bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimization of surgeon ergonomics with three-dimensional heads-up display for ophthalmic surgeries
Authors: Gupta Yogita , Tandon Radhika 
Published: February 2022

Purpose:
To describe the variables that may be utilized in the optimization of three-dimensional heads-up surgeries (3D-HUS) for achieving better ergonomics among ophthalmic surgeons.

Methods:
A cross-sectional study was conducted at the operating room of a tertiary eye care center, equipped with an ARTEVO 800 3D surgical microscope and display monitor. The parameters noted were monitor height (MH), surgeon eye-to-floor distance (ETFD), surgeon eye-to-monitor distance (ETMD) and viewing tilt (VT) angle. The neck and eye strain of the surgeon and assistant were scored as per Borg’s CR-10 scale, before and after surgeries.

Results:
Thirty (13 right, 17 left) eye surgeries were analyzed. The minimum ETMD was 51 inches (in) and the eye strain reduced with shorter ETMD (within the range 51 inches to 83 inches). The VT and ETFD were higher for right eye surgeries. The optimum MH was between 50 and 55 in. Overall, the neck strain and eye strain were in the range of 0–3 and 0–1, respectively.

Conclusion:
The various parameters affecting the 3D image quality, neck and eye strain are chair height, VT angle, eye centration, monitor distance, laterality of the eye, and room illumination.
Trends in teleconsultations for uveitis during the COVID-19 lockdown
Authors: Mahendradas Padmamalini , Sethu Swaminathan , Jayadev Chaitra , Anilkumar Aaditi , Kawali Ankush , Sanjay Srinivasan , Mishra Sai Bhakti , Shetty Rohit , Shetty Bhujang K 
Published: February 2022

Purpose:
To study the use of teleophthalmology as a tool to manage patients with uveitis and to describe the experience of teleconsultation for uveitis at a tertiary eye care hospital in India during the two waves of the COVID-19 pandemic.

Methods:
A prospective observational case series of uveitis patients seeking teleconsultations during the first (March 25–May 2020) and second lockdown (April 27 to June 21, 2021) in a tertiary eye care center were analyzed.

Results:
There were 79 teleconsultations in the first and 89 teleconsultations in the second lockdown. A majority of the patients presented in the age group of 41–60 years in both the lockdowns. There were both new or primary consultations and follow-up patients (6% vs. 94%) in the first lockdown, and similarly in the second lockdown (8% new vs. 92% follow-up). The majority of patients resided in Bengaluru city (78% in the first and 76% in the second lockdown). After evaluation through video consultation, only 15% required a hospital referral in the first lockdown, whereas in the second lockdown, 21.3% were referred to the hospital. During the second lockdown, 20% presented with COVID-19 infection-related ailments.

Conclusion:
Based on our preliminary experience using a customized smartphone-based application for teleconsultation, we found it to be an alternative option to provide continuation of ophthalmic care to uveitis patients. Given the current COVID-19 situation, it can help avoid physical visits of uveitis patients to the hospital.
Pars plana Aurolab aqueous drainage implantation for refractory glaucoma: Outcome of a new modified technique
Authors: Kader Mohideen A , Dabke Shylesh B , Shukla Aakriti G , Reddy Venugopal , Abdul Khadar Syed M , Maheshwari Devendra , Ramakrishnan Rengappa 
Published: February 2022

Purpose:
To report the outcomes of pars plana insertion of Aurolab aqueous drainage implant (AADI) in adults with refractory glaucoma by the novel technique of making scleral tunnel instead of patch graft to cover the tube to prevent its migration.

Methods:
A retrospective study was done between April 2016 and April 2018 on patients with ≥12 months of follow-up. The main outcome measure was a surgical failure at 12 months. The failure was defined as intraocular pressure (IOP) >18 mmHg or IOP ≤5 mmHg on two consecutive follow-up visits after 3 months, reoperation for glaucoma, loss of light perception vision, or implant explantation. Alternate definitions of failure including IOP >21 and IOP >15 mmHg were also considered.

