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Current concepts and recent trends in endothelial keratoplasty

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World Journal of Transplantation 2025年第2期15卷 84-105页

作者： Prateek Nishant Bharat Gurnani Prabhakar Singh Sony Sinha Kirandeep Kaur Ashish Kumar Ranjeet Kumar Sinha Department of ophthalmology-Refractive Surgery Uvea and Neuro-OphthalmologyAkhand Jyoti Eye HospitalMastichakSaran 841219BiharIndia Department of Cataract CorneaExternal DiseasesTraumaOcular SurfaceRefractive Surgery and Contact LensGomabai Netralaya and Research CenterNeemuch 458441Madhya PradeshIndia Department of ophthalmology-Cornea and Ocular Surface All India Institute of Medical SciencesKalyani 741245West BengalIndia Department of ophthalmology-Vitreo-Retina Neuro-Ophthalmology and OculoplastyAll India Institute of Medical SciencesPatna 801507BiharIndia Department of Cataracts Pediatric Ophthalmology and StrabismusGomabai Netralaya and Research CenterNeemuch 458441Madhya PradeshIndia Department of Cornea and Refractive Surgery Laxmi NetralayaJamal RoadPatna 800001BiharIndia Department of Community Medicine Patna Medical CollegePatna 800004BiharIndia

Endothelial keratoplasty(EK)is defined as an umbrella term comprising methods for selective surgical replacement of corneal endothelium and adjacent corneal tissue,which retains healthy portions of a patient's cornea while replacing diseased innermost corneal layer(s)with healthy donor tissue,to achieve corneal dehydration and transparency before the onset of irreversible stromal edema and permanent loss of corneal ***,the pathophysiology of corneal decompensation is increasingly being researched *** improvement in pharmacotherapy is progressively leading to reduction in the indications of *** addition,EK techniques have progressed towards using thinner tissue,optimizing visual *** have enabled better donor tissue formulation,usage,and attachment,and surgical modifications have enhanced the tissue utilization in difficult clinical scenarios lowering failure and ***,challenges are encountered in various complex clinical scenarios in-cluding eyes with prior intraocular surgery,complex anterior chamber anatomy,glaucoma,ocular surface disease *** complexities demand tailored surgical strategies,including modifications in graft handling,instru-mentation,and postoperative management to ensure *** to these details and addressing patient-specific factors can help improve outcomes in these difficult *** choice of procedure depends on multiple factors,including the surgeon's experience,patient's ocular anatomy,and the specific clinical *** review article encompasses the recent developments in this field presenting a comprehensive picture of our modern understanding of the indications,contraindications,surgical techniques,clinical situations,community aspects and future directions pertaining to EK.

关键词： Cell-and tissue-based Therapy Corneal transplantation Descemet stripping endothelial keratoplasty Immunosuppression therapy Refractive surgical procedures

Born with a luxated globe:An ocular emergency

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World Journal of Emergency Medicine 2022年第2期13卷 158-159页

作者： Neelam Pushker Sahil Agrawal Milind Changole Gautam Lokadarshi Amar Pujari oculoplasty Tumor&Paediatric Ophthalmology ServicesDr Rajendra Prasad Centre for Ophthalmic SciencesAIIMSNew Delhi 110029India

Dear editor,Globe luxation is defined as complete prolapse of the eyeball outside the orbital cavity with eyelids closed behind the ***,globe luxation can be categorized as traumatic,spontaneous or voluntary;males are affected more than females with an average age of 30 years.[1]Traumatic globe luxation is quite rare in children,with most cases reported in the adult age *** fracture comprises 5%to 25%of all facial fractures in the paediatric age group.[2]In cases with luxation of globe,immediate reposition is crucial for globe and vision *** describe the clinical features,evaluation,and management of globe luxation present at birth following normal vaginal delivery conducted elsewhere.

