Post Graduate Institute of Ophthalmology

Lal Bahadur Nagar, India

Post Graduate Institute of Ophthalmology

Lal Bahadur Nagar, India

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PubMed | St Marys NHS Foundation Trust, University of Tübingen, Post Graduate Institute of Ophthalmology, Imperial College London and 3 more.
Type: | Journal: Tuberculosis (Edinburgh, Scotland) | Year: 2016

Tuberculosis and sarcoidosis are chronic systemic diseases that have similar pulmonary and extra-pulmonary manifestations. Multiple studies have found an epidemiological, molecular, and immunological link between the two. It has been suggested that mycobacterium tuberculosis could be a common pathophysiologic mechanism for tuberculosis and sarcoidosis, and that both clinical entities can trigger similar immunological response in patients. Due to this close association, together with possible coexistence in the same patient, the diagnosis of one disease from another may be difficult. In our paper, we suggest that tuberculosis and sarcoidosis are two ends of the same spectrum. Given the pathophysiological and clinical link between the two, we also propose a classification system for tuberculosis and sarcoidosis: Sarcoidosis (S); Sarcoid-Tuberculous (ST); Tuberculous Sarcoid (TS) and Tuberculosis (TB). More research and clinical trials should first be done to affirm the link between the two disease entities.


Sengupta S.,Aravind Eye Hospital | Sengupta S.,Post Graduate Institute of Ophthalmology | Venkatesh R.,Aravind Eye Hospital | Venkatesh R.,Post Graduate Institute of Ophthalmology | And 2 more authors.
Journal of Glaucoma | Year: 2012

PURPOSE: To analyze the safety and efficacy of bevacizumab (1.25 mg/0.05 mL) versus 0.03% mitomycin C (MMC) for preventing bleb failure in patients undergoing single-site phacotrabeculectomy for primary open-angle glaucoma or chronic angle-closure glaucoma. MATERIALS AND METHODS: Thirty-eight consecutive patients with visually significant cataract and coexistent primary open-angle glaucoma or chronic angle-closure glaucoma were randomized into 3 groups. One group received conventional 0.03% MMC (n=13); the second group received 3 subconjunctival injections of bevacizumab (1.25 mg in 0.05 mL) (n=13); and the third group received bevacizumab soaked in sponges (1.25 mg in 0.05 mL) (n=12) intraoperatively on the sclera. Patients were followed up for 6 months. The primary outcome measure was treatment success and bleb morphology in the study eye at 6-month follow-up. RESULTS: All 3 groups showed significant reduction in mean intraocular pressure at 1 week after treatment, which was maintained at 6 months. However, the subconjunctival bevacizumab group had 90% patients with complete success as opposed to 60% in each of the other 2 groups (P=0.04). In both bevacizumab groups, bleb vascularity increased progressively over the 6-month follow-up. One patient in the subconjunctival bevacizumab group showed a local conjunctival necrosis. CONCLUSION: In this pilot study with a small number of subjects, short-term outcomes suggest that subconjunctival bevacizumab is equally effective in reducing intraocular pressure with a better safety profile compared with MMC in the dosing schedule studied. However, bevacizumab soaked in a sponge appears to have no advantages over MMC. Subconjunctival bevacizumab may be a useful agent for improving success and for limiting scar tissue after phacotrabeculectomy. Copyright © 2012 by Lippincott Williams & Wilkins.


Yadav N.,Post Graduate Institute of Ophthalmology | Kemmanu V.,Post Graduate Institute of Ophthalmology | Bhargava M.,Post Graduate Institute of Ophthalmology | Shetty B.,Post Graduate Institute of Ophthalmology
Indian Journal of Ophthalmology | Year: 2012

Scleral fixated intraocular lens (SFIOL) is a safe and effective option for managing optical aphakia. Suture related complications like suture erosion, suture breakage, endophthalmitis, etc. are unique to SFIOL. The knots can be covered by partial thickness flaps or they can be rotated into scleral tissues without flaps to reduce the complications. We performed a recently described novel technique which obviates the need for knot and scleral flaps in securing the SFIOL. This novel 2-point Ab externo knotless technique may reduce the knot related problems. Twenty-three eyes undergoing this knotless SFIOL procedure were analyzed for intraoperative and postoperative complications. Twenty-two eyes either maintained or improved on their preoperative vision. All patients had a minimum follow-up of 24 months.


