Central lamellar keratoplasty with peripheral intralamellar tuck: a new surgical technique for keratoglobus.

Purpose: To report a new technique of lamellar keratoplasty in a case of keratoglobus.

Methods: A patient with bilateral keratoglobus with maximal thinning in the juxtalimbal periphery underwent a lamellar procedure in the right eye. The visual acuity was 3/60.

Intralamellar autopatch with lamellar keratoplasty for paracentral corneal perforations.

Purpose: To report a new technique of tectonic intralamellar autopatch with lamellar keratoplasty (LK) for paracentral corneal perforations.

Methods: A partial thickness lamellar dissection of the host was undertaken to remove the superficial epithelium and the anterior stroma. A second lamellar dissection began at the periphery to approximately 1 mm away from the perforation to fashion a hinge.

Efficacy of induction chemotherapy in retinoblastoma, alone or combined with other adjuvant modalities.

Background: There are not much data available on the use of newer antimetabolites as an initial treatment modality in retinoblastoma, or their effect on vitreous seedings and de novo foci, especially in the Indian subcontinent.

Methods: To evaluate the efficacy of newer agents as induction chemotherapy, 34 tumors in 22 eyes of 19 children with bilateral retinoblastoma were treated with 2 cycles of carboplatin, etoposide, vincristine, and cyclophosphamide; each cycle was of 1 month duration. The tumor response was evaluated at 2 months and adjuvant salvage modalities (ie, cryotherapy, laser, and/or external beam radiotherapy) were added as needed.

Combined surgery, cryotherapy, and mitomycin-C for recurrent ocular surface squamous neoplasia.

Purpose: To report the outcome of combined excision, cryotherapy, and antimetabolite treatment of recurrent ocular surface squamous neoplasia.

Methods: The patients with recurrent ocular surface squamous neoplasia were treated by excision of lesion, cryotherapy of limbus, and conjunctival margin followed by 0.02% Mitomycin C application at the time of surgery.

Indications for lamellar keratoplasty in India.

Purpose: To study the indications for lamellar keratoplasty (LK) in a tertiary eye care hospital in northern India.

Methods: A retrospective analysis of 71 eyes that had undergone LK between January 1995 and December 1999 was performed. The parameters evaluated included demographic data, the diagnosis at admission, the laterality of involvement, and the graft size.

Prophylactic ondansetron in prevention of postoperative nausea and vomiting following pediatric strabismus surgery: a dose-response study.

Background: This study evaluated the antiemetic effectiveness, dose-response, and clinical usefulness of prophylactic ondansetron in the prevention of postoperative nausea and vomiting (PONV) in children undergoing strabismus repair.

Method: The authors observed 180 children, American Society of Anesthesiologists physical status I or II, 2-12 yr of age, who were undergoing strabismus repair. After induction of anesthesia with halothane and nitrous oxide in oxygen or intravenous thiopental, children received either placebo (saline) or intravenous ondansetron in doses of 25, 50, 75, 100, and 150 /microg/kg (n = 30).

Massive corneal and conjunctival squamous cell carcinoma.

A patient with massive, protuberant squamous cell carcinoma of conjunctiva invading the whole cornea, so as to hang from the surface, was referred with a visual acuity of hand motion near to face. A microscopically-controlled, frozen section guided excision, followed by double-freeze-thaw cryoapplication to the sclera and the edges of the conjunctival bed and lamello-lamellar sclerokeratoplasty, was performed. Three years later the patient's visual acuity was 20/60 with no evidence of recurrence of the lesion.

Comparison of symptomatic and asymptomatic, chronic, primary angle-closure glaucoma, open-angle glaucoma, and controls.

Purpose: To determine the clinical features and anatomic parameters in asymptomatic (creeping) and symptomatic, chronic, primary angle-closure glaucoma (PACG) as compared with open-angle glaucoma (OAG) and with control subjects with normal eyes.

Methods: Forty consecutive patients with each of the following four types of eyes were studied (N = 160): eyes with symptomatic PACG, eyes with asymptomatic PACG, eyes with OAG, and the eyes of age-, sex-, and refraction-matched control subjects. The refractive status, keratometry, pachymetry, corneal diameter, anterior chamber depth, lens thickness, axial length, and relative lens position were noted.

Combined central retinal artery and central retinal vein occlusion following pars plana vitrectomy.

Combined occlusion of the central retinal artery and central retinal vein is an infrequently encountered clinical entity. Although there are reports in the literature of a combined occlusion of the central retinal artery and vein, its occurrence following pars plana vitrectomy has not been described. We report the case of an elderly patient who developed this unusual occurrence following an uneventful pars plana vitrectomy for a posteriorly dislocated IOL.

Mitomycin-C in congenital glaucoma.

Background And Objective: To evaluate the adjunctive use of mitomycin-C (MMC) during trabeculotomy and trabeculectomy for eyes with high-risk congenital glaucoma.

