"Doughnut" Amniotic Membrane Transplantation With Penetrating Keratoplasty for Vernal Keratoconjunctivitis With Limbal Stem Cell Disease.

Purpose: Severe vernal keratoconjunctivitis (VKC) can cause ocular surface disease including partial or complete limbal stem cell deficiency (LSCD), especially in early-onset and severe limbal form of VKC. We report a novel technique of doughnut amniotic membrane transplantation (AMT) along with penetrating keratoplasty (PK) for management of partial LSCD and corneal scarring in a case of severe VKC.

Methods: Case report.

Determination of Oxidative Stress Markers in the Aqueous Humor and Corneal Tissues of Patients With Congenital Hereditary Endothelial Dystrophy.

Purpose: The aim of this study is to determine the presence of oxidative stress markers in the aqueous humor (AH) and corneal tissues of patients with congenital hereditary endothelial dystrophy (CHED).

Methods: Interventional prospective study was undertaken to quantify levels of ascorbic acid and glutathione in the AH of patients with CHED. AH was collected from patients undergoing keratoplasty and levels of ascorbic acid and glutathione were determined using biochemical assays and measured spectrophotometrically.

Successful Outcome of Simultaneous Allogeneic Simple Limbal Epithelial Transplantation With Therapeutic Penetrating Keratoplasty (PKP) for Limbal Stem Cell Deficiency and Sterile Keratolysis After Chemical Injury.

Purpose: To describe the successful outcome of simultaneous allogeneic simple limbal epithelial transplantation (SLET) combined with therapeutic penetrating keratoplasty (PKP) for limbal stem cell deficiency (LSCD) with sterile keratolysis after bilateral chemical injury.

Methods: A 37-year-old man presented with total LSCD and sterile keratolysis with perforation in the left eye after amniotic membrane transplantation for bilateral chemical injury before 3 months. The right eye had a stable ocular surface, absence of palisades of Vogt, and minimal anterior stromal scarring.

Oral mucous membrane grafts for total symblepharon and lid margin keratinisation post Stevens-Johnson syndrome.

A female patient in her late 40s presented with severe visual impairment and a history of oral ulcers, necrolysis of skin and hospitalisation after using gabapentin for neck pain 10 months ago. She was a diagnosed case of Stevens-Johnson syndrome (SJS) with chronic ocular sequelae-with total symblepharon and keratinised lid margins in the left eye and limbal stem cell deficiency and severe dryness in the right eye. Her visual acuity was perception of light in both eyes.

Extraocular spread following evisceration for rapidly progressive intraocular tuberculosis.

We describe a case of right eye tubercular (TB) panuveitis with corneal involvement where repeated intraocular sampling was unsuccessful. Finally, evisceration and histopathology of ocular tissue confirmed the diagnosis of ocular tuberculosis. A chest X-ray showed signs of pulmonary TB.

Chronic cicatrizing conjunctivitis: A review of the differential diagnosis and an algorithmic approach to management.

Cicatrizing conjunctivitis constitutes a group of chronic local and systemic disorders that cause conjunctival scarring. A systematic approach is required to sift through the clinical history, examination, and laboratory investigations of patients to arrive at the correct diagnosis of the underlying cause. Establishing the etiology is critical, as the therapeutic approach changes based on the cause of conjunctival inflammation.

Cataract Surgery in Dry Eye Disease: Visual Outcomes and Complications.

To describe the visual outcomes and complications following cataract surgery in dry eye disease (DED). This retrospective study included 668 eyes of 399 patients with DED, who underwent cataract surgery between 2011 and 2019 at our multi-tier ophthalmology hospital network. Based on etiology, they were divided into three groups: cicatrizing conjunctivitis (CC), meibomian gland dysfunction (MGD), and Sjogren's syndrome (SS).

Outcomes of Penetrating and Lamellar Corneal Patch Grafts.

Purpose: To report the indications, long-term structural and functional outcomes, and prognostic factors for the success of penetrating and lamellar corneal patch grafts.

Methods: This is a retrospective analysis of 49 patients who underwent the corneal patch graft procedure over 8 years. The baseline, preoperative, and postoperative characteristics along with their outcomes were evaluated.

Minor salivary gland transplantation for severe dry eye disease due to cicatrising conjunctivitis: multicentre long-term outcomes of a modified technique.

Aim: To report the clinical outcomes of autologous minor salivary gland transplantation (MSGT) for the treatment of severe dry eye disease caused by cicatrising conjunctivitis.

Methods: This was a retrospective case series of patients undergoing MSGT at four different centres from 2016 to 2018. The technical modifications included en bloc harvesting of a 20 mm×15 mm mucosa-gland-muscle complex and fixation of the glands to the superior bulbar surface anchored to the superior rectus muscle.

Femtosecond laser-assisted big bubble for deep anterior lamellar keratoplasty.

