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Indian Journal of Clinical and Experimental Ophthalmology

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1 MY FUTURE VISION FOR THE IJCEO, Rajendra P Maurya
Indian Journal of Clinical and Experimental Ophthalmology (IJCEO) is a refereed, peer-reviewed, indexed journal with academics and experts of repute as members of its Editorial Board. IJCEO publishes articles in the field of Ophthalmology and Vision science for a worldwide readership. It publishes original research papers, unusual case reports and critical reviews dealing with all sub specialties of Ophthalmology like Pediatric ophthalmology, Neuro-ophthalmology, Ocular Oncology & Oculoplasty, Community Ophthalmology, Ocular traumatology, Vitreo-retina and Cornea & refractive surgery etc. Special emphasis is given to issues that include new clinical trials, technical & surgical innovations and current ophthalmic updates, research activities and continued medical education in ophthalmic teaching. The role of Ophthalmology in society and, new findings from the frontiers of current research are always encouraged.
2 COMPARISON OF SURGICAL SUCCESS RATES AND AMOUNT OF CORNEAL ASTIGMATISM INDUCED BY HANG-BACK AND CONVENTIONAL MUSCLE RECESSION SURGERY IN HORIZONTAL STRABISMUS, Ishan Yadav, V.P. Singh, Prashant Bhushan, Rajendra P. Maurya, M.K. Singh
Purpose: To compare surgical outcomes and astigmatism induced by Hang-back and conventional recession surgery in horizontal strabismus. Methods: In a randomized, double blind, prospective trial, 40 patients of horizontal strabismus, (18 exotropia and 22 esotropia) were randomized into 2 groups according to the type of recession procedure performed. All ocular examinations were done pre and post-operatively including manual and automated keratometry, assessment of angle of deviation was carried out by a certified orthoptist. All patients were followed for a mean duration of 6 months. Results: Among esotropia success rate (defined as post-operative deviation of < 10 PD 6 months post operatively) was 80 % in patients with Hang-back recession and 84 % in patients with conventional recession (p=1). For exotropia success rate was 60 % in patients with hang-back recession and 75 % among patients of conventional recession (p>0.6). 90 % of eyes operated with conventional recession technique showed significant changes in average keratometry readings (defined as change of > 0.50 D), while for eyes operated by Hang-back technique only 37 % showed same changes (p
3 QUANTITATIVE AND QUALITATIVE ASSESSMENT OF DIABETIC RETINOPATHY AFTER LASER TREATMENT, Anukul Dixit, Ishan Yadav, Rajendra P Maurya, M. K. Singh, S. K. Singh
Aim: To investigate the visual and tomographic changes in patients undergoing pan retinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) with or without clinically significant macular edema (CSME). Methods: This was a prospective, interventional clinical trial including 78 eyes of 78 patients suffering from diabetic retinopathy (DR). All patients were divided into three groups based on the severity of diabetic retinopathy and presence of clinically significant macular edema (CSME). Laser was administered as per the ETDRS standards. Visual acuity (VA), Central macular thickness (CMT), HbA1c and other parameters recorded pre and post laser. Results: Mean BCVA decreases from 0.24 to 0.33 at one month (p0.05) after 4 months in group 1. In group 2 mean BCVA improved from 0.57 to 0.44 at one month (p0.05). Mean CMT in group one increased from 235? to 277? (p0.05). From group 2 mean CMT decreased from 379? to 325? at one month (p0.05). Conclusion: Laser photocoagulation still remains the gold standard treatment modality in cases of proliferative diabetic retinopathy (PDR) and in treatment of CSME.
4 TREATMENT OF VERNAL KERATOCONJUNCTIVITIS: COMPARISON BETWEEN TOPICAL CYCLOSPORINE 0.05% AND FLUOROMETHOLONE 0.1% IN TERMS OF EFFICACY AND SAFETY, Sanjiv Kumar Gupta, Ajai Kumar, Amit Verma, Siddharth Agrawal, Vishal Katiyar
Background: This study was undertaken to evaluate and compare the efficacy and safety of topical solutions of Cyclosporine and Fluorometholone in patients of vernal keratoconjunctivitis. Settings and design: This was a prospective, double blind, comparative, interventional randomized controlled trial, Material and methods: Patients of vernal kerato-conjunctivitis were included in the study after obtaining their informed consent.Each eye of one patient was prescribed either Cyclosporine eye drops or Fluorometholone eye drops. Patients vernal keratoconjunctivitis specific symptoms, signs and intraocular pressure were graded and measured repeatedly till 90th day. Statistical analysis used: The intra-group and inter-group changes in symptoms and signs during the course of study were compared using repeat measure ANOVA test. Results: Forty four subjects completed the study, with male preponderance. There was a progressive statistically significant reduction in the symptoms of itching, watering discharge and photophobia from day 7 till day 30 in both the groups.In Cyclosporine group there intra ocular pressure remained unaffected (P=0.17), but, in Fluorometholone group there was a significant increase in intra ocular pressure (P
5 UNRECOGNIZED LARGE WOODEN INTRAORBITAL FOREIGN BODY, Ishan Yadav, Rajendra P. Maurya, Prashant Bhushan, Mahendra K. Singh, Virendra P. Singh, Prithvi R.
