bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs
Authors: Maheshwari Devendra , Ramakrishanan Rengappa , Kader Mohideen Abdul , Pawar Neelam , Gupta Ankit 
Published: January 2021

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.
Anterior lamellar recession in the management of the trachomatous cicatricial entropion of the upper eyelids: Outcomes and indications
Authors: Owji Naser , Tehrani Jamshidian 
Published: January 2021

Aim: To evaluate the success and complications of anterior lamellar recession (ALR) in trachomatous cicatricial entropion.Methods: Twenty-six consecutive patients (forty upper eyelids) with trachomatous cicatricial entropion underwent ALR between 2003 and 2010. All patients had aberrant lashes with severe abnormal lid margin. Anatomical success was defined as disappearance of lid margin abnormality. Presence of aberrant lash did not indicate a treatment failure. Complete success was described as anatomical success without abrading abnormal lashes.Results: ALR was performed on the 40 upper eyelids (19 right and 21 left). The average duration of follow-up time was 34 months (range: six to 84 months). Anatomical success was achieved in 28 out of 40 lids (70%). Trichiasis developed in 18 eyelids post-operatively (45%), so complete success rate was 55%.Conclusion: ALR is a well-established procedure with an acceptable success rate for management of trachomatous cicatricial entropion and severe lid margin abnormality. The most important drawback of this procedure is development of trichiasis.
SLT may compromise the corneal endothelium
Authors: Ong Keith 
Published: January 2021

Purpose: Whitish spots are sometimes noted in the corneal endothelium after Selective Laser Trabeculoplasty (SLT). One wonders whether this could be laser burns to the corneal endothelium. To evaluate the corneal endothelium after SLT, corneal specular microscopy was performed before and after SLT.Method: 20 patients with open angle glaucoma, who had SLT in February-March 2012, had their corneal endothelium examined with specular microscopy before and after SLT.Results: 4 of the 20 patients showed numerous dark patches/spots on specular microscopy photographs of corneal endothelium after SLT. These dark patches/spots were found to have resolved by one month. 6 of the 20 patients showed few dark patches/spots after SLT. 10 patients had no significant dark patches/spots after SLT.Conclusion: The effect of SLT on the corneal endothelium is probably transient, and longterm effects probably negligible in normal corneas. However, in compromised corneas and corneas with pigment deposits on endothelium or reduced corneal endothelial transparency, there may be a risk of corneal endothelial compromise especially following repeated SLT. The results of this study highlight caution when deciding to do repeat SLT.
Frontalis muscle flap as sling in severe ptosis
Authors: Nagpal Ramesh C. , Grover Ashima , Maitreya Amit , Baradur Harsh 
Published: January 2021

Aim: Evaluation of the effect of frontalis muscle flap as sling surgery in severe ptosis with poor levator palpebral superioris (LPS) action.Method: Twenty-five eyes of 18 patients with severe congenital ptosis with poor LPS action were studied over a period of two years. It comprised of 13 eyes of 13 patients of severe unilateral congenital ptosis and ten eyes of five patients with ptosis associated with blepharophimosis syndrome. All patients underwent frontalis muscle flap sling surgery and were followed for six months.Result: At final follow up, 88% of patients had a satisfactory result. No patients required re-surgery. Lagophthalmos was the most common complication seen which subsided by six months. The surgical lid elevation was effective without any recurrence or complete failure.Conclusion: Frontalis muscle flap sling surgery is an effective procedure for severe ptosis with poor LPS action.
A family with Von Hippel-Lindau disease with different presentations
Authors: Wong Ching-lin , Lee Ming-Yueh , Sunder R. , Jamalia R. , Karunakar T.V.N. , Joseph A. 
Published: January 2021

