Selective suture cutting for control of astigmatism following cataract surgery

Use of 10-0 monofilament nylon in ECCE cataract surgery leads to high with the rule astigmatism. Many intraoperative and post operative methods have been used to minimise post operative astigmatism. We did selective suture cutting in 38 consecutive patients. Mean keratometric astigmatism at three and six weeks post operative was 5.76 and 5.42 dioptres (D) respectively. 77.5% of eyes had astigmatism above 2 D. Selective suture cutting along the axis of the plus high cylinder was done after six weeks of surgery. Mean post suture cutting keratometric astigmatism was 3.3 D and 70% of the eyes had astigmatism below 2 D. After 3 months of surgery mean keratometric astigmatism was reduced to 1.84 D. Axis of the astigmatism also changed following suture cutting. 40% of the eyes showed improvement in their Snellen acuity following reduction in the cylindrical power.

5-fluorouracil in trabeculectomy for patients under the age of 40 years

In an attempt to enhance the success of trabeculectomy in patients under 40 years old, beginning 48 hours after surgery, we injected 5 to 45 mg (mean, 35 mg) of 5-fluorouracil in 10 eyes of six patients. After a mean follow up of 14.9 months (range, 6 to 27 months), intraocular pressure was below 21 mm Hg in 9 of the 10 eyes, with no antiglaucoma medication.

Spontaneous extrusion of cysticercosis: report of three cases

We report three cases of spontaneous extrusion of cysticercosis. In two cases, it got extruded from the orbit and in one case from the subconjunctival space. Extrusion of cysticercosis was associated with improvement in clinical signs and symptoms.

Natural course of intraocular pressure after cataract extraction and the effect of intracameral carbachol

Intraocular pressure (IOP) is known to increase after intracapsular cataract extraction, extracapsular cataract extraction (ECCE), and ECCE with intraocular lens (IOL) implantation. Many pharmacological agents have been used to prevent this IOP rise. We conducted a two-phase, randomized, prospective study to evaluate the natural behavior of IOP after cataract surgery and the effect of intraoperative intracameral carbachol on it. In phase 1, 102 cases were randomly assigned to three groups for recording IOP at 24, 48, or 72 hours after ECCE. The IOP at 24 (mean 20.3 mm Hg) and 48 hours (mean 22.3 mm Hg) was significantly higher than the preoperative IOP (mean 16.1 mm Hg); 26.3% of cases in group 1A (24 hours) and 44.1% of cases in group 1B (48 hours) had IOPs greater than or equal to 25 mm Hg. In phase II, intracameral carbachol (0.01%) was used in 30 cases of ECCE and in 30 cases of ECCE with IOL implantation. The IOP at 24 hours (mean 16.3 mm Hg) was not significantly higher than the preoperative IOP and only 11.6% of the cases had IOPs greater than or equal to 25 mm Hg. The mean IOP at 24 hours without carbachol was significantly higher than the mean IOP at 24 hours with it. There was no statistically significant difference between IOP in the two groups one week after surgery.

Atrial fibrillation following electrical injury

The development of atrial fibrillation in 2 patients, following an electrical shock is reported. One patient, with an underlying pre-excitation syndrome, had to be cardioverted due to rapid ventricular rate and hypotension. The other, with normal conduction, tolerated the arrhythmia well and atrial fibrillation reverted spontaneously after 24 hours.

Anterior ischemic optic neuropathy and branch retinal artery occlusion in cavernous sinus thrombosis

A 60-year-old woman developed embolic occlusion of a branch retinal artery following septic cavernous sinus thrombosis. Two days later it was followed by loss of light perception due to embolic or vasculitic ischemic optic neuropathy. Recurrent emboli from a focus of carotid arteritis in cavernous sinus thrombosis may be responsible for visual loss in such eyes.

Atrophy of myelinated nerve fibers in pituitary adenoma

A one-eyed patient was referred as a case of amblyopia secondary to myelinated retinal nerve fibers. Investigations revealed a pituitary adenoma. Following surgical ablation of the tumor, reduction in the myelination became evident. We report this rare occurrence in a case of pituitary tumor with photographic documentation for the first time.

Cellular blue nevus with nevus cells in regional lymph nodes: a lesion that mimics melanoma

We report the case of a young man who had a large, firm, nodule covered by darkly pigmented skin over the outer aspect of the right ankle and palpable right inguinal lymph nodes. The mole had enlarged rapidly during the past month, contained deeply pigmented cells with increased cellularity and mitotic activity and groups of intensely pigmented nevus cells within the marginal sinus of the inguinal nodes. The excised mass with inguinal lymphadenectomy was reported as benign cellular nevus with benign nevus cell aggregates in lymph nodes. The purpose of this report is to emphasize how cellular blue nevus can masquerade as malignant melanoma and to increase clinical awareness of this benign variant of melanocytic nevus. We have attempted to elaborate its natural history and comprehensive criteria for diagnosis, so that inappropriate surgery and chemotherapy can be avoided in this lesion which occurs conceivably often enough to be more than just a curiosity.

Upper and lower limb standards in newborn

One thousand live born babies of various gestational ages were studied. Using standard techniques, various limbs anthropometric measurements were taken with a non-stretchable measuring tape. Normal values and S.D. for each gestational week were calculated and their relation with gestational age statistically analysed. All these measurements correlated with gestational age. Foot length correlated best with gestational age amongst all the measurements (r = 0.9399).

Blood pressure studies in Jaipur children

A total of 1500 apparently healthy children between 1-12 years of age were examined. Blood pressure (BP) readings were taken and standard deviation and percentiles worked out for different sexes and age groups. Prevalence of hypertension was found to be 2.86% in males and 2.97% in females in 5-12 years of age group. Obesity was prevalent in 24% of the hypertensive cases. A higher value of serum cholesterol as compared to controls was also seen in the hypertensive group.