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Roop P, Nayak S, Kittur A, Roop R, Sharma N. Evaluation of a new device to treat negative dysphotopsia. J Cataract Refract Surg 2024; 50:122-127. [PMID: 37753932 DOI: 10.1097/j.jcrs.0000000000001323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of Negative Dysphotopsia (ND) Ring implantation for treating and preventing ND. SETTING Multicentric tertiary eye hospitals. DESIGN Prospective interventional cohort study. METHODS 22 patients with ND were enrolled. Eyes with other ocular structural pathologies (corneal, macular, optic nerve head, retinal, neuro-ophthalmological) were excluded. In 15 eyes, the ring was implanted to treat ND (therapeutic group), and in 7 eyes, it was implanted during cataract surgery of the fellow eye as a prophylactic measure (prophylactic group) to prevent the occurrence of ND. Preoperative evaluation included video recording of the patients' complaints aside complete eye examination. Postoperatively, patients were interviewed to confirm resolution of complaints related to ND. The intraoperative difficulties and postoperative adverse events were recorded. A minimum follow-up of 1 year was completed for all eyes. RESULTS In the therapeutic group, 14 of 15 eyes (93.3%) patients reported complete resolution of ND on the first postoperative day while 1 patient reported persistence of a smaller and lighter temporal shadow. No ND was reported by any patient in any of the 7 eyes treated prophylactically. No significant adverse intraoperative event was recorded; however, vitreous upthrust was noted in 2 of 22 eyes (9.0%). No permanent drop in visual acuity was recorded in the therapeutic group. CONCLUSIONS ND Ring implantation was an easy, safe, and effective approach for both treating and preventing ND.
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Affiliation(s)
- Prakhyat Roop
- From the Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India (P. Roop, Nayak, Kittur, Sharma); AcuraVision Clinics, Roop Netralaya, Meerut, India (R. Roop)
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Bafna RK, Kalra N, Rathod A, Asif MI, Lata S, Parmanand K, Kaur N, Kittur AS, Shakkarwal C, Roop P, Agarwal R, Agarwal T, Sharma N. Hitch suture assisted tuck in Tenon's Patch Graft for management of Corneal Perforations. Eur J Ophthalmol 2022; 32:3372-3382. [PMID: 35234532 DOI: 10.1177/11206721221078682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe a novel modification of tuck-in Tenon's patch graft (TPG) using temporary horizontal mattress sutures and fibrin glue to hitch the graft in the management of corneal perforations. DESIGN Ambispective interventional case series. METHODS Modified technique of autologous TPG was used to seal corneal perforations measuring 3-5 mm, using horizontal mattress sutures to hitch the graft in a lamellar pocket, followed by application of fibrin glue. The horizontal mattress sutures were removed after the reformation of the anterior chamber. The primary outcome measure was a well formed anterior chamber in the post-operative period and the secondary outcome was epithelization time. RESULTS The surgery was performed in 22 eyes. The mean age was 43.86 ± 16.02 (26-66) years, with 14 males and eight females. The etiologies of corneal perforation included dry eye (n = 10), neurotrophic keratitis (n = 6), trauma (n = 2), chemical injury (n = 2) and exposure (n = 2). The mean size of the perforation with the thinned-out area was 4.3 mm (range 3-5 mm). The mean duration of epithelialization was 14.31 ± 2.63 days (7-21 days). No intraoperative complications were observed. All eyes had a well-formed anterior chamber in the immediate postoperative period. Postoperatively, two eyes had graft pseudoectasia due to a thick graft and supra tenon haemorrhage each; one eye each had graft thinning with the formation of pseudopterygium and graft melting. CONCLUSION Tenon's patch graft, along with the use of temporary horizontal mattress sutures and fibrin glue, is an effective modification of the technique for managing corneal perforations measuring 3-5 mm.
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Affiliation(s)
- Rahul Kumar Bafna
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Nidhi Kalra
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Aishwarya Rathod
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Mohamed Ibrahime Asif
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Suman Lata
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Kumar Parmanand
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Navpreet Kaur
- 78595Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi
| | - Amogh Shreekant Kittur
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Chetan Shakkarwal
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Prakhyat Roop
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Rinky Agarwal
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Tushar Agarwal
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
| | - Namrata Sharma
- Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi
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Abstract
Background This video shows the dreaded complication of expulsive suprachoroidal haemorrhage in a penetrating keratoplasty . It teaches the various measures that help in preventing and managing the challenge peri-operatively. Purpose This video is intended to sensitize the corneal surgeons about this rare complication using real-time surgical video and prepare them to face this challenge by demonstrating the preventive and mitigating strategies. Synopsis A patient who was suitably taken up for an autokeratoplasty had expulsive choroidal haemorrhage in the non-seeing eye. This complication was managed using glycerin-preserved donor corneal button. Further, the video discusses various pre-operative and intra-operative optimizations to avoid such a complication and mitigate the damage caused by it, should it ever happen during a surgery. Highlights Expulsive choroidal haemorrhage can be a traumatizing event and one must be mentally prepared to manage it. Pre-operative high-risk factors should always be managed and intra-operative maneuvers performed to prevent the complication, as shown in the video. Video link https://youtu.be/s_ImBugPELw.