Objective: To report three cases of Von Hippel-Lindau (VHL) disease from a family with different presentations.Method: Case series.Results: Case 1, a 14-year-old Malay boy with a history of gradual blurring of vision in both eyes presented with sudden deterioration of right vision. Fundus examination revealed bilateral retinal capillary hemangioma with exudative retinal detachment. His right eye underwent combination therapy of laser photocoagulation, cryotherapy, intravitreal anti-VEGF and photodynamic therapy, but failed to improve vision. His left visiondeteriorated and eventually required surgical intervention. Case 2 was the sister of case 1. She was a 17-year-old Malay girl who presented with sudden onset of left eye pain and redness. Diagnosis of left eye rubeotic glaucoma with closed funnel retinal detachment secondary to a huge retinal hemangioma was made. She underwent left eye external drainage of subretinal fluid plus anterior retinal cryopexy. The rubeotic vessel regressed postoperatively and IOP reduced. Case 3 was the eldest sister of case 1; a 19-year-old Malay girl who came for eye screening after two of her siblings were diagnosed with VHL. She was, however, asymptomatic. Fundus examination revealed right retinal capillary hemangioma. She was treated with laser photocoagulation and her condition remained stable. Systemic investigations identified midline cystic masses in the brain, spine and pancreas. Conclusions: This case series highlight different clinical pictures of Von Hippel-Lindau disease. As marked visual loss is a dreadful sequela of VHL, it is important to screen the family members as early detection and management of ocular and systemic lesions save sight and life.
Keratoconus associated with cone-rod dystrophy
Authors: Kannan Balaji 
Published: January 2021

Keratoconus is known to be associated with a variety of ocular and systemic disorders. The common posterior segment disorders known to be associated with keratoconus are retinitis pigmentosa, macular coloboma, Leber’s congenital amaurosis, retinal aplasia and retrolental fibroplasias. Occurrences of keratoconus in association with tapetoretinal degeneration is rare and has been reported infrequently. Visualization of the fundus is often difficult in cases of keratoconus due to the associated refractive error and corneal opacities. This may make it difficult for the ophthalmologist to clinically diagnose associated macular degenerative changes preoperatively. We report a case of keratoconus who was diagnosed to have cone-rod dystrophy following successful corneal transplantation.
Usefulness of the Non-Contact Tonometry in Out-Patient Screening
Authors: Selvin Satheesh Solomon T , Jacob Chris Elsa Samson , Kuriakose Thomas 
Published: January 2021

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg. The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram.
The results of therapeutic keratoplasties performed in severely thinned or perforated corneas
Authors: Yuksel Bora , Binzet Menekse , Uzunel Umut Duygu , Kusbeci Tuncay 
Published: January 2021

Purpose: To report the visual and anatomic outcomes of therapeutic keratoplasties performed in severely thinned or perforated corneas.Material and methods: Medical records of 37eyes of 37 patients operated between 2000 to 2014 were reviewed retrospectively. Indications, preoperative findings, surgical procedures, donor size, post-operative graft clarity, visual improvement, globe integrity and follow-up periods were analyzed. Mean age was 57,7 (20-85 ). Nineteen patients were male and 18 female. Mean follow-up was 28.7 (14-132) months.Results: Surgical indication was infectious in 17 (45.9%) and noninfectious in 20 eyes (54.1%). Infectious causes were bacterial ulcer 8 (21.7%), herpes simplex 7 (18.9%) and fungus in 2 (5.4%) eyes. Noninfectious causes were traumatic 6 (16.2%), Stevens-Johnson syndrome 2 (5.4%), desmatocele 2 (5.4%) other causes ( keratectasia, bullous keratopathy, acne rosacea, interstitial keratitis, lagophthalmos, and rheumatoid arthtritis). The underlying cause of cornel melting was unknown in 4 eyes (10.8%). Combined PK was performed in18 of 37 eyes (48.7%), PK alone in 14 (37.8%) and patch graft in 5 (13.5%). Graft survival rate was 30/37 (81.1%) through follow-up. Anatomical integrity was achieved in 23 (92.0%) of 25 perforated corneas. Visual improvement was obtained in 28 eyes (75.6%). Visual acuity was ≥ 0.05 in 6 eyes (16.2%) preoperatively, it increased to 22 eyes (59.4%) post-operatively.Conclusion: Therapeutic keratoplasty including PK and patch grafting is an effective surgical procedure in patients with severe corneal melting or perforation due to varying aetiologies. It restores the globe integrity also provides visual improvement.
Long-term survival of corneal transplants and visual outcomes among private patients of corneal surgeons in Metropolitan Manila (the Philippines)
Authors: Chan David Francis Fullon , Padilla Ma. Dominga B. 
Published: January 2021

