Raghudeep Eye Hospital

A bstract Unilateral retinal detachment (RD) in young adults is uncommon, especially when accompanied by lens pathology such as posterior capsule microcalcifications. We report the case of a 20-year-old male who presented with visual disturbances in the right eye, where multimodal imaging—including slit-lamp examination, B-scan ultrasonography, and optical coherence tomography (OCT)—revealed minimal exudative RD, posterior lens capsule microcalcifications visible both clinically and on imaging, and vitreous opacities. OCT confirmed neurosensory elevation with subretinal fluid pockets and irregular outer retinal architecture. Systemic investigations showed proteinuria and mildly elevated C-reactive protein, without other systemic or autoimmune markers. Follow-up is ongoing, and initial management involves close ophthalmologic monitoring and further immunological workup. This case underscores the diagnostic importance of multimodal imaging and a high index of suspicion for isolated ocular inflammation in atypical retinal presentations.

Intumescent cataracts complicate cataract surgery due to high intra-lenticular pressure, often causing radial tears, such as the Argentinian flag sign. The micro-Rhex-pression technique offers a precise solution for achieving safe continuous curvilinear capsulorhexis in these cases. By creating a small central puncture in the anterior capsule and using controlled decompression with capsule massage to release liquified cortex, this method effectively reduces intra-lenticular pressure and minimizes tear risks. Applied in over 1,600 cases, it achieved a 99.6% success rate with minimal complications. Compared to costly femtosecond laser capsulotomy, micro-rhex-pression is affordable, efficient, and easy to learn, making it highly accessible. This technique advances intumescent cataract management by providing a reliable, safe, and accessible approach for optimal surgical outcomes. Its straightforward approach and short learning curve make it accessible, providing surgeons with a reliable method to improve outcomes in managing challenging intumescent cataracts. This technique enhances surgical safety and accessibility, transforming the approach to such complex cataracts.

Introduction: Glaucoma, causes irreversible vision loss, involves optic nerve damage due to increased aqueous outflow resistance in primary open-angle glaucoma (POAG) or iris blockage in primary-angle closure glaucoma (PACG). Objective: This study evaluates different treatment patterns and their effectiveness in primary glaucoma using the NEI VFQ-25. Method: A 2-month prospective observational study included patients with primary glaucoma, excluding those with secondary glaucoma or other ocular conditions. The sample size was determined based on study duration. Treatment groups received medical, laser, or surgical interventions, alone or combined. NEI VFQ-25 was administered at baseline and one month. Results: Among 100 patients, mean age 56.7 years, equally divided between POAG and PACG, QoL improved significantly across all treatment groups, greatest in medical treatment alone, multimodal treatment, least. One-way ANOVA showed difference in treatment approach on outcomes. Conclusion: Using NEI-VFQ-25, study assessed QoL in glaucoma patients across six treatment groups, finding highest QoL with medical therapy alone and lowest with combined treatments.

This study aimed to compare efficacy, safety, and immunogenicity of the biosimilar ranibizumab in comparison with the Innovator Ranibizumab in treatment-naive patients with neovascular (wet) age-related macular degeneration (nAMD or wAMD). This comparative, double blind, multicentre, Phase III clinical study randomized eligible patients in a 3:1 ratio to receive either OPTIMAB® (Alkem Laboratories Ltd./ Enzene Biosciences Ltd.) or Innovator Ranibizumab. Intravitreal injections of Innovator Ranibizumab (0.5 mg in 0.05 mL) and OPTIMAB® (0.5 mg in 0.05 mL) were administered every four weeks for 12weeks (three doses). Primary efficacy endpoints included loss of <15 letters from baseline, gain of ≥15 letters from baseline in visual acuity, mean change in best corrected visual acuity (BCVA) from baseline, and change in central subfoveal thickness (CSFT) from baseline at week 12. Safety was assessed through monitoring of adverse events (AEs) and serious adverse events (SAEs) throughout the study. Overall, of the 152 patients randomized, 141 (92.8%) patients (mean age, 66.6 ± 9.37 years) completed the study. Percentage of patients who lost < 15 letters in BCVA at week 12 from baseline was comparable in both the groups (100.0%, each). On secondary end point analysis, the two groups had comparable mean changes in BCVA (OPTIMAB®, 11.8 ± 9.18; innovator ranibizumab, 12.9 ± 10.29; P =0.5509); proportion of patients who gained ≥ 15 letters in visual acuity (OPTIMAB®, 32.18%; innovator ranibizumab, 25.74%; P = 0.4785) and mean change in CSFT (OPTIMAB®, -76.6 ± 89.03; Innovator ranibizumab, -73.1 ± 92.23μm; P = 0.8422) at week 12 as compared to baseline. OPTIMAB® and innovator ranibizumab demonstrated comparable safety over the 12-week treatment period and no patient expressed anti-ranibizumab antibody in either group patient. Biosimilar ranibizumab (OPTIMAB®) was non-inferior to innovator ranibizumab in terms of efficacy, safety, and immunogenicity in the patients of nAMD.