关键词： ocular editor lux

Practice patterns among ophthalmic surgeons in treating concomitant oculoplastic conditions in preoperative period:A questionnaire-based study

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World Journal of Clinical Cases 2025年第1期13卷 29-37页

作者： Bijnya Birajita Panda Chitaranjan Mishra Bhagabat Nayak Avik Kumar Roy Logesh Balakrishnan Priyadarshini Mishra Department of ophthalmology All India Institute of Medical SciencesBhubaneswar 751019OdishaIndia Department of Vitreo-Retina Trilochan NetralayaSambalpur 768004India Department of Glaucoma services LV Prasad Eye InstituteBhubaneswar 751013India Department of Statistics Apollo HospitalsChennai 823104India

BACKGROUND Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic *** oculoplastic conditions,like nasolacrimal duct obstruction,have been extensively studied,whereas others,like eyelid malposition and thyroid eye disease,have received minimal or no *** To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic *** A cross-sectional survey was disseminated among ophthalmologists all over *** survey included questions related to pre-operative evaluation,anaesthetic and surgical techniques preferred,post-operative care,the use of adjunctive therapies,and patient follow-up *** A total of 180 ophthalmologists responded to the *** practitioners(89%)felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was *** most common surgical techniques employed were lacrimal drainage procedures(Dacryocystorhinostomy)(63.3%),eyelid malposition repair(36.9%),and ptosis repair(58.7%).Post-operatively,47.7%of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid ***-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease *** Approximately 50%of ophthalmologists handle prevalent oculoplastic issues themselves,seeking the expertise of an oculoplastic surgeon under particular *** ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract *** conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.

关键词： oculoplasty Ophthalmic plastic surgery Nasolacrimal duct obstruction Practice patterns Survey

Factors affecting residual exotropia after two muscle surgery for intermittent exotropia

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International Journal of ophthalmology(English edition) 2017年第7期10卷 1120-1125页

作者： Shailja Tibrewal Nishtha Singh Marazul Islam Bhuiyan Suma Ganesh pediatric ophthalmology and Strabismology services Dr.Shroff's Charity Eye Hospital Chittagong Eye Infirmary & Training Complex Pahartali

AIM： To study the factors affecting residual exotropia（〉10 PD） at 4-6wk postoperative visit following two rectus muscle surgery for intermittent exotropia [bilateral lateral rectus（LR） recession or unilateral recess resect procedure].METHODS： A retrospective chart review of patients with intermittent exotropia ≤50 PD who underwent two rectus muscle surgery in between Jan. 2011 to Dec. 2013 was performed. Possible factors were compared between patients with residual exotropia（〉10 PD） and successful outcome（within 10 PD of orthotropia） at the 4-6wk postoperative visit. Effect/dose ratio was calculated by dividing the effect of surgery by the total amount（mm） of muscle surgery ***： One hundred and fifty-seven patients with mean age of 14y（range 3-53y） were included. Twentyseven patients（17.2%） had residual exotropia at 4-6wk postoperative follow up. Age at surgery（P=0.009） and preoperative deviation for distance（P≤0.001） and near（P=0.001） were identified as important predictors of unsuccessful outcome. The occurrence of residual exotropia was not affected by amblyopia, anisometropia, lateral incomitance, pattern deviation, vertical deviation, type of exotropia or type of surgery done（recess-resect or bilateral LR recession）. The effect/dose ratio was more in deviations 〉40 PD in the both recess-resect and bilateral LR recession type of surgery. The effect/dose ratio was less in patients with residual exotropia as compared to the successful outcome group（1.36 PD/mm vs 2.05 PD/mm in the bilateral LR recession surgery and 1.93 PD/mm vs 2.63 PD/mm in the unilateral recess-resect surgery）.CONCLUSION： Residual exotropia is seen in 17% of patients after two muscle surgery for intermittent exotropia. Patients with older age and larger preoperative deviation have greater chances of developing failure of two muscle strabismus surgery for intermittent exotropia.

