Publications by authors named "Ravilla D Ravindran"
Background/aims: To propose an approach to determine the target ratio of cataract surgical rates (CSRs) of female to male subpopulations to increase sex parity in cataract surgical coverage (CSC), based on the sex gap in cataract burden and incidence, and demonstrate its application to Theni district, India.
Methods: A population-based longitudinal study between January 2016 and April 2018. We recruited 24 327 participants using random cluster sampling.
Purpose: To examine the difference in post-operative visual outcomes of cataract surgeries between a tertiary and secondary centre at Aravind Eye Hospitals in Tamil Nadu, India.
Methods: Our retrospective cross-sectional study analysed cataract surgeries at a secondary centre and its associated tertiary centre in 2021. Our main outcome measures were postoperative best corrected visual acuity (BCVA), spherical equivalent, and intraoperative and postoperative complications.
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.
Embracing technology in cataract surgical training - The way forward.
Indian J Ophthalmol
November 2022
While ophthalmology as a surgical branch itself has evolved technologically with newer instruments, techniques and procedures; ophthalmic surgical training appears to have stagnated in terms of how it is delivered and how trainees' learning and performance are assessed. This collaborative editorial attempts to identify the lacunae in ophthalmic residency training and highlight how technological tools such as surgical simulators can be incorporated into ophthalmic training even in limited-resource settings with good results.
View Article and Find Full Text PDFPurpose: To determine whether exposure to unclean cooking fuels was associated with subsequent cataract progression as reported in previous cross-sectional studies.
Design: Prospective cohort study.
Methods: This is a secondary observational analysis of the community-based Antioxidants in Prevention of Cataracts trial (ClinicalTrials.
Purpose: To determine whether four new operating room (OR) protocols instituted because of COVID-19 reduced the cataract surgical postoperative endophthalmitis rate (POE).
Design: Retrospective, sequential, clinical registry study.
Methods: 85 552 sequential patients undergoing cataract surgery at the Aravind Eye Hospitals between 1 January 2020 and 25 March 2020 (56 551 in group 1) and 3 May 2020 and 31 August 2020 (29 011 in group 2).
Purpose: The occurrence of relative afferent pupillary defect (RAPD) secondary to optic nerve diseases and widespread retinal disorders is well established. However, only very few reports of RAPD in macular disorders exist in the literature. In this study, we used automated pupillometer to evaluate RAPD in eyes with macular lesions.
View Article and Find Full Text PDFPurpose: Health care workers are at higher risk of acquiring the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This study aims to understand the seroprevalence of anti-SARS-CoV-2 IgG antibody among the eye care workers in South India.
Methods: The participants included eye care workers from the nine eye care centres.
Article Synopsis
- - The study aims to identify hand position archetypes used by experienced surgeons during manual small incision cataract surgery (MSICS) to create a standardized language and techniques for teaching.
- - Experienced surgeons performed specific MSICS steps in a lab, while their hand movements were recorded through images and videos to establish common hand position archetypes.
- - The findings highlighted key hand positions for each surgical step and suggested that formalizing these positions could enhance trainee learning, influence instrument design, and potentially improve surgical results.
Objective: It is important that ophthalmology residency programs are structured to provide opportunities for all residents to gain adequate surgical experience. The aim of this study is to examine differences between female and male residents in number of cataract surgeries performed, surgical outcomes, and rate of learning, and to draw implications for the training of ophthalmology residents.
Design: In this hospital-based retrospective cohort study we examined the cumulative number of surgeries performed, and the intraoperative complications rate, of male and female residents over time.
Nuclear cataract is the most common type of age-related cataract and a leading cause of blindness worldwide. Age-related nuclear cataract is heritable (h = 0.48), but little is known about specific genetic factors underlying this condition.
View Article and Find Full Text PDFPurpose: To report trends in cataract surgery indications, visual acuity outcomes, complication rates and reoperation rates at ten Aravind Eye Hospitals in Tamil Nadu, India.
