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ABSTRACT: Evaluation of efficacy of autologous platelet-rich plasma eyedrops as an adjunct to standard medical treatment as compared with standard medical treatment with artificial tears in acute ocular chemical injury.
Twenty eyes with grade III to grade V chemical injury were randomly assigned to 2 groups. Group I (10 eyes) received autologous platelet-rich plasma eyedrops along with standard medical treatment, and group II (10 eyes) received standard medical treatment alone. Follow-up was on days 3, 7, 14, 21, 30, 60, and 90. Chi-square test for categorical variables and Mann-Whitney test for quantitative variables were applied for statistical analysis.
The mean time between exposure and presentation was 2.15 ± 0.93 days (group I, 2.2 ± 0.73 days; group II, 2.1 ± 0.98 days; P = 0.81). Complete epithelialization was achieved in all the eyes. The mean ± SD and median (range) time to complete epithelialization were 40 ± 31.57 days and 25.5 (7-90) days in group I and 47 ± 26.15 days and 30.0 (21-90) days in group II (P = 0.29). For grade III injuries, mean ± SD and median (range) time to complete epithelialization were 14 ± 7 days and 14 (7-21) days in group I and 28.5 ± 3.67 days and 28.5 (21-30) days in group II (P = 0.006) [Wilcoxon rank sum (Mann-Whitney) test]. At 3 months, corneal clarity showed significant improvement in grade I compared with grade II (P = 0.048). Similarly, the percentage improvement in best-corrected visual acuity was 63.64 ± 55.75 and 37.74 ± 9.66 for grades I and II, respectively (P = 0.082).
Topical autologous platelet-rich plasma therapy is safe and effective, and it promotes rapid reepithelialization of ocular surface and can be administered along with standard medical therapy.
Cornea 07/2012; 31(9):989-93. · 1.73 Impact Factor
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ABSTRACT: Keratoconus is characterized by progressive primary corneal ectasia, resulting in decreased visual acuity in young adults and remains a leading indication for corneal transplantation surgery worldwide. Collagen crosslinking treatment of the cornea, pretreated with riboflavin drops, with UVA light has been described as a revolutionary new treatment that is effective in arresting the progression of keratoconus and results in corneal strengthening. This review discusses current collagen crosslinking treatment for keratoconus including the basic changes induced in the cornea, results of various clinical trials and complications involved. Data available are conclusive of the fact that collagen crosslinking treatment of progressive keratoconus using the photosensitizer riboflavin and UVA light of 370 nm wavelength is effective in the stabilization of progressive keratoconus.
Expert Review of Ophthalmology 01/2012; 7(1):33-44.
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Cornea 05/2010; 29(7):838-9; author reply 839-40. · 1.73 Impact Factor
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ABSTRACT: To evaluate the anterior segment in opaque grafts with post-penetrating keratoplasty glaucoma (PPKG) by using ultrasound biomicroscopy (UBM).
An observational clinical case series of patients with opaque corneal grafts with PPKG who underwent UBM examination of the anterior chamber is reported. Indication for keratoplasty, lens status, intraocular pressure at the time of presentation, and the time of diagnosis of glaucoma were noted. Examination included slit-lamp biomicroscopy, posterior-segment ultrasound evaluation, and UBM evaluation of the anterior segment.
Thirty-one eyes of 31 patients with PPKG were recruited into the study. The mean intraocular pressure was 35.5 +/- 5.8 mm Hg (range, 26-52 mm Hg). The mean time of follow-up after penetrating keratoplasty was 6.97 +/- 2.98 months (range, 2-16 months). Of the 31 patients, 11 had undergone penetrating keratoplasty for therapeutic purposes (infectious keratitis), whereas the remaining 20 had undergone keratoplasty for optical reasons. Fourteen (45.1%) patients were pseudophakic, 13 (41.9%) were aphakic, and 4 (12.9%) were phakic. The types of synechiae noted on the UBM included peripheral anterior synechiae in 30/31 (96.7%) eyes, synechiae at the graft-host junction in 13/31 (41.93%) eyes, both peripheral anterior synechiae and graft-host junction synechiae in 12/31 (38.7%) eyes, central iridocorneal synechiae in 6/31 (19.3%) eyes, and intraocular lens iris synechiae in 3/31 (9.6%) eyes.