Results:
The study included 32 eyes of 32 patients. The mean age was 46.2 ± 17.5 years. The most common etiology is traumatic glaucoma (12 eyes, 37.5%). The mean preoperative IOP and anti-glaucoma medications were 43.3 ± 10.3 and 3.4 ± 0.5 mmHg, respectively; both the parameters at the final follow-up were reduced to 15.2 ± 8.1 and 1.6 ± 0.5 mmHg. The Kaplan–Meier survival estimates demonstrated that the cumulative probability of failure was 15.6% (95% CI; 6.8–33.5%) at 3 months, 18.7% (95% CI; 8.9–37.0%) at 6 months, and 25.0% (95% CI; 13.4–43.8%) at 12 months.

Conclusion:
Pars plana AADI implantation with a newer modification technique is a useful procedure in reducing IOP and the number of anti-glaucoma medications in the eyes with refractory glaucoma. The visual acuity may be stabilized with the concurrent treatment of posterior segment pathology.
Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery
Authors: Belenje Akash , Takkar Brijesh , Agarwal Komal , Tyagi Mudit , Aggarwal Vinod , Padhi Tapas R , Narayanan Raja 
Published: February 2022

Purpose:
To evaluate the causes of jet stream injury (JSI)-related iatrogenic retinal breaks (IRBs) during vitreoretinal surgery (VRS).

Methods:
The precise surgical environment, which includes the indication and type of surgical procedure, retina status, details of instrumentation and fluidic parameters, and characteristics of the jet responsible for the IRB, was noted from case records. The nature of IRB and its healing and impact on anatomical and visual outcomes were analyzed.

Results:
Five eyes of five patients with complete documentation of both the JSI and the IRB were included. Two cases were operated for macular hole, and one each for vitreous hemorrhage, retinal detachment, and endophthalmitis. One case had infusion-fluid-related JSI, while four developed it because of injection of surgical adjuncts (drugs, PFCL, and dye). JSI developed in two cases when the vitreous cavity was filled with fluid, while it was air-filled in three cases. In four cases, the fluid migrated into subretinal space, necessitating further maneuvers following which the breaks healed, but were directly responsible for vision loss in two cases.

Conclusion:
JSI related IRBs are rare but may be directly responsible for vision loss if they impact the macula. The balance between jet stream velocity, its distance from the retinal surface, the intervening media (vitreous cavity), and retinal health play an important role. It can occur because of both infusion as well as injection jets. Precautions must be taken in cases vulnerable to complications with suggested modifications in the surgical technique.
A glued technique of external dacryocystorhinostomy
Authors: Rizvi Syed Ali Raza , Sabah Mehnaz , Mehmood Faizan , Maheshwari Rakesh , Alam Md. Shahid 
Published: February 2022

Purpose:
Fibrin glue was used for anastomosis of lacrimal sac and nasal mucosal flaps and was compared with the conventional suture technique in external dacryocystorhinostomy.

Methods:
A prospective interventional randomized control study in which 50 consecutive patients of primary acquired nasolacrimal duct obstruction (PANDO) were equally allocated into two groups. The case group underwent glued technique of external dacryocystorhinostomy (Ext DCR) in which fibrin glue was used for the apposition of the anterior lacrimal sac and nasal mucosal flaps. In the control group, conventional technique of Ext DCR was used to suture the flaps. Functional success was assessed by improvement in epiphora and fluorescein dye disappearance test (FDDT), whereas anatomical success was assessed by lacrimal irrigation and endoscopic view of the osteotomy site.

Results:
The anatomical success in both the groups was 92%, whereas the functional success was 92% in the case group and 88% in the control group. The difference in the success rates between the two groups was statistically non-significant.

Conclusion:
Glued technique of Ext DCR is a simple and easy alternative to suturing of the flaps. Though the final outcome was comparable in both the groups, glue can be especially useful in uncooperative cases, in cases of excessive bleeding, or in situations where the flaps are very thin or have become friable.
Evaluation of macular and peripapillary vascular parameter change in healthy subjects after caffeine intake using optical coherence tomography angiography
Authors: Yilmaz Tugan Busra , Subasi Sevgi , Pirhan Dilara , Karabas Levent , Yuksel Nursen , Demirci Kucuk Kubra 
Published: February 2022

Purpose:
To observe the effects of caffeine intake on vessel densities in macular and peripapillary regions and to analyze the correlations of vascular properties of these two interlinked regions in healthy volunteers using optical coherence tomography angiography (OCTA).

