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Goel R.,Gurunanak Eye Center | Apoorva A.G.,Gurunanak Eye Center | Jain S.,Gurunanak Eye Center | Malik K.P.S.,Subharti Medical College | And 2 more authors.
Open Ophthalmology Journal | Year: 2014

Silicon rods are widely employed for frontalis sling suspension. However, on passing through the tissues, at times, the silicon rod gets detached from the stainless steel needle. This occurs more commonly in patients of blepharophimosis syndrome, in which hypoplasia of superior orbital rim with deficiency of skin between lid and brow, causes difficulty in passage of the needle when it is manipulated upwards from lid towards the brow. To overcome these problems we describe the use of an 18 G intravenous catheter to railroad the needle with the silicon rod, obviating the blind upward maneuvers with the needle and protecting against the damage to the silicon rod -needle assembly. The technique is easily reproducible, safe and can be used in all silicon rod suspensions. © Goel et al.; Licensee Bentham Open.

Goel R.,Gurunanak Eye Center | Jain S.,Gurunanak Eye Center | Malik K.,Subharti Medical College | Nagpal S.,Shri Banarsidas Chandiwala | And 3 more authors.
Expert Review of Ophthalmology | Year: 2015

Many oculoplastic conditions like ectropion, entropion, ptosis, lid lacerations, canalicular trauma and dacryocystitis are commonly seen in everyday practice of any ophthalmologist. Delay in treatment of entropion and ectropion can lead to blindness due to development of secondary changes in cornea. Neglecting a child with severe ptosis can result in irreversible visual loss. Incorrect primary repair of lacerated lid and failure to repair the torn canaliculi are difficult to handle at a later stage even by an expert surgeon. Long-standing blocked distal lacrimal passages may result in suppurative infections with skin excoriation. This review elucidates the correct approach to some common oculoplastic diseases so as to achieve a timely intervention and referral and thereby avoid preventable complications. © 2015 Informa UK Ltd.

Goel R.,Gurunanak Eye Center | Garg S.,Gurunanak Eye Center | Nagpal S.,Gurunanak Eye Center | Kumar S.,Gurunanak Eye Center | Kamal S.,Gurunanak Eye Center
Saudi Journal of Ophthalmology | Year: 2014

We report a case of naso-cutaneous fistula due to thermal injury during transcanalicular laser dacryocystorhinostomy followed by superadded infection with coagulase negative staphylococcus in a diabetic patient. The case highlights the importance of meticulous wound care in the management and possibility of its occurrence even with minor thermal injury in immunocompromised patients. © 2013 Saudi Ophthalmological Society, King Saud University.

Goel R.,Gurunanak Eye Center | Nagpal S.,Gurunanak Eye Center | Kumar S.,Gurunanak Eye Center | Kamal S.,Gurunanak Eye Center | And 2 more authors.
International Ophthalmology | Year: 2015

The purpose of this study is to study the operative difficulties and success rate of transcanalicular laser-assisted endoscopic dacryocystorhinostomy in patients of chronic dacryocystitis with deviated nasal septum (DNS). A prospective interventional clinical study of 36 consecutive patients suffering from chronic dacryocystitis with nasolacrimal duct obstruction with DNS undergoing primary TCLADCR from March to June 2011 was carried out. Diode laser was used to create a 16-mm2 ostium which was enlarged to 64 mm2 using Blakesley’s forceps. Success was defined as anatomical patency and absence of symptoms at 12 months of follow-up. Out of the 36 patients, 25 were females with ages 20–72 years, and 19 were left sided. There were 12 high, 12 mid and 12 basal DNS towards the side of surgery, mild to moderate in severity. Intraoperatively there was difficulty in visualising the aiming beam in the nose, tedious manipulation of endoscope and excessive bleeding in 3 patients. Increased bleeding and failures were significantly higher in high DNS (Fisher exact test—2 tailed: 0.0045). The procedure was successful in 94.4 % cases with average ostium size of 21.94 mm2 at 12 months and no statistically significant difference in success rates between mild and moderate DNS (Fisher exact test—2 tailed: 1.000). Also there was no difference in the complication rate between mild and moderate DNS (Fisher exact test—2 tailed: 0.0841). TCLADCR is an effective procedure in patients with mild to moderate mid and basal DNS and obviates the need for multiple procedures and a cutaneous scar. © 2015, Springer Science+Business Media Dordrecht.

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