PURPOSE: There are currently no published studies on the outcomes of keratoplasty in the Philippines. This study aimed to report graft survival rates at years 1, 3, and 5 after surgery, visual outcomes, and causes of graft failure among private patients of corneal surgeons in Metropolitan Manila receiving tissue from a single local eye bank in the period 2008-2012.
DESIGN: Retrospective cohort, multicenter study.
METHODS: POPULATION: Private patients of Metro Manila corneal surgeons, receiving tissue from the Santa Lucia International Eye Bank of Manila in 2008-2012. 241 of 593 yielded sufficiently complete data sets. PROCEDURE: Donor and tissue characteristics, pre-op and latest follow-up characteristics/clinical findings were retrieved and processed. Data from the eye bank was merged with follow-up data from surgeons submitted March-October 2014. MAIN OUTCOME MEASURES: Survival rates at 1, 3, and 5 years; best-corrected visual acuity as of latest follow-up; causes of failure.
RESULTS: 1-year survival: 90.4%, 3-year: 71.5%, 5-year: ~52.7%. Overall, 43.5% had VA of 20/50 or better, and 25% counting fingers or worse, with variations across diagnoses.
CONCLUSION: Though small in sample size and response rate, survival trends parallel studies with larger populations elsewhere. Specific trends like favorable survival in keratoconus were consistent. Indications for surgery have changed little since 2005, but regraft has become the most common indication. Further data collection and completion are required for multivariate analysis on factors regarding survival. Inflammation, infection, trauma, poor adherence are among the identified reasons for failure.
Influence of anterior chamber depth on postoperative refractive outcome in Chinese eyes
Authors: Wong Rachel SH , Ong Keith 
Published: January 2021

Aim or Purpose: This study aims to evaluate the refractive surprise (RS) after cataract surgery with various intraocular lens (IOL) formulas in eyes with very shallow or deep anterior chamber depth (ACD).
Design: This is a prospective cohort study of patients from a private ophthalmology practice in Sydney.
Methods: Thirty-one patients who had their cataract surgery in 2014 were included. The cohort consists of 20 eyes with ACD < 2.8 mm and 25 eyes with ACD > 3.2 mm. Patients’ demographic variables and their predicted refractive outcomes using the SRK-T, Haigis, Holladay 1, and Holladay 2 IOL formulas were collected. Actual refractive outcomes were obtained from consultations at least one-month postoperatively. RS was calculated from the difference between predicted refraction outcome of IOL formulas and the actual postoperative refraction achieved.
Results: The linear correlations between ACD and RS were not significant (p > 0.05). In the group with ACD < 2.8 mm, the mean refractive surprise using SRK-T, Haigis, Holladay 1, and Holladay 2 formulas were -0.191 ± 0.541, -0.189 ± 0.444, -0.201 ± 0.449, and -0.154 ± 0.489 D, respectively. In the group with ACD > 3.2 mm, the mean refractive surprise using the IOL formulas were -1.364 ± 0.541, -1.420 ± 0.541, 0.027 ± 0.394, and -0.045 ± 0.343 D, respectively.
Conclusion: The positive linear correlation between ACD and RS was weak. In eyes with ACD < 2.8 mm, the least RS was found with the Holladay 2 formula, while in eyes with ACD > 3.2 mm, this was found with Holladay 1.
Comparison of intraocular pressure and central corneal thickness in non-glaucomatous North- East Indian tribals versus general Indians
Authors: Natung Tanie , Goswami Prasanta Kumar , Keditsu Avonuo , Shullai Wakaru 
Published: January 2021