Methods:
In this prospective randomized, double-masked, placebo-controlled study, 120 participants were grouped into two groups: sixty subjects as a study group, which received caffeine and sixty subjects as a placebo group, which received a placebo. OCTA imaging was performed at baseline and 1 h after drug intake. Changes in macular and radial peripapillary capillary (RPC) vessel densities (VD) and foveal avascular zone (FAZ) parameters and correlation of these parameters were analyzed.

Results:
Baseline macular and RPC VD and FAZ parameters showed no significant difference between study and placebo groups (P > 0.05 for all). VD parameters in all segments of superficial and deep macular regions and peripapillary region showed a statistically significant decrease after caffeine intake (P < 0.001 for all). All macular superficial VD parameters showed a positive correlation with deep perifovea VD (P < 0.05 for all). Also, superficial perifovea VD was positively correlated with all deep macular VD parameters except deep fovea VD (P < 0.05 for all).

Conclusion:
We show that caffeine causes a decrease in macular and peripapillary vessel densities in healthy subjects, and correlations were observed between macular and peripapillary VD parameters. We believe that future studies are needed to support the effect of caffeine on peripapillary VD and the idea of using deep perifovea VD as the main parameter to estimate superficial macular parameters.
Funduscopy-guided fluorescein angiography-free focal laser photocoagulation for central serous chorioretinopathy
Authors: Mohanty Anuja , Mahapatra Santosh K 
Published: February 2022

Purpose:
To identify and correlate hypopigmented spots on fundoscopy with the leakage points on fluorescein angiography (FA) in patients with central serous chorioretinopathy (CSCR) to provide criteria for FA-free focal laser photocoagulation (FLP).

Methods:
Fifty consecutive patients of acute CSCR were evaluated between March and October 2019 confirming the inclusion and exclusion criteria. Colocalization of leakage points with discrete hypopigmented spots on clinical fundoscopy was evaluated using FA. Positive predictive value (PPV) was calculated to identify the status of association between these to formulate criteria for FA-free FLP of CSCR patients in future.

Results:
Out of the 50 eyes, 38 (76%) had a discrete hypopigmented spot on fundoscopy which coincided with the leakage point on FA. The PPV of finding a leakage point at the area of discrete hypopigmented spot is 95%. Colocalization with a pigment epithelial detachment was found in 25 (65.7%) of these 38 eyes. Retinal pigment epithelial irregularities were found associated in all of these 38 eyes. Subretinal homogenously hyperreflective material was found in 8 (21.05%) of 38 eyes. optical coherence tomography following FLP of leakage point in all cases showed complete resolution of CSCR in 47 (94%) eyes.

Conclusion:
This study demonstrates that hypopigmented spots on clinical fundus examination in CSCR patients, when present, coincide with the leakage point of FA. This may aid to undergo FA-free FLP treatment in CSCR patients.
Clinical profile and management of sixth nerve palsy in pediatric patients (0–15 years) in Southern India – A hospital-based study
Authors: Kalita Iva Rani , Veena K , Mouttappa Fredrick , Sundaralakshmi Priya , Singh Harsh Vardhan 
Published: February 2022

Purpose:
This study was done to evaluate the clinical profile in pediatric patients (0–16 years) presenting with acute onset esotropia due to sixth nerve palsy and its management options in a tertiary care set up of Southern India.

Methods:
A total of 12 patients presenting to our OPD with acute onset esotropia due to sixth nerve palsies were included in this retrospective study. All patients were observed for 6 months and managed with prism and/or patching while waiting for spontaneous resolution and later managed surgically. Neuroimaging was done in all cases.

Results:
The mean deviation of esotropia at presentation was 30.17 ± 5.7 Prism Diopter (range 12–50 Prism Diopter 95% CI, SD 10.11). Mean age of the patients during presentation was 8.6 ± 2.4 years (range: 1–15 years, SD 4.27). Among the common causes of sixth nerve palsy in our study population were trauma and idiopathic intracranial hypertension followed by tumor and miscellaneous causes. Only three patients underwent surgical correction of residual deviation after a waiting period of 6 months for self-resolution. Spontaneous resolution was observed in 41.6% patients, and surgical correction (unilateral resection–recession) was done in 25% of the patients with good surgical outcome.

