Indian Journal of Clinical and Experimental Ophthalmology

3-9

Authors: 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<0.002). Surgeons comfort score using visual analogue scale was also compared. Conclusion: Hang-back recession is an effective alternative to conventional recession with an added advantage of decreased amounts of surgically induced astigmatism, especially in children with smaller globes, poor exposure and high myopia.

18-24

Authors: 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<0.0001). In the patients with mild disease, the improvement was similar in both the groups (P=0.486, Repeated measures ANOVA test). Conclusions: In mild cases of vernal keratoconjunctivitis, topical Cyclosporine is equally effective as topical Fluorometholone, and Cyclosporine is safer as there is no rise in intra ocular pressure.

31-36

Authors: 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

41-45

Authors: 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.