Patients And Methods: A prospective, randomized, double-blind study was performed to compare the effect of a single, 4-minute intraoperative exposure to 0.2 mg/ml (group 1) or 0.

Absence of pericentromeric heterochromatin (9qh-) in a patient with bilateral retinoblastoma.

The polymorphisms of constitutive heterochromatin regions, present on chromosomes 1, 9, 16 and Y, are inherited in a Mendelian fashion. The C-band heteromorphism has been reported to be associated with various types of cancer. Heterochromatin is considered to play a role in protecting genome against the mutagens.

Frosted-iris intraocular lens for traumatic aniridia with cataract.

We describe an eye with traumatic cataract and aniridia in which we implanted a frosted-iris intraocular lens following endocapsular cataract extraction. The lens was well tolerated and the cosmetic result acceptable.

Combined keratoplasty, cataract extraction, and intraocular lens implantation after corneolenticular laceration in children.

Over a period of two years we performed combined penetrating keratoplasty, cataract extraction, and intraocular lens implantation in seven children between the ages of 2 and 12 years old. The interval between trauma and the surgery varied from six weeks to six months (3.5 +/- 1.

The fat pad in dermis fat grafts.

Background: Dermis fat grafts are used in orbital reconstruction in a variety of procedures. However, there have been few controlled studies testing their effectiveness. This is a prospective study on 40 patients.

Topical atropine and timolol therapy in failed retinal detachment surgery.

We conducted a double-blind randomized prospective study to evaluate the efficacy of topical timolol alone and topical timolol and atropine combined in cases of operated failed retinal detachment surgery cases in which no apparent open break explained the surgical failure. In both groups with and without proliferative vitreoretinopathy no statistically significant difference in retinal reattachment was found.

Nd:YAG "sweeping"--an indirect technique for clearing intraocular lens deposits.

Corticosteroid-resistant deposits on the anterior surface of intraocular lenses (IOLs) in 11 patients who had complained of poor vision were "swept" with a Neodymium:YAG laser beam. As contrasted with previous "direct hit" methods, our method is indirect, using a low-power, defocused beam to generate an acoustic shock-wave, which then sweeps the lens surface clear of deposits. The deposits were cleared in all 11 patients, with no damage to the IOL or any other postlaser complications.

Vitreofoveal traction syndrome in the young.

Young patients with sub-optimal visual acuity and no obvious ophthalmic pathology were found to complain of a 'shadow' or decreased brightness, with no metamorphopsia, at the point of regard, suggesting a pathology anterior to the neuroepithelium of the retina. Examination of fourteen such patients with a fundus contact lens revealed a focal vitreo-foveal detachment in eleven patients. Nine patients had a white plaque attached to this detachment, with a corresponding visible loss of superficial retinal tissue in one case.

Critical evaluation of therapeutic keratoplasty in cases of keratomycosis.

Therapeutic keratoplasty was done in 123 neglected cases of fungal ulcers that did not respond to maximal medical therapy. It is recommended that, if the surgery is contemplated, it should be done before the ulcer perforates. A 0.

Congenital ocular fibrosis with musculoskeletal abnormality: a new association.

Two siblings demonstrated an association of congenital ocular fibrosis (COF) syndrome with musculoskeletal abnormalities consisting of generalized muscle wasting, scoliosis, pigeon-chest deformity, bilateral fusion of the ribs in triplets, prominent coccyx, and sacral dimple. While most of the ocular and systemic "associations" hitherto described in the literature might have been coincidental, the coexistence of a generalized musculloskeletal disease with the COF syndrome raises the possibility that the ocular condition may be part of a more widespread disease process affecting the skeletal muscles.

Neodymium:yttrium aluminum garnet laser anterior capsulotomy.

Anterior capsulotomy of the lens capsule is one of the important steps before extracapsular lens extraction. A neodymium:yttrium aluminum garnet laser anterior capsulotomy was done in 144 eyes with immature, mature, and hypermature senile cataracts. This noninvasive technique is a safe and useful way to treat immature cataracts.

Types of posterior capsular breaks and their surgical implications.

We studied the pathogenesis, clinical features, and management of posterior capsular breaks in 28 cataract patients during planned extracapsular cataract extraction and intraocular lens implantation surgery. In the age-related cataract group (17 cases), the posterior capsular breaks were fresh, caused by the irrigation-aspiration cannula. Located in the upper part of the posterior capsule, they had thin margins and tended to enlarge with continued irrigation.

Corneal endothelial changes following pars plana lensectomy.

The corneal endothelial status was studied in 40 eyes of patients with congenital cataract before and 3 months after surgery. Twenty eyes of patients who underwent pars plana lensectomy revealed a mean endothelial cell loss of 8% (SD +/- .76) while the remaining 20 eyes which were operated by needling aspiration had a endothelial cell loss of 10% (SD +/- .