Purpose: To compare the intraocular pressure (IOP) and central corneal thickness (CCT) of non-glaucomatous North-East (NE) Indian tribals and general Indians.
Materials and methods: In a prospective, cross-sectional study, the IOP and CCT of non-glaucomatous NE Indian tribals (n = 50) and non-glaucomatous general Indians (n = 50) were compared. Glaucoma was ruled out by history, detailed ocular examinations, and investigations.
Results: There was very good correlation between the CCT and IOP values of right and left eyes (p = 0.940 and 0.847, respectively). The difference in the IOP values in the two groups was not statistically significant (p = 0.312 for Oculus Dexter [OD], p = 0.400 for Oculus Sinister [OS]). Similarly, the difference in the CCT values in the two groups was not statistically significant (p = 0.736 for OD and 0.613 for OS). The mean CCT and IOP OD for the whole population was 530.50 ± 35.42 μm and 13.80 ± 2.760 mmHg, respectively. By linear regression analysis, the IOP OD of the whole population had good correlation with CCT OD of the whole population (adjusted r2 = 0.084, p = 0.002), but not with age (adjusted r2=0.000, p=0.314) and sex (adjusted r2 = 0.010, p = 0.163). Similarly, CCT OD for the whole population did not have good correlation with age (adjusted r2 = -0.009, p = 0.762) and sex (adjusted r2 = -0.007, p = 0.603).
Conclusions: In this study of individuals with normal corneas and without glaucoma, no racial variation was found in the CCT and IOP values of the two groups. The IOP OD of whole population had good correlation with CCT, but not with age and sex. There was good correlation between OD and OS values of IOP and CCT.
Inter-rater reliability for visual acuity, refractive error, corneal reflex, and inter-pupillary distance among two masked optometrists in school children population
Authors: Prabhu Avinash , Pinto Alstreed Marita , Thalukdar Juthika , Ve Ramesh S. 
Published: January 2021

Purpose: To observe the inter-rater reliability between the observers for visual acuity, refractive error, corneal reflex, and inter-pupillary distance.
Methods: A random subset of 50 students from primary (1st to 4th grade), higher primary (5th to 7th grade) and secondary school (8th to 10th grade), for a total of 150 students were selected by stratified sampling from the prevalence study VARES (Visual acuity, refractive error, and squint) performed among 1752 school children of Udupi district, India in 2013-2014. The Institutional Ethical Committee & District Health Administration board permission was acquired. There were two examiners: Examiner 1 (JT), a qualified optometrist with two years of experience, and Examiner 2 (MT), an optometry student. Examiners 1 and 2 performed a single measurement for visual acuity using the COMPlog computerized logMAR vision chart at 3 metres; Landolt C or Sloan letter optotypes used. Refractive error, corneal reflex, and inter-pupillary distance was measured by Plusoptix Power-refractor twice by Examiner 1 and thrice by Examiner 2; the average of each value was considered for analysis. Data was tested for normality using the Kolmogorov-Smirnov test. Statistical significance was considered p < 0.05. The agreement between the observers for the two procedures was traced by a Bland-Altman plot.
Results: The mean age of the students was 10.21 years (± 2.80 SD). The measurement of agreement for visual acuity (COMPlog) between the examiners was tested using Kappa statistics with 0.79 for OD, p < 0.05 and 1.0 for OS, p < 0.05 supported by Wilcoxon sign rank test showing 0.067 for OD and 0.564 for OS between the observers. The Bland-Altman plot also showed good agreement between the observers. Paired t-test for refractive error showed 0.117 (CI: -0.11­–0.10) for OD & 0.067 (CI: -0.005–0.157) for OS, with Bland-Altman plot showing good agreement between the observers. Paired t-test showed 0.323 for corneal reflex and 0.520 for inter-pupillary distance.
Conclusion: From the results we report that there is no interobserver variability for visual acuity, refractive error, corneal reflex and inter-pupillary distance in school screening with COMPlog and Plusoptix A09.
External dacryocystorhinostomy
Authors: Long Li Ying , Mohd Khialdin Safinaz , Ahmad Azli Nazila Binti 
Published: January 2021

