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Venugopal A.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology
Cornea | Year: 2016

PURPOSE:: To evaluate outcomes after Auro keratoprosthesis (kpro) implantation. METHODS:: Retrospective observational case series. The records of all patients who were implanted with Auro kpro from December 2012 to August 2015 at a single institute were retrospectively analyzed to evaluate preoperative characteristics, postoperative outcomes, and complications. RESULTS:: Fifteen cases were included in the study. Failed graft was the most common indication for the surgery (n = 14; 93.3%). The mean BCVA (Log MAR) improved from 2.20 ± 0.43 in the preoperative period to 1.46 ± 1.12 (P = 0.0247) at the mean final follow-up of 13.5 months. The best corrected visual acuity (BCVA) improved to 20/200 or better in 9 patients (60%) at the final follow-up. Postoperative complications included retroprosthetic membrane formation (n = 7; 46.7 %), graft infection (n = 4; 26.7%), sterile corneal melt (n = 3; 20%), and spontaneous optic extrusion (n = 1; 6.7%). Eleven patients retained prosthesis at the final follow-up (retention rate = 73.3%). CONCLUSIONS:: Auro kpro seems to be effective in treating end-stage corneal diseases. The outcomes are comparable to Boston kpro in terms of visual acuity, postoperative complications, and retention rates. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source

Nakhwa C.P.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | Sindal M.D.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology
Middle East African Journal of Ophthalmology | Year: 2015

A 50-year-old Indian male presented with defective vision in the right eye for 6 months. He was diagnosed to have idiopathic macular telangiectasia (IMT) type 1 associated with diffuse macular edema and multiple retinal arterial macroaneurysms (RAM). Intravitreal bevacizumab was administered for the treatment of macular edema, following which there was a rupture of a preexisting RAM with multilevel retinal hemorrhages. The hemorrhage gradually resolved over time with foveal thinning noted at last visit. We report this case for the rare occurrence of IMT type 1 and also the possibly associated rupture of RAM post intravitreal bevacizumab injection. Source

Sindal M.D.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | Nakhwa C.D.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology
Oman Journal of Ophthalmology | Year: 2015

The authors report a case of a preterm neonate who presented with lid edema, corneal edema, and an inflammatory membrane with whitish exudates in the pupillary area, suggestive of endophthalmitis. There was also a cutaneous ulcer with an eschar on the right wrist at the site of extravasation associated with previous intravenous catheter. Cultures from the ulcer and vitreous samples both grew Serratia marcescens with identical antibiotic sensitivity and resistance patterns. The ocular infection was rapidly progressive and did not respond to administered medical and surgical therapy leading to subsequent phthisis bulbi. Serratia can cause endophthalmitis refractory to antibiotics and despite aggressive and timely treatment can have an unfavorable outcome. This report aims at highlighting the possibility of metastatic infection from an extravasation injury with a potentially fatal outcome. Source

Ramesh S.,Sri Paramakalyani College | Ramakrishnan R.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | Jayahar Bharathi M.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | Amuthan M.,Sri Paramakalyani College | Viswanathan S.,Sri Paramakalyani College
Indian Journal of Pathology and Microbiology | Year: 2010

Background / Aims: The eye may be infected from external sources or through intra-ocular invasion of micro-organisms carried by the blood stream. This study was undertaken to isolate and identify the specific bacterial pathogens causing ocular infections and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents. Materials and Methods: A retrospective analysis of all patients with clinically diagnosed bacterial ocular infections such as blepharitis, conjunctivitis, internal and external hordeolum, suppurative scleritis, canaliculitis, keratitis, dacryocystitis, preseptal cellulitis, endophthalmitis and panophthalmitis presenting between January 2005 and December 2005 was performed. Extra-ocular and intra-ocular specimens were collected and were subjected to direct microscopy and culture. Results: A total of 756 patients with bacterial ocular infections were analyzed, of which 462(61%) eyes had adnexal bacterial infection, 217(28.7%) had corneal infection, 6 (0.8%) had scleral involvement and the remaining 71(9.39%) eyes had infection of the intra-ocular tissues. The predominant bacterial species isolated was S. aureus (195 of 776; 25%) followed by S. pneumoniae (169 of 776; 21.78%) and coagulase negative staphylococci (142 of 776; 18.3%). The largest number of gram-positive isolates were susceptible to cefazolin (545 of 624; 87.34%), chloramphenicol (522 of 624; 83.65%) and gatifloxacin (511 of 624; 81.89%) and gram-negative isolates were to amikacin (127 of 136; 93.38%), gatifloxacin (125 of 136; 91.91%) and ofloxacin (119 of 136; 87.5%), while aerobic actinomycetes were to amikacin (100%), gatifloxacin (14 of 16; 87.5%), chloramphenicol (14 of 16; 87.5%) and ofloxacin (13 of 16; 81.25%). Conclusions: S. aureus frequently causes infections of eyelids and conjunctiva, S. pneumoniae of lacrimal apparatus and cornea and coagulase negative staphylococci causes intra-ocular infections. Of all routinely used antibacterials tested, flouroquinolones, especially gatifloxacin and ofloxacin represented a good choice for treating bacterial ocular infections. Source

Bharathi M.J.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | Rameshkumar G.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | Ramakrishnan R.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | Venugopal Reddy Y.C.,Aravind Eye Hospital and Postgraduate Institute of Ophthalmology | And 2 more authors.
Current Eye Research | Year: 2013

Purpose: This study is aimed to determine the utility of various polymerase chain reaction (PCR) methods in vitreous fluids (VFs) for detecting the infectious genomes in the diagnosis of infectious endophthalmitis in terms of sensitivity and specificity. Methods: This prospective and consecutive analysis included a total of 66 VFs that were submitted for the microbiological evaluation, which were obtained from 66 clinically diagnosed endophthalmitis patients presented between November 2010 and October 2011 at the tertiary eye care referral centre in South India. Part of the collected VFs were subjected to cultures and smears, and the remaining parts were utilized for five PCR methods: uniplex, nested, semi-nested, multiplex and nested multiplex after extracting DNA, using universal eubacterial and Propionibacterium acnes species-specific primer sets targeting 16S rRNA gene in all bacteria and P. acnes, and panfungal primers, targeting 28S rRNA gene in all fungi. Results: Of the 66 VFs, five (7.5%) showed positive results in smears, 16 (24%) in cultures and 43 (65%) showed positive results in PCRs. Among the 43 positively amplified VFs, 10 (15%) were positive for P. acnes genome, one for panfungal genome and 42 (62%) for eubacterial genome (including 10 P. acnes positives). Among 42 eubacterial-positive VFs, 36 were positive by both uniplex (first round) and multiplex (first round) PCRs, while nested (second round) and nested multiplex (second round) PCRs produced positive results in 42 and 41 VFs, respectively. Of the 43 PCR-positive specimens, 16 (37%) had positive growth (15 bacterial and one fungal) in culture. Of 50 culture-negative specimens, 27 (54%) were showed positive amplification, of which 10 were amplified for both P. acnes and eubacterial genomes and the remaining 17 were for eubacterial genome alone. Conclusions: Nested PCRs are superior than uniplex and multiplex PCR. PCRs proved to be a powerful tool in the diagnosis of endophthalmitis, especially for detecting uncultured microbes. © 2013 Informa UK Ltd All rights reserved. Source

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