Hydrophilic Intraocular Lens Opacification � A Case Report

Purpose : To report a case of late opacification of the hydrophilic acrylic Intraocular Lens (IOL) after uneventful Cataract Surgery. Methods : A 60-year-old male presented with chief complaint of gradual diminution of vision in right eye over the past one year. He was Normotensive, Non-diabetic and had a normal Lipid Profile. History revealed that he underwent uneventful phacoemulsification with posterior chamber hydrophilic intraocular in the bag implantation for pre-senile cataract in his Right Eye ten years ago. He had the best corrected visual acuity of 6/6 in his Right Eye for nine years Post Cataract Surgery. Slit-lamp examination confirmed Intraocular Lens Opacification. Results : Intraocular Lens exchange was performed in his Right Eye. The hydrophilic IOL was replaced with poly methyl methacrylate intraocular lens. The explanted IOL showed uniform grayish-white opacification. Post operative period was uneventful. Intraocular pressure by applanation tonometry was 16.4 mm Hg in both the eyes. Patient抯 best corrected visual acuity was 6/6 with -1 D Cyl. at 90 degree, Postoperatively. Over a follow up period of one year, the patient did not develop complications like posterior capsular IOL opacification. Conclusion: Intraocular Lens opacification is an extremely rare late postoperative complication of Phacoemulsification which can be managed effectively by IOL exchange procedure in cases of opacified IOL optics causing visual morbidity

Supraorbital Keyhole Approach for Anterior Circulation Aneurysms: An Institutional Experience

Background: Pterional approach is most accepted and most common approach for clipping of intracranial anterior circulationaneurysms. This approach imparts good exposure of anterior and middle skull base. However the Pterional approach haspotential adverse effects, such as long operative time, excessive blood loss, long hospital stay, and temporal muscle atrophy.Supraorbital keyhole via eyebrow incision is a minimal invasive approach for anterior circulation aneurysm surgery. This approachhas advantages of less operative time, less blood loss, less brain retraction, short hospital stay and no temporal muscle atrophy.Objective: Objective of this study to emphasize the advantages and limitations of supra orbital key hole approach for anteriorcirculation aneurysm surgery based on our institutional experience.Material and Methods: Between September 2017 and February 2020, total 16 patients with anterior circulation aneurysmswere operated by suprorbital keyhole craniotomy approach. All patients included were ≥18 years of age with Subarachnoidhemorrhage grade 1, grade 2, grade 3 on modified fischer scale. Intra operative and postoperative parameter noted andanalyzed over a period of 3 months follow up.Results: There were good cosmetic results with less approach related complications. We achieved good recovery (4/5) onGlasgow outcome scale score 4 or 5 were achieved in 87.5% of the patients in follow period of 3 months.Conclusion: Supra orbital key hole approach is not a standard approach for all kind of anterior circulation aneurysms, it can beapplied for small sized aneurysms with SAH grade up to 3 on modified fischer scale. An thorough pre-op work up, experience,skilled hand are prerequisites for supra orbital keyhole approach in aneurysm surgery. Selection of this approach should bebased on aneurysms morphology, size of aneurysm, grade of SAH, brain edema, and the surgeon’s experience.

Diabetic retinopathy: a preventable scourge.

In recent years, the India has witnessed a rapidly exploding epidemic of diabetes mellitus. It would not be hyperbolic to state that diabetes mellitus is the mother of morbidity of all vital organs. Diabetic retinopathy and its complications cause considerable ocular morbidity as well. With effective management strategies visual loss due to the disease can be controlled and further dissemination of the disease could be prevented. The key to proper management of diabetic retinopathy includes prophylaxis by controlling blood sugar, periodical screening of retina for early detection, prompt referral for prevention of progression by appropriate laser photocoagulation, surgical correction of various anatomical abnormalities, low vision aids and rehabilitative measures in patients with severe visual loss. Howerver, the awareness level of visual consequences of this widely prevalent disease even amongst diabetics is lacking.

Maxillary zoster with corneal involvement.

A case, of maxillary zoster with corneal involvement in a young patient is described. Corneal involvement in maxillary zoster (Medline search) is rare.