Kurian M.,Post Graduate Institute of Ophthalmology | Nagappa S.,Post Graduate Institute of Ophthalmology | Bhagali R.,Post Graduate Institute of Ophthalmology | Shetty R.,Post Graduate Institute of Ophthalmology | Shetty B.K.,Post Graduate Institute of Ophthalmology
Journal of Cataract and Refractive Surgery | Year: 2012

Purpose: To quantify image-quality characteristics after correction of refractive error with a posterior chamber phakic intraocular lens (PC pIOL) in eyes with stable or stabilized keratoconus. Setting: Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India. Design: Case series. Methods: Eyes with stable or stabilized keratoconus that had V4 Visian PC pIOL implantation for correction of refractive error were evaluated postoperatively for visual-quality metrics. Results: Ten eyes of 7 patients had PC pIOL implantation. The preoperative mean refractive spherical equivalent of -7.21 diopters (D) ± 2.25 (SD) decreased to -0.55 ± 1.53 D at 6 weeks and -0.44 ± 1.21 D at 6 months. The efficacy index was 0.72 and the safety index, 1.13. The mean modulation transfer function (MTF) was 18.96 ± 14.16 (≥30 cycles per degree = good), the Strehl ratio was 0.11 ± 0.07 (1 = perfect), and the objective scatter index (OSI) was 4.45 ± 3.29 (≥1.5 = significant scatter). The MTF correlated inversely with secondary coma (P=.026), negative vertical coma (P=.014), and the root mean square (RMS) of total aberrations (P=.010) and higher-order aberrations (HOAs) (P=.015). The OSI was directly correlated with secondary coma (P=.021), secondary trefoil (P=.016), the RMS of total aberrations (P=.032), and HOAs (P=.050). Conclusion: In keratoconus, the refractive error could be corrected with the PC pIOL; however, the associated aberrations had an adverse impact on the ultimate visual quality and have to be addressed. © 2012 ASCRS and ESCRS Published by Elsevier Inc.


Kummelil M.K.,Post Graduate Institute of Ophthalmology | Hemamalini M.S.,Post Graduate Institute of Ophthalmology | Bhagali R.,Post Graduate Institute of Ophthalmology | Sargod K.,Post Graduate Institute of Ophthalmology | And 3 more authors.
Indian Journal of Ophthalmology | Year: 2013

Keratoconus is a progressive non-inflammatory thinning of the cornea that induces myopia and irregular astigmatism and decreases the quality of vision due to monocular diplopia, halos, or ghost images. Keratoconus patients unfit for corneal procedures and intolerant to refractive correction by spectacles or contact lenses have been implanted toric posterior chamber phakic intraocular lenses (PC pIOLs) alone or combined with other surgical procedures to correct the refractive errors associated with keratoconus as an off label procedure with special informed consent from the patients. Several reports attest to the safety and efficacy of the procedure, though the associated corneal higher order aberrations would have an impact on the final visual quality.


Roy A.S.,Biomechanics and Mathematical Modeling Solutions | Shetty R.,Biomechanics and Mathematical Modeling Solutions | Kummelil M.K.,Post Graduate Institute of Ophthalmology
Indian Journal of Ophthalmology | Year: 2013

Keratoconus (KC) is progressive disease of corneal thinning, steepening and collagen degradation. Biomechanics of the cornea is maintained by the intricate collagen network, which is responsible for its unique shape and function. With the disruption of this collagen network, the cornea loses its shape and function, resulting in progressive visual degradation. While KC is essentially a stromal disease, there is evidence that the epithelium undergoes significant thinning similar to the stroma. Several topographical approaches have been developed to detect KC early. However, it is now hypothesized that biomechanical destabilization of the cornea may precede topographic evidence of KC. Biomechanics of KC has been investigated only to a limited extent due to lack of in vivo measurement techniques and/or devices. In this review, we focus on recent work performed to characterize the biomechanical characteristics of KC.