Aim: To analyse the epidemiological data, surgical technique, success rate, and complications of patients who underwent external DCR in Hospital Selayang from January 2015 to December 2016.
Method: Retrospective case series.
Results: A total of 21 eyes of 20 patients who underwent external DCR from January 2015 to December 2016 were identified and reviewed. There were 15 females (75%) and 5 males (25%). Age ranged from 5 to 75 years old, with a median age of 56 years old (IQR 23). Twelve patients presented with epiphora while eight patients presented with symptoms of dacryocystitis. One case was congenital, two were secondary nasolacrimal duct obstruction and the rest were primary nasolacrimal duct obstruction. All patients underwent external DCR under general anaesthesia. Silicone tube were inserted in 21 eyes, of which all were removed 3 months after the surgery except one patient whom had his tube dislodged accidentally. The overall success rate was 90.5% (n = 19), which was defined as no or minimal intermittent epiphora or no reflux on lacrimal irrigation at 12 months postoperative. There was one patient who had a cerebrospinal fluid leak treated successfully with intravenous antibiotics.
Conclusion: The surgical success rate for external dacryocystorhinostomy was comparable to that of the global success rate of external DCR. This is attributed to the application of surgical technique such as anterior suspended flap modification and posterior flap excision.
Feasibility, safety and clinical efficiency of optometric service pathways at primary and tertiary care level in Ampang, Malaysia
Authors: Hussin Duratul Ain , Hendicott Peter , Carkeet Andrew , Baker Philip , Chen Ai-Hong , Asnir Zalifa Zakiah , Zainal Abidin Zairah , Hussain Rusnah , Mokhtar Azlina 
Published: January 2021

Aim: To evaluate feasibility, safety, and clinical efficiency of optometrists in conducting diabetic retinopathy screening and ocular health screening.
Methods: This was a prospective observational trial study of newly developed optometric service pathways established at a community health clinic for diabetic retinopathy screening and a hospital ophthalmology clinic for ocular health screening. The study was carried out to assess the feasibility and safety of eye examinations conducted by optometrists. Patients were examined by optometrists using a standard eye examination at both clinics and re-examined by ophthalmologists as the reference standard. Optometrists recorded diagnoses of ocular conditions and classified referral urgency for each patient and these were compared with the diagnoses made by ophthalmologists, who were masked to the optometrists’ findings.
Results: There was a high concordance of 87.0% (95% CI 80.4%-93.6%) for the diagnoses between the optometrists and ophthalmologists. Of 26 patients considered by the optometrists to need ophthalmology referral, 23 were agreed as such by the ophthalmologists, giving good agreement, κ = 0.76 (95% CI 0.53 -0.94) between the optometrists and ophthalmologists on referral classification. Agreement by the ophthalmologists for referral urgency classifications (very urgent/urgent or non-urgent) was very good (κ = 0.85, 95%CI 0.62-1.00).
Conclusions: Ocular health examination by optometrists using optometric-eyecare pathways is feasible and safe. Optometrists showed strong agreement with ophthalmologists when diagnosing patients who had a range of ocular conditions. Optometrists were also able to triage referrals and their urgency accurately, suggesting that they could play an extensive role as primary eye care providers, thus reducing unnecessary referrals to ophthalmology clinics.