关键词： residual exotropia intermittent exotropia strabismus exotropia rectus muscle

Extraocular retinoblastoma in Indian children:clinical,imaging and histopathological features

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International Journal of ophthalmology(English edition) 2013年第4期6卷 481-486页

作者： Sumita Sethi Neelam Pushker Seema Kashyap Sanjay Sharma Mridula Mehta Sameer Bakhshi Saurbhi Khurana Supriyo Ghose oculoplasty and pediatric ophthalmology services Dr.Rajendra Prasad Centre for Ophthalmic SciencesAll India Institute of Medical Sciences Department of Ocular Pathology Dr.Rajendra Prasad Centre for Ophthalmic SciencesAll India Institute of Medical Sciences Department of Radiodiagnosis All India Institute of Medical Sciences Department of Medical Oncology Dr.B.R.Ambedkar Institute Rotary Cancer HospitalAll India Institute of Medical Sciences

AIMTo study eyes with extraocular dissemination (EORB), with the following aims: first to establish the mean lag period and to understand various reasons for delayed presentation, second to study their imaging profile... 详细信息

关键词： extraocular retinoblastoma imaging histopathological features

Anterior segment optical coherence tomography for identifying muscle status in strabismus surgery

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International Journal of ophthalmology(English edition) 2016年第6期9卷 933-934页

作者： Brijesh Takkar Pradeep Sharma Ashutosh Kummar Singh Pranita Sahay Vitreo Retina services Dr R P Centre for Ophthalmic SciencesAll India Institute of Medical SciencesAnsariNagarNew Delhi 110029India pediatric ophthalmology and Strabismus services Dr R PCentre for Ophthalmic SciencesAll India Institute ofMedical SciencesAnsari NagarNew Delhi 110029India

Anterior segment optical coherence tomography （AS-OCT） finds very few indications in the domain of strabismus surgery. Current applications remain restricted to determining limbus-muscle insertion distance and anterior segment changes after strabismus surgery. We discuss two cases of operated strabismus surgery where AS-OCT imaging helped in identifying the operated eye and/or extra ocular muscles （EOM） and thus proved instrumental in planning and management.

关键词： AS Anterior segment optical coherence tomography for identifying muscle status in strabismus surgery

Expression of multidrug resistance proteins in retinoblastoma

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International Journal of ophthalmology(English edition) 2017年第11期10卷 1655-1661页

作者： Swati Shukla Arpna Srivastava Sunil Kumar Usha Singh Sandeep Goswami Bhavna Chawla Mandeep Singh Bajaj Seema Kashyap Jasbir Kaur Department of Ocular Biochemistry Dr. Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi 110029 India oculoplasty & pediatric Opthalmology services Dr. Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi 110029 India Department of Ocular Pathology Dr. Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi 110029 India

AIM： To elucidate the mechanism of multidrug resistance in retinoblastoma, and to acquire more insights into in vivo drug ***： Three anticancer drug resistant Y79 human RB cells were generated against vincristine, etoposide or carboplatin, which are used for conventional chemotherapy in RB. Primary cultures from enucleated eyes after chemotherapy（PCNC） were also prepared. Their chemosensitivity to chemotherapeutic agents（vincristine, etoposide and carboplatin） were measured using MTT assay. Western blot analysis was performed to evaluate the expression of p53, Bcl-2 and various multidrug resistant proteins in retinoblastoma ***： Following exposure to chemotherapeutic drugs, PCNC showed less sensitivity to drugs. No significant changes observed in the p53 expression, whereas Bcl-2 expression was found to be increased in the drug resistant cells as well as in PCNC. Increased expression of P-glycoprotein（P-gp） was observed in drug resistant Y79 cells; however there was no significant change in the expression of P-gp found between primary cultures of primarily enucleated eyes and PCNC. Multidrug resistance protein 1（Mrp-1） expression was found to be elevated in the drug resistant Y79 cells as well as in PCNC. No significant change in the expression of lung resistance associatedprotein（Lrp） was observed in the drug resistant Y79 cells as well as in ***： Our results suggest that multidrug resistant proteins are intrinsically present in retinoblastoma which causes treatment failure in managing retinoblastoma with chemotherapy.