Kurian M.,Post Graduate Institute of Ophthalmology | Das S.,Post Graduate Institute of Ophthalmology | Umarani B.,Post Graduate Institute of Ophthalmology | Nagappa S.,Post Graduate Institute of Ophthalmology | And 2 more authors.
Journal of Cataract and Refractive Surgery | Year: 2013

Phacoemulsification is challenging in soft cataracts due to the difficulty in cracking the nucleus by a divide-and-conquer technique or by chopping. We describe another technique, the Y sign for trenching endpoint: a clinical sign that indicates the surgeon should stop trenching and start cracking during classical divide-and-conquer nucleofractis emulsification using proximal downslope trenching. This technique exploits the morphological structure of the lens to precisely gauge the depth of the trench at which the surgeon can split even a soft nucleus into small wedges without instrument cheese-wiring and thus perform safer phacoemulsification while reducing the risk for posterior capsule rupture. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2013 ASCRS and ESCRS.


Kummelil M.K.,Post Graduate Institute of Ophthalmology | Das S.,Post Graduate Institute of Ophthalmology | Srikanth D.T.,Post Graduate Institute of Ophthalmology | Nagappa S.,Post Graduate Institute of Ophthalmology | And 2 more authors.
Journal of Cataract and Refractive Surgery | Year: 2013

Phaco chop is the preferred technique for many phaco surgeons. A critical step in chopping is the surgeon's ability to impale the nucleus in the middle of the core endonucleus, which can be challenging. We describe a clinical sign in the phaco chop technique to help surgeons identify the center of the endonucleus without estimating the nucleus thickness. This technique uses the morphological structure of the lens and the lens fiber orientation to precisely gauge the depth at which the surgeon should impale and hold the nucleus for effective chopping. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. © 2013 ASCRS and ESCRS.


Kodavoor S.K.,Post Graduate Institute of Ophthalmology | Dandapani R.,Post Graduate Institute of Ophthalmology | Kaushik A.R.,Post Graduate Institute of Ophthalmology
Indian Journal of Ophthalmology | Year: 2016

A 32-year-old female patient underwent deep anterior lamellar keratoplasty (DALK) in both eyes for advanced keratoconus. She developed an infiltrate in the nasal paracentral interface of the left eye. In view of the paracentral location, localized epithelial removal/stromal scraping was done and the infiltrate was removed using forceps and sent for microbiological assay, which revealed fungal filaments. The patient successfully responded to intensive topical antifungal therapy with the maintenance of visual acuity. Interface keratitis following DALK frequently needs graft lift/interface wash due to deep location, rapid spread and poor penetration and efficacy of topical medications. In view of a paracentral location, modified debulking with topical therapy resulted in a satisfactory outcome in our case thereby avoiding the need for more invasive treatments.


PubMed | Post Graduate Institute of Ophthalmology
Type: Journal Article | Journal: Journal of cataract and refractive surgery | Year: 2016

Scleral fixation of intraocular lenses (IOLs) is traditionally performed after conjunctival dissection and preparation of scleral flaps. The Hoffman pocket technique creates scleral pockets without conjunctival dissection. We describe a technique that uses a Hoffman pocket and 7-0 polytetrafluoroethylene (Gore-Tex) sutures for scleral fixation of a foldable posterior chamber IOL in patients with insufficient capsule support. The technique eliminates the need for conjunctival dissection, scleral cauterization, knot rotation, and sutured wound closure. The favorable properties of the suture material and the use of a small incision to insert a foldable IOL are additional advantages.None of the authors has a financial or proprietary interest in any material or method mentioned.

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