Intraorbital foreign bodies are relatively rare and are often associated with vision threatening complications. Their clinical presentation and treatment outcome is variable depending on the size and composition of the foreign body. Metallic and inert substances like glass and plastic are relatively well tolerated but organic foreign bodies like wood is poorly tolerated and may lead to severe inflammatory reaction and secondary infection needing prompt surgical intervention. Although identification and removal of wooden foreign bodies is very difficult, we report this case for its unusual presentation, where a large intraorbital wooden foreign body presented with a disfigured scar of right upper eye lid, two years after road traffic accident. The foreign body was removed successfully without any complications.
6 PREDICTORS OF VISUAL RESPONSE TO INTRAVITREAL BEVACIZUMAB FOR TREATMENT OF DIABETIC MACULAR EDEMA, Sunny Kumar Gupta, Ishan Yadav, Sujit Deshmukh, Rajendra P Maurya4, V P Singh
Objective: To evaluate which factors influence maximum gain in best-corrected visual acuity after intravitreal injection of Bevacizumab as treatment for diffuse diabetic macular edema. Methods: This was a prospective, interventional trial including 112 eyes of 100 participants. Visual outcomes measured by change in visual acuity (VA) score, proportion gaining ?15 letters, and change in central retinal thickness (CRT), presence of macular ischaemia, IS/OS integrity. Results: Mean change in the VA score was 9.2 2.3 SD letters with a total of 79 eyes gaining ?15 letters. Change in median CRT was 81.5 ????m. Younger age, higher baseline VA score, shorter duration of Diabetic Macular Edema (DME), absence of macular ischemia and an intact IS/OS junction were significantly associated with greater VA score improvement. Conclusion: Pronounced macular edema and intact IS/OS junction may have a positive impact, and marked macular ischemia and a high preoperative best-corrected visual acuity may have a negative impact, on an increase in best-corrected visual acuity after intravitreal Bevacizumab injection in patients with diabetic macular edema.
7 PARTIAL THICKNESS SCLERAL MICRO-PATCH GRAFT, AUTOCONJUNCTIVAL GRAFT AND FIBRIN GLUE IN MANAGEMENT OF SURGICALLY INDUCED NECROTIZING SCLERITIS, Tarun Arora, Supriya Arora, Vijay Sharma
A 45-year-old male patient presented with necrotizing scleritis after 2 weeks of having undergone ptyregium surgery with bare sclera technique. Examination revealed a scleral thinning measuring 3 x 3 mm with anterior chamber inflammation. Lamellar scleral graft was dissected from the donor sclera and trephined to the approximate size of the scleral melt. Edges of the host scleral melt were freshened and fibrin tissue glue was used to attach the lamellar graft at the site of defect. Conjunctival autograft was simultaneously harvested from superior quadrant and attached over the bare sclera with the help of fibrin glue.Postoperatively the patient was prescribed high dose oral steroids along with topical antibiotics, steroids and lubricants. The patient improved symptomatically and showed good graft apposition.
8 OCULO-CUTANEOUS MANIFESTATIONS OF NEUROFIBROMATOSIS TYPE I: A CASE REPORT, Rajendra P Maurya, Ishan yadav, Virendra P. Singh, Mohan Kumar
Background: Neurofibromatosis (NF) is one of the most common genetic disorders with variable expression. It is characterized by neuroectodermal tumors arising within multiple organs. Case Report: We report an interesting case of 14 year old girl who presented with swelling and mild mechanical ptosis of right eye upper lid which was associated with multiple cutaneous abnormalities and fibromatosis of external genitalia. Complete excision of lid mass was done and histopathological examination revealed neurofibromatosis type I. Conclusions: The clinical manifestations, diagnosis, treatment and complications of neurofibromatosis are discussed.