Transcanalicular laser dacryocystorhinostomy using low energy 810 nm diode laser

Hypertrophic scarring may be a cause of failure after transcanalicular laser dacryocystorhinostomy [DCR] surgery. This hypertrophic scarring results from tissue charring and excessive coagulation, which may be caused by the high laser energy. We have evaluated the use of low energy settings to prevent hypertrophic scarring, for a successful outcome. To perform and evaluate transcanalicular laser DCR using low energy 810 nm diode laser. Interventional, non-comparative, case series. Patients with nasolacrimal duct obstruction and chronic dacryocystitis, who needed DCR, and were fit for surgery under local anesthesia, were recruited to undergo transcanalicular laser DCR using a 810 nm diode laser. The outcome was measured by the patency of the lacrimal passage, as indicated by the relief in the symptoms and the patency on syringing at the last follow-up. The surgical time and surgical complications were noted. Descriptive analysis. The study included 94 patients. The average age was 30.1 years [range 15 - 69 years]. Seventy [74.4%] patients were female. Eight patients had failed external DCR. Per-operative patency of the passage was obtained in all the patients. Average surgical time was seven minutes [5 - 18 minutes]. At the end of the study period of one year, a successful outcome was seen in 85 patients [90.5%]. There were eight patients of previous failed DCR surgeries, and six of them achieved a cure at the end of follow-up. Transcanalicular Laser DCR can be safely performed using a low power 810 nm diode laser. The surgery is elegant, minimally invasive, allows fast rehabilitation, and has an excellent success rate

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

Diabetic retinopathy in type II diabetics detected by targeted screening versus newly diagnosed in general practice

<p><b>INTRODUCTION</b>The aim of this study was to compare the occurrence of diabetic retinopathy in targeted screening diabetic patients (Group I) with newly diagnosed diabetic patients in general practice (Group II).</p><p><b>MATERIALS AND METHODS</b>This was an observational cross-sectional study. Data were obtained from 25,313 subjects who participated in the diabetic screening camps, and 128 newly diagnosed diabetes who presented to the diabetic retinopathy screening camps in general practice in rural and urban south India. The study variables were collected from all patients who underwent eye examination from the target screening detected diabetics [(n = 173) Group I] and those newly diagnosed in general practice [(n = 128) Group II]. The variations in prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in Group I and Group II and the factors affecting it were identified.</p><p><b>RESULTS</b>The occurrence of diabetic retinopathy was 6.35% (95% CI, 2.5-9.5) in Group I and 11.71% (95% CI, 5.6-16.4) in Group II. No significant difference was observed on occurrence of diabetic retinopathy, including sightthreatening retinopathy, in rural versus urban population and in Group I versus Group II. Patients diagnosed in general practice (Group II) with systolic blood pressure (BP) >140 were more likely to have retinopathy (P = 0.02).</p><p><b>CONCLUSIONS</b>Diabetic retinopathy including sightthreatening complications was found at the time of diagnosis of diabetes in the targeted screening group as well as in newly diagnosed diabetics in the general practice group.</p>