Current paradigms in refractive surgery.

Refractive surgeries have evolved from the archaic incisional corneal procedures to the use of sophisticated femtosecond lasers and new-generation phakic intraocular lenses (pIOL) for surgical correction of refractive errors. The armamentarium of modern-day refractive surgery includes corneal-based procedures such as photorefractive keratectomy, laser-assisted in situ keratomileusis and keratorefractive lenticule extraction, as well as lensbased pIOL implantation. The current procedures are associated with a high index of efficacy and predictability, with enhanced safety and a significant reduction in sight-threatening complications.

Determination of sample size for various study designs in medical research: A practical primer.

Formulating a research question and selecting an appropriate study design for answering that question are crucial initial steps in the research process. The population, intervention, control group, and outcomes measures (PICO time and setting [TS]) framework provides a practical guide in this regard, which stands for population, intervention, control, outcome, type of research question, and study design. The various study designs have their own merits and demerits, and implementing the methodology meticulously requires knowledge of all of these.

Effect of topical brinzolamide on visual function and waveform in patients of infantile nystagmus syndrome: A randomized control trial.

Purpose: To evaluate the effect of topical carbonic anhydrase inhibitor (brinzolamide) versus placebo on visual function and waveforms in infantile nystagmus syndrome (INS).

Design: Prospective, placebo-controlled, double-blind, cross-over study.

Methods: Setting- A tertiary eye care center.

EVALUATION OF PRONE VERSUS SUPINE POSITIONING IN FRESH RHEGMATOGENOUS RETINAL DETACHMENT TREATED WITH PARS PLANA VITRECTOMY AND GAS.

Purpose: To compare Supine versus Prone positioning in fresh rhegmatogenous retinal detachments treated with vitrectomy and gas tamponade.

Methods: This was a prospective randomized controlled trial of 72 eyes with fresh rhegmatogenous retinal detachment that underwent 25-gauge vitrectomy: 37 eyes were allotted supine position and 35 were allotted prone position. Cases were evaluated for single-surgery reattachment rates, best-corrected visual acuity, intraocular pressure, cataract formation, and any complications.

Characterization of retinal hemorrhages delimited by the internal limiting membrane.

Clinically, hemorrhages at the vitreoretinal interface have been termed as 'pre-retinal' in location. However, there is a careful distinction to be made between sub-hyaloid and sub-internal limiting membrane (ILM) planes of blood collection. In the past half-century, a body of literature has accrued on sub-internal limiting membrane hemorrhage.

Gene Therapy for Inherited Retinal Diseases: From Laboratory Bench to Patient Bedside and Beyond.

This comprehensive review provides a thorough examination of inherited retinal diseases (IRDs), encompassing their classification, genetic underpinnings, and the promising landscape of gene therapy trials. IRDs, a diverse group of genetic conditions causing vision loss through photoreceptor cell death, are explored through various angles, including inheritance patterns, gene involvement, and associated systemic disorders. The focal point is gene therapy, which offers hope for halting or even reversing the progression of IRDs.

Ocular manifestations of central insulin resistance.

Central insulin resistance, the diminished cellular sensitivity to insulin in the brain, has been implicated in diabetes mellitus, Alzheimer's disease and other neurological disorders. However, whether and how central insulin resistance plays a role in the eye remains unclear. Here, we performed intracerebroventricular injection of S961, a potent and specific blocker of insulin receptor in adult Wistar rats to test if central insulin resistance leads to pathological changes in ocular structures.

Dexamethasone Intravitreal Implant for the Treatment of Macular Edema and Uveitis: A Comprehensive Narrative Review.

Purpose: The purpose of this review article is to provide a comprehensive review of the current applications of intravitreal DEX implant (Ozurdex, Allergan Inc, Irvine, CA) for a variety of ophthalmic conditions - ranging from FDA approved indications to off-label uses. We have attempted to provide relevant evidence from the literature to help a reader develop an understanding of the biological and pharmacokinetic properties of DEX implant, its uses, and potential side effects.

Methods: PubMed searches were performed using the terms "Ozurdex", or "intravitreal DEX implant", AND "retinal vein occlusion", or "diabetic macular edema", or "uveitis".

Cataract in retinopathy of prematurity - A review.

Preterm babies with retinopathy of prematurity (ROP) can become blind if they do not receive appropriate timely intervention. The presence of cataract in these individuals in addition to visual deprivation amblyopia, also delays proper screening, adequate treatment, and makes follow-up assessment difficult. Anatomical differences in these infants and amblyopia management, especially in unilateral cataract, are other important concerns, and hence, management of these cases with cataract and ROP is challenging.

Effect of short-term meditation training in central serous chorioretinopathy.