Purpose: To assess the utility of a femtosecond laser-assisted stromal channel to assist the creation of a big bubble (BB) for deep anterior lamellar keratoplasty (DALK) surgery in cadaveric corneas.

Setting: L V Prasad Eye Institute, Hyderabad, India.

Design: Experimental study.

Palpebral lobe of the human lacrimal gland: morphometric analysis in normal versus dry eyes.

Aim: To study the morphological features of the palpebral lobe of the main lacrimal gland in normal and dry eyes.

Methods: This cross-sectional study included 25 healthy subjects and 83 patients with dry eye disease (DED). The aetiological groups of DED were cicatrising conjunctivitis (CC, n=35), evaporative dry eyes (EDE, n=25) and Sjogren's syndrome (SS, n=23).

Rituximab therapy combined with methotrexate for severe necrotizing scleritis in a case of granulomatosis with polyangiitis.

A 19-year-old girl presented with severe pain and redness in her right eye and also with nasal congestion and epistaxis since the past 5 months. The patient was systemically investigated and tested positive for proteinase 3 anti-neutrophil cytoplasmic antibody (PR-3 ANCA) with raised erythrocyte sedimentation rate (ESR). The provisional diagnosis of granulomatosis with polyangiitis (GPA) was made, and she was started on systemic steroids and azathioprine after consultation with the rheumatologist.

Scleritis: Differentiating infectious from non-infectious entities.

Scleritis is a rare painful ocular disorder, associated with severe ocular pain and tissue destruction. Although a majority of these cases are immune mediated and at least half of these are associated with systemic immune-mediated diseases, a smaller minority are due to infections of the sclera. The two conditions closely mimic each other, and a thorough knowledge of the subtle differences is necessary in order to reach a timely diagnosis.

Dry eye disease in children and adolescents in India.

Purpose: To describe the etiological causes and clinical profile of dry eye disease (DED) among children and adolescents seeking eye care in India.

Methods: This was a cross-sectional study of 1023 new patients (≤21 years of age) diagnosed with DED presenting between 2010 and 2018 to a multi-tier ophthalmology hospital network. Children and adolescents with both symptoms and signs of dry eyes were considered as subjects.

Allergic conjunctivitis in children: current understanding and future perspectives.

Purpose Of Review: The rising global burden of allergic diseases, particularly in the pediatric population, is of serious concern. Ocular allergy is one of the most common ocular pathologies met in clinical practice. A large proportion of children and adolescents suffer from allergic eye diseases (AEDs), which affect their quality of life.

A reliable animal model of corneal stromal opacity: Development and validation using in vivo imaging.

Purpose: To validate an animal model of corneal stromal opacity by using objective vision-independent in vivo imaging metrics.

Methods: This was a prospective study, with two arms: (i) observational human arm which included 14 patients with healed unilateral ulcerative keratitis; and (ii) experimental rabbit arm, which included 6 New Zealand white rabbits. A 3-mm central wound was created in the left eye of the rabbits by manually removing 200-250 μm of the superficial stroma, followed by rotating-burr application.

Toll-like receptor gene polymorphisms in patients with keratitis.

Objective: To investigate differences in SNPs in TLR genes between people who had keratitis and controls in an Indian population.

Methods: 145 cases of keratitis and 189 matched controls were recruited. DNA was extracted from peripheral blood.

A randomized masked pilot clinical trial to compare the efficacy of topical 1% voriconazole ophthalmic solution as monotherapy with combination therapy of topical 0.02% polyhexamethylene biguanide and 0.02% chlorhexidine in the treatment of Acanthamoeba keratitis.

Purpose: To compare the efficacy of topical voriconazole 1% and the combination therapy of 0.02% polyhexamethylene biguanide (PHMB) and 0.02% chlorhexidine for the treatment of Acanthamoeba keratitis (AK).

Endophthalmitis with opaque cornea managed with primary endoscopic vitrectomy and secondary keratoplasty: Presentations and outcomes.

Purpose: To describe the outcomes of endophthalmitis with opaque cornea managed with primary endoscopic vitrectomy and secondary keratoplasty.

Methods: Retrospective consecutive interventional case series. All cases of endophthalmitis with opaque cornea which underwent endoscopic vitrectomy followed by secondary keratoplasty were analyzed.

Lid-Related Keratopathy in Stevens-Johnson Syndrome: Natural Course and Impact of Therapeutic Interventions in Children and Adults.

Purpose: To compare the long-term visual outcomes of different management strategies in children and adults with Stevens-Johnson Syndrome (SJS)-induced chronic lid-related keratopathy.

Design: Retrospective comparative case series.

Methods: This study included 705 eyes of 401 patients (81 children and 320 adults) with SJS who presented with chronic lid-related keratopathy between 1990 and 2015.