Secondary angle closure caused by anterior synechiae formation is one of the important causes of PPKG in eyes with opaque grafts. UBM serves as a useful tool for anterior-segment evaluation in such cases and can help in planning the site for glaucoma filtering surgeries and drainage devices.
Cornea 06/2008; 27(4):402-5. · 1.73 Impact Factor
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ABSTRACT: Eye donation is an act of supreme kindness to humanity and the society is obliged to bring honor to the memory of all eye donors for this truly philanthropic gift. Understanding the functioning of eye banks, donor criteria and the process of eye donation is the basis for facing challenges within eye banking in the developing world. The number of banks and their organizational level, methods of explantation, processing and preservation, quality standards, and new developments will have to be reviewed and regulated regularly. Efforts towards improvement in eye banking will ensure higher standards of both the quality and quantity of corneal tissue for rehabilitation of corneal blind patients. Effective state legislation is required to meet a society's ophthalmic surgical needs in transplantation programs. Incorporating advanced tissue-engineering services into the scope of the functions of an eye bank will make such higher end facilities available to routine corneal surgeons, thereby raising the standard of eye banking to greater heights.
Expert Review of Ophthalmology 11/2007; 2(6):923-930.
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ABSTRACT: To study the cellular populations of healthy corneas of Indian eyes using confocal microscopy and to evaluate the correlation with age, gender and laterality.
The central corneas of 100 eyes of 50 healthy subjects were examined using an in-vivo slit scanning confocal microscope (Confoscan 2). Images were analysed for cell densities of the epithelium, stroma and endothelium.
Good quality images enabling analysis of all cell layer populations were obtained in 74 eyes of 43 healthy subjects (22 males and 21 females) with a mean age of 31.89 +/- 13.47 (range 19-71 years). The basal epithelial cell density was 3601.38 +/- 408.19 cells/mm2 (range 3017.3-4231.1 cells/mm2). The mean keratocyte nuclei density in the anterior stroma was 1005.02 +/- 396.86 cells/mm2 (range 571.6-1249.6 cells/mm2) and in the posterior stroma was 654.32 +/- 147.09 cells/mm2 (range 402.6-1049.1 cells/mm2). Posterior keratocyte nuclei density was 30.76% less than the anterior stromal keratocyte nuclei density. The difference in keratocyte nuclei density was statistically significant (P=0.001). The mean endothelial cell density was 2818.1 +/- 361.03 cells/mm2 (range 2118.9-4434 cells/mm2) and the mean endothelial cell area was found to be 385.44 +/- 42.66 mm2 (range 268.9-489.2 mm2). Hexagonal cells formed 22.5-69.4% of the endothelial cell populations (mean 42.04 +/- 11.81%). Mean coefficient of cell size variation was 32.29 +/- 3.06 (range 27.2-39.2). No statistically significant differences were found in cell densities of any corneal layer either between female and male patients or between right and left eyes. Basal epithelial cell density, anterior stromal keratocyte nuclei and posterior stromal keratocyte nuclei density were unaffected by age (r=0.12, 0.07, -0.12 respectively) (P=0.001). There was a statistically significant negative correlation between mean endothelial cell density and increase in age (r=-0.42, P=0.001). Coefficient of cell size variation and age were positively correlated (r=0.73, P=0.001).
In-vivo slit scanning confocal microscopy is useful for the study of corneal cell populations. Our study provides normative data of these cell populations.