To compare intraoperative performance and early postoperative outcomes following phacoemulsification with two systems using active fluidics and one using gravity-based fluidics. In this prospective randomized trial, 200 eyes were randomized to the traditional and Active Sentry groups (n = 80 eyes each) where the Centurion Vision System was used with traditional or Active Sentry (Alcon Laboratories, Inc) hand-pieces, respectively, or the Infinit group (n = 40 eyes) where the Infiniti Vision System (Alcon Laboratories, Inc) was used. Within the traditional and Active Sentry groups, there were two subgroups with low (30 mm Hg) or high (55 mm Hg) intraocular pressure (IOP) used. Outcome measures compared were: cumulative dissipated energy (CDE), percentage change in central corneal thickness (CCT) at 1 day, 1 week, and 1 month, anterior chamber cells at 1 day and 1 week, rate of rise and fall of IOP following occlusion break, corneal endothelial cell density (ECD), and macular thickness 6 months postoperatively. CDE was significantly lower in group II compared to the traditional group (2.96 ± 1.4 vs 4.14 ± 2.2, P = .001). With 30 mm Hg IOP, the Active Sentry group had significantly less percentage change in CCT at 1 week postoperatively compared to the traditional handpiece group (0.01% vs 0.02%, P = .008). Incidence of anterior chamber cells less than grade 2 on day 1 was significantly higher in the Active Sentry group (82.9% vs 52%, P = .03). Percentage change in ECD was significantly lower in the Active Sentry group (-0.957 vs -0.98%, P = .005). Significantly faster rise of IOP to baseline following occlusion break was seen in the Active Sentry group. The use of Active Sentry handpiece was associated with lower CDE, less postoperative increase in CCT, fewer anterior chamber cells, and faster rise of IOP following occlusion break. [J Refract Surg. 2024;40(5):e304-e312.].

Glaucoma, a prevalent and debilitating eye disease, has long been associated with vision impairment and blindness. However, recent research has shed light on the often-underestimated psychological dimensions of this condition. Anxiety and depression, two pervasive psychiatric comorbidities, have been increasingly recognized among glaucoma patients. This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology, in the context of managing depression and anxiety in glaucoma patients. By meticulously examining peer-reviewed literature, we synthesize current knowledge on the prevalence, risk factors, and underlying mechanisms of anxiety and depression in glaucoma. The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders. Factors such as progressive vision loss, complex medication regimens, and the fear of further visual deterioration contribute to their vulnerability. Moreover, we delve into the bidirectional relationship between glaucoma and mood disorders, shedding light on the complex interplay between ocular and emotional health. Our review investigates the implications of anxiety and depression on glaucoma management, including their potential impact on treatment adherence, disease progression, and overall quality of life. We also explore the neurobiological pathways linking glaucoma and mood disorders, providing a foundation for future research and potential therapeutic interventions. In conclusion, recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care. This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma. By addressing anxiety and depression in glaucoma care, healthcare providers can enhance the overall quality of life for these patients, ultimately leading to improved outcomes and a brighter future for those affected by this condition. This review offers valuable insight for healthcare practitioners and researchers, providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.

This review analyzed all pertinent articles on keratoconus (KCN) and cataract surgery. It covers preoperative planning, intraoperative considerations, and postoperative management, with the aim of providing a simplified overview of treating such patients. Preoperatively, the use of corneal cross-linking, intrastromal corneal ring segments, and topo-guided corneal treatments can help stabilize the cornea and improve the accuracy of biometric measurements. It is important to consider the advantages and disadvantages of traditional techniques such as penetrating keratoplasty and deep anterior lamellar keratoplasty, as well as newer stromal augmentation techniques, to choose the most appropriate surgical approach. Obtaining reliable measurements can be difficult, especially in the advanced stages of the disease. The choice between toric and monofocal intraocular lenses (IOLs) should be carefully evaluated. Monofocal IOLs are a better choice in patients with advanced disease, and toric lenses can be used in mild and stable KCN. Intraoperatively, the use of a rigid gas permeable (RGP) lens can overcome the challenge of image distortion and loss of visual perspective. Postoperatively, patients may need updated RGP or scleral lenses to correct the corneal irregular astigmatism. A thorough preoperative planning is crucial for good surgical outcomes, and patients need to be informed regarding potential postoperative surprises. In conclusion, managing cataracts in KCN patients presents a range of challenges, and a comprehensive approach is essential to achieve favorable surgical outcomes.