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Affiliation(s)
- Namrata Sharma
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Tushar Agarwal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Jeewan S Titiyal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rasik B Vajpayee
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Prakhyat Roop
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Affiliation(s)
- Deepali Singhal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prakhyat Roop
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prafulla Kumar Maharana
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Kumar A, Kumawat D, Sundar M D, Gagrani M, Gupta B, Roop P, Hasan N, Sharma A, Chawla R. Polypoidal choroidal vasculopathy: a comprehensive clinical update. Ther Adv Ophthalmol 2019; 11:2515841419831152. [PMID: 30834360 PMCID: PMC6393826 DOI: 10.1177/2515841419831152] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 01/22/2019] [Indexed: 12/16/2022] Open
Abstract
Polypoidal choroidal vasculopathy as a disease is yet to be comprehended completely. The clinical features consisting of huge serosanguineous retinal pigment epithelial and neurosensory layer detachments, although unique may closely mimick neovascular age-related macular degeneration and other counterparts. The investigative modalities starting from indocyanine angiography to optical coherence tomography angiography provide diagnostic challenges. The management strategies based on the available therapies are plenty and not vivid. A detailed review with clarifying images has been compiled with an aim to help the readers in getting a better understanding of the disease.
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Affiliation(s)
- Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Devesh Kumawat
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Dheepak Sundar M
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Meghal Gagrani
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Barkha Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prakhyat Roop
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Nasiq Hasan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Anu Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Sundar MD, Roop P, Kumar A, Chawla R, Hasan N. Do oblate eyeballs exist? A rare case of rhegmatogenous retinal detachment in an elliptical globe. Indian J Ophthalmol 2019; 67:302-305. [PMID: 30672504 PMCID: PMC6376822 DOI: 10.4103/ijo.ijo_1150_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A patient, being a moderate myope with an axial length of 24.71 mm, presented to us with a fresh rhegmatogenous retinal detachment and marked peripheral chorioretinal degeneration. Difficulty in maneuvering with the standard 23 gauge vitrectomy cutter, inability to identify the break due to poor peripheral contrast, inadequate laser uptake, and an unusual large silicon oil fill (7.3 ml) were a few findings raising suspicion. Postoperative ocular ultrasonography showed an oblate eyeball with a relatively longer oblique axis (26.1 mm) as compared to the axial length confirming our suspicion. Oblateness should be suspected when the chorioretinal degenerations are more marked in the periphery as compared to the posterior pole. Intraoperative difficulties should be kept in mind while operating such cases.
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Affiliation(s)
- M Dheepak Sundar
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science, New Delhi, India
| | - Prakhyat Roop
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science, New Delhi, India
| | - Atul Kumar
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science, New Delhi, India
| | - Rohan Chawla
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science, New Delhi, India
| | - Nasiq Hasan
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science, New Delhi, India
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Roop P, Angmo D, Kamble N, Tomar AS. Uncontrolled neovascular glaucoma - an alarming manifestation of chronic myeloid leukemia on imatinib therapy - a case report and review of literature. Indian J Ophthalmol 2019; 67:285-287. [PMID: 30672497 PMCID: PMC6376821 DOI: 10.4103/ijo.ijo_1288_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 45-year-old diabetic male, with diabetic retinopathy and medically uncontrolled neovascular glaucoma (NVG) underwent intracameral bevacizumab followed by trabeculectomy, with controlled intraocular pressures (IOP) post-operatively, OD: 12 mmHg; OS: 14 mmHg. Patient was referred to hematology, where he was diagnosed as chronic myeloid leukemia (CML) and started on imatinib mesylate. Thereafter, he presented with recurrence of neovascularization and vascularization of the bleb along with OS vitreous hemorrhage at 6 weeks follow-up. While he was planned for OS vitreo-retinal surgery, he presented with OD spontaneous hyphema with raised IOP (OD: 38 mmHg, OS: 16 mmHg). He had maintained a tight glycemic control. Following imatinib therapy, there was a rapid progression and recurrence of neovascularization, eventually leading to failure of trabeculectomy OD and bilateral severe loss of vision. Imatinib may be implicated in the worsening of NVG in CML patients, especially with co-existing diabetes and thus, such patients should receive regular thorough ophthalmic evaluation as long as imatinib continues.
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Affiliation(s)
- Prakhyat Roop
- Glaucoma Research and Clinical Facility, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Dewang Angmo
- Glaucoma Research and Clinical Facility, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Kamble
- Glaucoma Research and Clinical Facility, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ankit S Tomar
- Glaucoma Research and Clinical Facility, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Abstract
In existing designs of intraocular lenses (IOLs), optical outcomes are compromised even after perfectly executed surgery. The reason for this is misalignment of optical axis of the eye and its visual axis. There is a need to design an IOL which compensates for this misalignment and hence enhances the optical outcomes of cataract surgery. The present innovation attempts to fulfill this unmet need and optimizes optical outcomes of all IOLs of different optical profiles - spherical, aspheric, toric, and multifocal. In addition, the improvised design of IOL offers other benefits such as delaying the formation of after-cataract and ameliorating negative dysphotopsia.
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Affiliation(s)
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- Centre for Sight, Roop Netralaya, Meerut, Uttar Pradesh, India
| | - Prakhyat Roop
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Roop P. Modified Scharioth's technique of scleral fixation of intraocular lens. Indian J Ophthalmol 2017; 65:1264-1265. [PMID: 29133674 PMCID: PMC5700616 DOI: 10.4103/ijo.ijo_532_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
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- Medical Director, Centre for Sight, Roop Netralaya, Meerut, Uttar Pradesh, India
| | - Prakhyat Roop
- Junior Resident, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Roop P. Discrepancy in evaluating angle κ. J Cataract Refract Surg 2017; 43:994-995. [DOI: 10.1016/j.jcrs.2017.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
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