Evaluating a new surgical dosage calculation method for esotropia

To evaluate a simplified method for correction of ocular deviation in patients of infantile and acquired basic esotropia. Thirty-six consecutive patients of infantile and acquired basic esotropia were selected for this study. Patients underwent unilateral recession-resection surgery as per the new norm gram. Patients underwent 3.5-7 mm recession of medial rectus [MR] in one eye depending on the pre-operative deviation and patient's age. Together they also underwent 6 or 7 mm resection of the lateral rectus [LR] in the same eye depending on patient's age [6 mm for 3 years and below and 7 mm for older age]. In patients 3 years and below, a correction of 6, 7, or 8 PD/mm of recession of MR was expected when the pre-operative deviation was lesser than 30 PD, between 30 and 60 PD, or above 60 PD, respectively. Similarly, these values were 5,6, and 7 PD/mm of MR recession in patients above 3 years. A ratio between achieved and expected correction was calculated and the calculation was deemed successful for a patient if this ratio fell between 0.9 and 1.1. The calculation procedure was successful in 33 out of 36 patients [91%]. The two-tailed probability on paired Wilcoxon test was 0.187. This simplified method of surgical dosage calculation using MR recession as basis is predictable in patients of infantile and basic Esotropia. It may serve as a useful tool for minimizing variability of surgical results

Cataract surgery under topical anesthesia: gender-based study of pain experience

Pain perception, expression, tolerance, and the healthcare provider's evaluation and management of pain are affected by the gender of the patient. To the best of our knowledge, there is lack of gender-based evaluation of pain during cataract surgery under topical anesthesia. This study has been initiated to evaluate and determine pain experience during cataract surgery under topical anesthesia and to study the gender-based differences of the same. Hospital based study involving cataract surgery under topical anesthesia using standard cataract surgery. It was an interventional comparative case series. One hundred and sixty patients were included in four groups, according to the gender and choice of surgery. Patients underwent either phacoemulsification with foldable intra ocular lens [IOL] or manual small incision cataract surgery with rigid IOL under topical anesthesia. Patients ranked their pain experience on VAS scale after the surgery and the surgeon recorded the ease/difficulty accordingly using a questionnaire. Med Calc version 10.2.0.0 [www.medcalc.be] for windows was used to analyze the results. Analysis of variance [ANOVA] test and KruskAl Walis test were used to analyze the data. The overall visual analog scale [VAS] score was 0.8 [SD 1.3 range 0-8], with no statistical difference among the groups [P=0.5]. The average surgeon's score was 3.3 [SD 0.71 range 3-7], with no statistical difference between the groups [P=0.37].There were no sight threatening complications during the surgery in any group. The outcome of the study demonstrates that the patients undergoing cataract surgery under topical anesthesia perceive comparable pain and discomfort irrespective of their gender