challenges. The purpose of this review is to summarize these factors and analyse the influence of each of them on the visual outcomes following premium IOL implantation.

Hitch suture assisted tuck in Tenon's Patch Graft for management of Corneal Perforations.

Purpose: To describe a novel modification of tuck-in Tenon's patch graft (TPG) using temporary horizontal mattress sutures and fibrin glue to hitch the graft in the management of corneal perforations.

Design: Ambispective interventional case series.

Methods: Modified technique of autologous TPG was used to seal corneal perforations measuring 3-5 mm, using horizontal mattress sutures to hitch the graft in a lamellar pocket, followed by application of fibrin glue.

Long-term Outcomes of Fibrin Glue-Assisted Intrascleral Haptic Fixation of Posterior Chamber Intraocular Lenses in Children.

Objectives: To evaluate the long-term outcomes of intrascleral haptic fixation of posterior chamber intraocular lens (PCIOL) with fibrin glue in children.

Methods: This is a retrospective case study conducted in a tertiary eye institute in North India. A total of 118 eyes of 82 children who underwent glued intrascleral haptic fixation of PCIOLs were retrospectively analyzed.

Management of small perforated corneal ulcers: Training model in mammalian eye to enhance surgical skills of residents.

Purpose: To demonstrate a training technique on the mammalian eye for optimum Cyanoacrylate Tissue adhesive application in cases of perforated corneal ulcers.

Methods: A full-thickness defect simulating a perforation was created on the goat's eye cornea to teach the technique of cyanoacrylate glue application in cases of corneal perforations to novice surgeons.

Results: This training model on the mammalian eye was tested by 10 residents at our centre.

Intrascleral haptic fixation for haptic exposure after Yamane technique.

A 55-year-old patient presented with exposure of both the haptics beyond the conjunctiva of the scleral fixated multipiece intraocular lens (IOL). Two diagonally opposite scleral pockets were created, and the exposed haptics was redirected and repositioned aseptically into these pockets to facilitate intrascleral fixation. Herein, we report a simple rescue method for management of exposed haptic after Yamane technique of scleral fixated IOL.

Microscope Integrated Optical Coherence Tomography Guided Descemet Stripping Automated Endothelial Keratoplasty in Congenital Hereditary Endothelial Dystrophy.

Purpose: To describe the outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) in congenital hereditary endothelial dystrophy (CHED) and to evaluate the role of microscope integrated optical coherence tomography (Mi-OCT) during the surgery.

Design: Retrospective data analysis.

Methods: A retrospective study from the medical records of all those patients who were diagnosed with CHED and underwent DSAEK at our centre from 2015 were evaluated.

Posterior Chamber Phakic Intraocular Lens Implantation for Refractive Correction in Corneal Ectatic Disorders: A Review.

Purpose: To summarize the indications and outcomes of posterior chamber phakic intraocular lens (PIOL) implantation in corneal ectasias including keratoconus, pellucid marginal degeneration (PMD), post-refractive surgery, and post-keratoplasty ectasias.

Methods: A review of the literature was conducted using the relevant keywords from various databases up to August 15, 2020. All pertinent studies were reviewed, and the relevant articles were studied in detail for efficacy, stability, predictability, and safety outcomes.

Animal and cadaver human eyes for residents' surgical training in ophthalmology.

In ophthalmology residency programs surgical training plays a vital role in creating confident and skillful surgeons. As almost all ophthalmic surgery needs microscope training, creating a well-taught environment for hand-eye coordination, ocular tissue handling, and anticipation of complications is essential. Wet lab training with animal or cadaver human eyes offers diverse possibilities.

Novel technique of tetra trephination for elliptical-shaped tectonic patch grafts in peripheral sterile keratolysis.

Purpose: To describe a novel technique of tectonic patch grafts for elliptical-shaped peripheral sterile keratolysis with iris prolapse.

Methods: We performed a full thickness corneo-scleral patch graft in five eyes of five patients with elliptical-shaped peripheral sterile keratolysis with perforation and iris tissue prolapse. In this technique, four disposable trephines with predetermined diameter were employed to fashion both the host and the donor without any free-hand dissection.

Bilateral liquefactive corneal necrosis: a rare and devastating complication of vitamin A deficiency in the adult.

A 34year-old man presented with diminution of vision, pain and whitish opacity in both eyes (right eye followed by left eye) since 1 week. He is a known case of chronic alcoholic abuse. He had multiple episodes of haemoptysis in the past.