Conclusion:
At 1-year follow up, the motor outcome was satisfactory except for one patient who had diffuse pontine glioma and had worsening neurological symptoms on follow-up.
Outcome of transcutaneous retrobulbar injection of liposomal amphotericin B in post-COVID-19 rhino-orbito-cerebral mucormycosis: Our experience
Authors: Ramamurthy Lakshmi B , Bhandari Ridhi , Kanakpur Savitha , Thejaswini P 
Published: February 2022

Purpose:
To assess the outcome and response of transcutaneous retrobulbar injection of amphotericin B (TRAMB) in post-coronavirus disease of 2019 (COVID-19) rhino-orbito-cerebral mucormycosis (ROCM) and to establish a scoring system in guiding treatment modalities.

Methods:
An interventional, prospective study was done on 82 eyes of post-COVID-19 ROCM from May 2021 to July 2021. A comprehensive multi-departmental evaluation along with detailed ophthalmic examination, laboratory investigations, and radiological examination was done. Scoring points were given to each symptom, sign, and radiological features of orbit and the total score was taken. Based on these scores, severity of disease was grouped into A, B, and C corresponding to mild, moderate, and severe orbital ROCM. One milliliter of reconstituted liposomal amphotericin B was given to all patients every alternate day as three doses. Efficacy of these injections was assessed in all groups, even though other treatment modalities like orbital debridement and exenteration were considered for moderate and severe cases. Patients were followed up for a period of 8 weeks.

Results:
Out of 82 eyes, symptomatic improvement was seen in a major proportion (72%) of patients. A statistically significant improvement in scores was noted in group A (93% improved) with a P value of 0.002, while 68.4% showed improvement in group B (P-value- 0.0001). Group C with severe disease showed minimal improvement in post-injection scores of 41% (P-value 0.086), necessitating surgical intervention. No serious adverse effect of the drug or procedure was noted.

Conclusion:
Significant improvement in scores of groups A and B highlights TRAMB as an effective and safe treatment modality in mild to moderate ROCM. It is an effective adjunct in severe cases, along with other interventions. Also, the scoring system helps in assessing the severity and guiding in management strategies.
Comparison of once daily dose of 0.3% nepafenac alone and three times dose of 0.1% nepafenac alone in pain and inflammation control after phacoemulsification
Authors: Bardoloi Narayan , Sarkar Sandip , Burgute Pankaj Suresh , Deb Amit Kumar , Dholkawala Roshni , Aggarwal Priyal , Gokhale Tanmay 
Published: February 2022

Purpose:
To compare the efficacy of a once-daily dose of 0.3% nepafenac and three times daily dose of 0.1% nepafenac in controlling pain and inflammation following phacoemulsification.

Methods:
In this prospective randomized control single-blind study. patients who underwent uneventful phacoemulsification were divided into two groups. Group A received 0.1% nepafenac eye drops three times/day for 4 weeks and group B received 0.3% nepafenac eye drops once daily for 4 weeks following phacoemulsification. All the patients received moxifloxacin 0.5% eye drops four times/day for 2 weeks. None of the patients in any group received any form of corticosteroids.

Results:
The mean age of the patients in group A was 63.55 ± 8.5 years, while in group B, it was 60.05 ± 7.76 years. There was no significant result in the preoperative baseline demographics and intraoperative parameters between both the groups. The results were statistically insignificant in terms of inflammatory markers between both groups on day 1. But, on day 7, group B showed better results in terms of lid edema, conjunctival congestion, and anterior chamber cells. The patients in group B also perceived significantly less pain on day 1 (P = 0.02) and day 7 (P < 0.001). The central macular thickness was also significantly lower in group B at day 30 (P < .001) and day 90 (P < .001), respectively.

Conclusion:
Once-daily dose of higher concentrated nepafenac (0.3%) is equally effective and shows better results than 0.1% nepafenac for pain and inflammation control.
iSMART Contoura laser-assisted in situ keratomileusis: A new planning software
Authors: Khatib Zain 
Published: February 2022

Background:
Topography guided laser-assisted in situ keratomileusis (LASIK) has always been some sort of an enigma in terms of its understanding and interpretation. Contoura LASIK is one such form of FDA approved topography guided LASIK on the Wavelight platform for virgin eyes. Inspite of promising so much, its complete application has not yet been fully understood and cannot be applied for all cases.