Indian Journal of Ophthalmology 10/2003; 51(3):225-30. · 1.02 Impact Factor
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ABSTRACT: Objective: To study the cellular populations of healthy corneas of Indian eyes using confocal microscopy and to evaluate the correlation with age, gender and laterality. Methods: The central corneas of 100 eyes of 50 healthy subjects were examined using an i n-vivo slit scanning confocal microscope (Confoscan 2). Images were analysed for cell densities of the epithelium, stroma and endothelium. Results: Good quality images enabling analysis of all cell layer populations were obtained in 74 eyes of 43 healthy subjects (22 males and 21 females) with a mean age of 31.89 ± 13.47 (range 19-71 years). The basal epithelial cell density was 3601.38 ± 408.19 cells/mm2 (range 3017.3 -4231.1cells/mm2). The mean keratocyte nuclei density in the anterior stroma was 1005.02 ± 396.86 cells/mm2 (range 571.6 - 1249.6 cells/mm2) and in the posterior stroma was 654.32 ± 147.09 cells/mm2 (range 402.6 - 1049.1 cells/mm2). Posterior keratocyte nuclei density was 30.76% less than the anterior stromal keratocyte nuclei density. The difference in keratocyte nuclei density was statistically significant (P=0.001). The mean endothelial cell density was 2818.1 ± 361.03 cells/mm2 (range 2118.9 - 4434 cells/mm2) and the mean endothelial cell area was found to be 385.44 ± 42.66 mm2 (range 268.9 - 489.2 mm2). Hexagonal cells formed 22.5 - 69.4% of the endothelial cell populations (mean 42.04 ± 11.81%). Mean coefficient of cell size variation was 32.29 ± 3.06 (range 27.2 - 39.2). No statistically significant differences were found in cell densities of any corneal layer either between female and male patients or between right and left eyes. Basal epithelial cell density, anterior stromal keratocyte nuclei and posterior stromal keratocyte nuclei density were unaffected by age (r= 0.12, 0.07, - 0.12 respectively) (P= 0.001). There was a statistically significant negative correlation between mean endothelial cell density and increase in age (r= - 0.42, P=0.001). Coefficient of cell size variation and age were positively correlated (r=0.73, P=0.001). Conclusion: In-vivo slit scanning confocal microscopy is useful for the study of corneal cell populations. Our study provides normative data of these cell populations.
Indian Journal of Ophthalmology. 01/2003;
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ABSTRACT: The aim was to evaluate the outcome of Ahmed glaucoma valve (AGV) in post-penetrating-keratoplasty glaucoma (PKPG).
In this prospective study, 20 eyes of 20 adult patients with post-PKPG with intraocular pressure (IOP) >21 mmHg, on two or more antiglaucoma medications, underwent AG (model FP7) implantation and were followed up for a minimum of 6 months. Absolute success was defined as 5 < IOP < 21 mmHg and qualified success as 5 < IOP < 21 mmHg with medications or minor procedures.
The mean IOP decreased from 42.95 ± 10.24 to 17.69 ± 3.64 mmHg (P < 0.001) and the use of medications dropped from 2.92 to 0.39 (P < 0.001) after AGV implantation. The absolute success was achieved in 11 eyes and qualified success in 9. There was no significant change in best corrected visual acuity, graft clarity, or graft thickness. Six device-related complications occurred after AGV implantations which were successfully managed with medical or minor surgical therapy.
Postkeratoplasty refractory glaucoma managed by AGV implantation revealed a satisfactory outcome up to 6 months of follow-up.
Indian Journal of Ophthalmology 59(3):185-9. · 1.02 Impact Factor
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ABSTRACT: Glaucoma drainage devices are an option in refractory glaucomas for control of intraocular pressure (IOP). We evaluated the outcome of pars plana Ahmed glaucoma valve along with triamcinolone-assisted vitrectomy in 11 eyes with uncontrolled IOP on maximum tolerable antiglaucoma therapy. The mean preoperative IOP of 33.64 +/- 5.99 (range 26 to 44 mmHg) decreased to 17.09 +/- 2.26 (range 14 to 20 mmHg) and 17.45 +/- 1.81 mm of Hg (range 14 to 24 mmHg) at 6 and 12 months following surgery. The mean number of antiglaucoma medications decreased from 3.27 +/- 0.05 to 0.64 +/- 0.67 and 0.55 +/- 0.6 at 6 and 12 months following surgery.
Indian Journal of Ophthalmology 58(5):440-2. · 1.02 Impact Factor