Methods: In this retrospective database study we analyzed seven years of data of cataract surgeries at Aravind during January 1, 2012 to December 31, 2018. Our main outcome measures were preoperative and 1-month postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA); and rates of intraoperative complications and reoperations.
Purpose: We compared rates of intraocular lens (IOL) decentration, neodymium-doped yttrium aluminum garnet capsulotomy for posterior capsule opacification (PCO), and visual acuity (VA) in eyes with and without pseudoexfoliation (PEX) 5 years after undergoing cataract surgery.
Design: Prospective comparative interventional study.
Methods: This multicenter study population included 1 eye of both 930 cataract patients with and 470 cataract patients without uncomplicated PEX (no small pupils or phacodonesis) all undergoing phacoemulsification by experienced Aravind Eye Care System surgeons.
Purpose: To analyze the posterior capsule rupture (PCR) rates among staff and trainee cataract surgeons, and the postoperative endophthalmitis (POE) rates in uncomplicated and complicated eyes both with and without intracameral moxifloxacin prophylaxis (ICMP).
Setting: Ten regional Aravind Eye Hospitals in India.
Design: Retrospective multicenter clinical registry within a single hospital network.
Purpose: To identify patient characteristics associated with follow-up compliance and to draw implications for better cataract treatment services.
Setting: Aravind Eye Hospital, Madurai, India.
Design: Retrospective case study.
Importance: Studies in high-income countries provide limited evidence from randomized clinical trials on the benefits of teleretinal screening to identify diabetic retinopathy (DR).
Objective: To evaluate the effectiveness of teleretinal-screening hospital referral (TR) compared with universal hospital referral (UR) in people with diabetes.
Design, Setting, And Participants: A cluster randomized clinical trial of 8 diabetes clinics within 10 km from Aravind Eye Hospital (AEH), Madurai, India, was conducted.
Purpose: The primary objective was to assess associations between annual surgeon case volume and visual acuity outcomes after cataract surgery. Secondary objectives included (1) assessing associations between other case and patient characteristics and visual acuity outcomes and (2) assessing associations between annual surgeon case volume and complication rates.
Design: Database study.
Purpose: The relative afferent pupillary defect (RAPD) is an important sign of asymmetrical retinal ganglion cell damage. The purpose of this study was to quantify RAPD by a pupillometer (RAPiDo, Neuroptics) and assess its correlation with asymmetric glaucoma and manual pupillary assessment.
Methods: A total of 173 subjects were enrolled in the study and categorized into glaucoma, n = 130, and control, n = 43.
Background: Cataract is a major health burden in many countries and a significant problem in India. While observational studies show lower cataract risk with increasing dietary or plasma vitamin C, randomised controlled trials of supplements have been negative. Genetic variants in vitamin C transporter proteins (), especially rs33972313, may provide evidence on a causal association of vitamin C with cataract.
View Article and Find Full Text PDFPurpose: To compare intraoperative complication rates, 1-year visual outcomes, and postoperative complication rates over the first postoperative year in eyes with and without pseudoexfoliation undergoing cataract surgery.
Design: Prospective, comparative, interventional study.
Participants: Nine hundred thirty eyes with cataract and uncomplicated pseudoexfoliation (without phacodonesis, clinically shallow anterior chambers, or pupil size <4 mm) and 476 controls with cataract but without pseudoexfoliation recruited from 4 centers of the Aravind Eye Care System in Southern India.
Purpose: The goal of this study was to document the resident learning curve for manual small-incision cataract surgery (MSICS) and to identify implications for the design of ophthalmology residency programs aimed to train surgeons for developing countries.
Design: Hospital-based retrospective cohort study.
Participants: All 38 residents entering 2 postgraduate residency programs at Aravind Eye Hospital, Madurai, in 2012 and 2013.
Purpose: To investigate prevalence and risk factors for myopia, hyperopia and astigmatism in southern India.
Methods: Randomly sampled villages were enumerated to identify people aged ≥40 years. Participants were interviewed for socioeconomic and lifestyle factors and attended a hospital-based ophthalmic examination including visual acuity measurement and objective and subjective measurement of refractive status.