Purpose:
The iSMART Contoura LASIK is a software designed by the author, aimed to specifically to plan and treat eyes with Contoura LASIK.

Synopsis:
This is computer based software which studies the higher order aberrations being treated by the machine, and applies geometry and vector mathematics to appropriately modify the final treatment refraction so as to completely correct the refractive error. The software guides almost everything related to LASIK planning including safety parameters like percent tissue altered and residual stromal bed, the ring and stop size for microkeratome needed, femto flap diamter and Contoura planning. This software will be a useful tool for all Wavelight EX500 Contoura LASIK users.

Highlights:
This video demonstrates briefly the overview, working and utility of the iSMART LASIK software along with a quick understanding of how Contoura LASIK planning is done using it.

Online Video Link:

https://youtu.be/5x7jWmr08O4
Rescue of photoreceptor with human mesenchyme stem cell and human mesenchyme stem cell expressing erythropoietin in total degeneration of retina animal model
Authors: Abd Rashid Munirah , Chenshen Lam , Ee Hwan Avin Koh , AlSaeedy Hiba , Mok Pooi Ling , Subbiah Suresh Kumar , Md Isa Hazlita , Yong Then Kong , Nizam Harun Mohd Hairul , B S Mohamad Syed Mohamed Suhail , Ng Min Hwei Angela , Luu Chi D , Bastion Mae-Lynn Catherine 
Published: February 2022

Purpose:
This study aimed to investigate the efficacy of human-derived umbilical cord mesenchymal stem cells (HDUMSC) and human-derived umbilical cord mesenchymal stem cells expressing erythropoietin (HDUMSC-EPO) to rescue total degenerated retina in a rat model.

Methods:
The study included four treatment groups, namely negative control using normal saline (HBSS) injection, positive control using sodium iodide 60 mg/kg (SI), SI treated with HDUMSC, and SI treated with HDUMSC-EPO given via subretinal and intravenous routes, to test the efficacy of retinal regeneration following SI-induced retinal degeneration. Retinal function in both phases was tested via electroretinography (ERG) and histological staining examining the outer nuclear layer (ONL).

Results:
There was a statistically significant result (P < 0.05) in the SI treated with HDUMSC-EPO only when comparing day 11 (mean = 23.6 μv), day 18 (mean = 25.2 μv), day 26 (mean = 26.3 μv), and day 32 (mean = 28.2 μv) to the b-wave ERG on day 4 rescue injection day (mean = 12.5 μv). The SI treated with HDUMSC-EPO showed significant improvement in b-wave ERG readings in the Sprague–Dawley (SD) rat but did not restore baseline readings prior to degeneration (day 0). Both treated groups’ ONL thicknesses did not show significant changes compared to the negative control group (HBSS) following rescue therapy.

Conclusion:
Total retinal degeneration following intravenous SI injection was observed at 60 mg/kg. SI treated with HDUMSC and HDUMSC-EPO showed no regenerative potential compared to baseline in SI-induced total retina degeneration on ERG or histology, whereas SI treated with HDUMSC-EPO group showed a substantial increase in b-wave ERG amplitude over time.
Myopia prevalence in a population-based childhood visual impairment study in North India - CHVI-2
Authors: Wadhwani Meenakshi , Vashist Praveen , Singh Suraj Senjam , Gupta Vivek , Gupta Noopur , Saxena Rohit 
Published: February 2022

Purpose:
The aim of the study was to determine the prevalence of myopia at the community level.

Methods:
A population-based, cross-sectional study was planned in 40 clusters among children identified with subnormal vision in the urban community of Delhi. House-to-house visits were conducted for visual acuity screening of 20,000 children aged 0–15 years using age appropriate visual acuity charts. All the children with visual acuity of < 6/12 in any eye in the age group between 3 and 15 years and inability to follow light in age group 0–3 years were referred for detailed ophthalmic examination.

Results:
A total of 13,572 (64.7%) children belonged to the age group of 6–15 years. Of these, a total of 507 (3.7%) were found to be having myopia (spherical equivalent of -0.50 DS or worse in one or both eyes) with positive association with higher age groups.

Conclusion:
The estimated prevalence of myopia is 3.7%; the proportion of uncorrected myopia was 45%, which reflects that refractive error services need to be improved further.