Purpose: Stress and Type A personality are established risk factors for the development of central serous chorioretinopathy (CSC). Meditation is known to have a positive effect on reducing stress levels. This study aimed to assess the effect of short-term meditation training in patients of CSC.

Prevalence of myopia and its risk factors in rural school children in North India: the North India myopia rural study (NIM-R Study).

Background: To assess the prevalence of myopia and its risk factors in rural school children.

Methods: Children in classes 4-7 of eight randomly selected schools (five government and three private) in rural Haryana, with unaided vision <6/9.5 were screened, their cycloplegic refraction is done, myopes were identified.

Optical Coherence Tomography Angiography of Early Stage 1a Retinal Hemangioblastoma in Von-Hippel-Lindau.

Von-Hippel-Lindau (VHL) syndrome is characterized by focal vasoproliferative tumors of retinal capillaries called retinal capillary hemangioblastomas (RCH). These tumors are initially small and can be easily missed if not looked for carefully. As they grow, these tumors are more demanding to treat and hence the importance of detecting them early and treating them.

Diagnostic Accuracy of WINROP, CHOP-ROP and ROPScore in Detecting Type 1 Retinopathy of Prematurity.

Background: Algorithms for predicting retinopathy of prematurity (ROP) requiring treatment need to be validated in Indian settings to determine if the burden of screening can be reduced without compromising the sensitivity of existing gestation and weight-based cut offs.

Objective: To evaluate the performance of the available algorithms namely, WINROP (Weight, Insulin-like growth factor I, Neonatal ROP), CHOP-ROP (Children's Hospital of Philadelphia ROP) and ROPScore in predicting type 1 ROP and time from alarm to treatment by each algorithm.

Study Design: Ambispective observational.

Trabeculectomy: is releasable suture trabeculectomy a cause of better bleb?

To compare the outcome of fixed suture trabeculectomy with releasable suture trabeculectomy in terms of IOP control, bleb morphology, complications and need of antiglaucoma medication post-surgery. This study enlisted 200 cases of open angle glaucoma, whose IOP was uncontrolled despite maximal medication. Trabeculectomy was performed using releasable suture in one group of 100 patients and fixed suture in another group of 100 with mitomycin 0.

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.

Neovascular glaucoma - A review.

Neovascular glaucoma (NVG) is a sight-threatening secondary glaucoma characterized by appearance of new vessels over the iris and proliferation of fibrovascular tissue in the anterior chamber angle. Retinal ischemia is the common driving factor and common causes are central retinal vein occlusion, proliferative diabetic retinopathy, and ocular ischemic syndrome. The current rise in the prevalence of NVG is partly related to increase in people with diabetes.

Effect of Mindfulness Meditation on Intraocular Pressure and Trabecular Meshwork Gene Expression: A Randomized Controlled Trial.

Purpose: To evaluate the effect of mindfulness meditation (MM) on intraocular pressure (IOP) and trabecular meshwork (TM) gene expression in patients with medically uncontrolled primary open angle glaucoma (POAG).

Design: Parallel arm, single-masked, randomized controlled trial.

Methods: Sixty POAG patients with IOP ≥21 mm Hg taking maximal topical medication and scheduled for trabeculectomy were included in this study at a tertiary eye care center in India.

Single-port transconjunctival vitrectomy for malignant glaucoma.

The management of malignant glaucoma involves either anterior vitrectomy with zonulectomy and iridectomy or 3-port core pars plana vitrectomy (PPV) by retinal surgeons. The proposed modification can be performed with reasonable success rates. In this technique, synechiolysis and anterior chamber irrigation were performed through a limbal incision, and a single-port 23- or 25-gauge vitrector was introduced through PPV superotemporally to perform anterior vitrectomy and central posterior capsulotomy in pseudophakic eyes.

Study on change in corneal biomechanics and effect of percent tissue altered in myopic laser-assisted keratomileusis.

Purpose: To evaluate corneal biomechanical changes and their correlation with the percentage of tissue altered (PTA) in myopic femtosecond (FS)-flap LASIK.

Methods: Prospective longitudinal observational study of 80 eyes of FS LASIK. Demographic details, LASIK parameters, preoperative and postoperative (day 1, month 1, 3, and 6), UCVA, BCVA, refraction, corneal topography, corneal hysteresis (CH), and a corneal resistance factor (CRF) were noted.

Sinskey hook and viscoelastic assisted posterior capsular plaque extraction.

Posterior capsule plaques (PCPs) are a rare cause of suboptimal vision after eventless cataract surgery. While these can be managed with posterior capsulotomy, violation of the posterior capsular integrity and associated vitreous disturbances may lead to sight-threatening complications. Viscoseparation and peeling of PCPs with the aid of retinal end-grasping forceps and irrigation and aspiration have also been described in adults for getting rid of PCPs with minimal disturbance of PC and vitreous.