关键词： retinoblastoma chemotherapy multidrug resistance multidrug resistance associated proteins

Diabetes more than retinopathy,it’s effect on the anterior segment of eye

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World Journal of Clinical Cases 2023年第16期11卷 3736-3749页

作者： Arvind Kumar Morya Prasanna Venkatesh Ramesh Kirandeep Kaur Bharat Gurnani Aarti Heda Karan Bhatia Aprajita Sinha Department of ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia Glaucoma and Research Mahathma Eye Hospital Private LimitedTennurTrichy 620001Tamil NaduIndia pediatric ophthalmology and Strabismus Sadguru Netra ChikitsalayaSadguru Seva Sangh TrustJanaki-KundChitrakoot 485334Madhya PradeshIndia Cornea and Refractive services Sadguru Netra ChikitsalayaSadguru Seva Sangh TrustJanaki-KundChitrakoot 485334Madhya PradeshIndia Department of ophthalmology National Institute of OphthalmologyPune 411000MaharashtraIndia Department of ophthalmology Manaktala Eye and Maternity HomeMeerut 250001Uttar PradeshIndia Department of ophthalmology Worcestershire Acute HospitalWorcestershire 01601United Kingdom

Diabetes mellitus(DM)is one of the chronic metabolic noncommunicable diseases that has attained worldwide *** threatens healthy life around the globe,with mild-to-severe secondary complications and leads to significant illness including nephropathy,neuropathy,retinopathy,and macrovascular abnormalities including peripheral vasculopathy,and ischaemic heart *** into diabetic retinopathy(DR),which affects one-third of persons with diabetes,has made considerable strides in recent *** addition,it can lead to several anterior segment complications such as glaucoma,cataract,cornea,conjunctiva,lacrimal glands and other ocular surface *** DM also caused gradual damage to corneal nerves and epithelial cells,which raises the likelihood of anterior segment diseases including corneal ulcers,dry eye disease,and chronic epithelial *** DR and other associated ocular complications are well-known,the complexity of its aetiology and diagnosis makes therapeutic intervention *** glycaemic control,early detection and regular screening,and meticulous management is the key to halting the progression of the *** this review manuscript,we aim to provide an in-depth understanding of the broad spectrum of diabetic complications in the anterior segment of the ocular tissues and illustrate the progression of diabetes and its pathophysiology,epidemiology,and prospective therapeutic *** first such review article will highlight the role of diagnosing and treating patients with a plethora of anterior segment diseases associated with diabetes,which are often neglected.

关键词： Diabetes Ocular surface Cataract Glaucoma Lens Uvea

pediatric Nd:YAG laser capsulotomy in the operating room: review of 87 cases

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International Journal of ophthalmology(English edition) 2019年第5期12卷 779-783页

作者： Michael Kinori Narasimhan Jagannathan Anne M Langguth Marjorie A Sasso Marilyn B Mets Bahram Rahmani Hawke Yoon Rebecca Mets-Halgrimson Sudhi P Kurup Janice L Zeid The Goldschleger Eye Institute Sheba Medical CenterTel Ha ShomerAffiliated to the Sackler Faculty of MedicineTel Aviv University Department of pediatric Anesthesiology Ann & Robert H.Lurie Children's Hospital of Chicago Division of ophthalmology Ann & Robert H.Lurie Children's Hospital of Chicago Department of ophthalmology Northwestern University Feinberg School of Medicine Department of Surgical services Ann & Robert H.Lurie Children's Hospital of Chicago

AIM: To report a large series of children having Nd:YAG laser capsulotomy in the operating room using the lateral decubitus position. METHODS: Medical records of children who underwent Nd:YAG laser capsulotomy in the operating room at Ann & Robert H. Lurie Children's Hospital of Chicago between September 2008 and April 2017 were reviewed. Induction of general anesthesia and intubation was performed in the supine position after which the patient was placed in lateral decubitus position. The Nd:YAG laser capsulotomy was performed using a standard protocol. At the completion of the procedure, the patient was turned back into the supine position and extubated. RESULTS: This study included 87 eyes of 60 patients. Patient's age ranged from 1 to 18 y(mean 6.4±4.1 y). In most cases(84/87, 97%), the procedure was performed under general anesthesia. In all cases, good focus on the membrane was achieved, and the procedure was performed successfully. There were no intraoperative ocular or anesthesia-related complications. CONCLUSION: When performing Nd:YAG laser capsulotomy in the operating room, the lateral decubitus position allowsan easy and safe approach without the risk of potentially devastating complications that have been associated with the previously described sitting and prone positions.

关键词： posterior capsular opacification YAG capsulotomy general anesthesia pediatric cataract