Long term outcomes of bilateral congenital and developmental cataracts operated in Maharashtra, India. Miraj pediatric cataract study III.

Aim: To study long term outcome of bilateral congenital and developmental cataract surgery. Subjects: 258 pediatric cataract operated eyes of 129 children. Materials and Methods: Children who underwent pediatric cataract surgery in 2004‑8 were traced and examined prospectively in 2010‑11. Demographic and clinical factors were noted from retrospective chart readings. All children underwent visual acuity estimation and comprehensive ocular examination in a standardized manner. L. V. Prasad Child Vision Function scores (LVP‑CVF) were noted for before and after surgery. Statistics: Statistical analysis was done with SPSS version 16 including multi‑variate analysis. Results: Children aged 9.1 years (std dev 4.6, range 7 weeks‑15 years) at the time of surgery. 74/129 (57.4%) were boys. The average duration of follow‑up was 4.4 years (stddev 1.6, range 3‑8 years). 177 (68.6%) eyes had vision <3/60 before surgery, while 109 (42.2%) had best corrected visual acuity (BCVA) >6/18 and 157 (60.9%) had BCVA >6/60 3‑8 years after surgery. 48 (37.2%) had binocular stereoacuity <480 sec of arc by TNO test. Visual outcome depended on type of cataract (P = 0.004), type of cataract surgery (P < 0.001), type of intra‑ocular lens (P = 0.05), age at surgery (P = 0.004), absence of post‑operative uveitis (P = 0.01) and pre‑operative vision (P < 0.001), but did not depend on delay (0.612) between diagnosis and surgery. There was a statistically significant improvement for all the 20 questions of the LVP‑CVF scale (P < 0.001). Conclusion: Pediatric cataract surgery improved the children’s visual acuity, stereo acuity and vision function. Developmental cataract, use of phacoemulsification, older children and those with better pre‑operative vision had betterlong‑termoutcomes.

Assessment of peripapillary retinal nerve fiber layer thickness using scanning laser polarimetry (GDx VCC) in normal Indian children.

Purpose: To obtain reference values of RNFL thickness in normal Indian children and to study the association of RNFL thickness with central corneal thickness(CCT) and axial length(AL). Materials and Methods: 200 normal Indian children (mean age 8.6 ± 2.9 yrs) were examined on the GDxVCC. The inferior average (IA), superior average (SA), temporal-superior-nasal-inferior-temporal (TSNIT) average and nerve fiber index (NFI) values were recorded and compared between males and females as well as between the different age groups. The association of TSNIT average with AL and CCT was examined. Results: Values for the RNFL parameters were-SA: 64.9 ± 9.7, IA: 63.8 ± 8.8, TSNIT average: 53.5 ± 7.7 and NFI 21.5 ± 10.8. Superior, inferior and TSNIT averages did not differ significantly between males and females (P = 0.25, P = 0.19, P = 0.06 respectively; Mann-Whitney U test). No significant differences were found in TSNIT average across age groups. There was a statistically significant positive correlation between CCT and TSNIT average (r = 0.25, r2 = 0.06, P < 0.001). The correlation TSNIT average and AL(r = −0.12; r2= 0.01) was not significant (P = 0.2). Conclusion: Reference values for RNFL parameters reported for Indian children are similar those reported in adults. There is a small correlation between central corneal thickness and RNFL as reflected in average TSNIT.

Sir Nicholas Harold Ridley. He changed the world, so that we might better see it.

Cataract surgery with intraocular lens (IOL) implantation has become the most common and most successful of all operations in medicine. Sir Harold Ridley's first cataract extraction with implantation of an IOL marked the beginning of a major change in the practice of ophthalmology. Millions of patients worldwide have benefited from Sir Ridley's invention, and are likely to continue to derive benefit from this device. However, the development of the IOL was not without its share of ups and downs. Sir Harold Ridley, the inventor of IOL, died at the age of 94, on 25 May 2001, and ophthalmology lost one of its greatest and most influential practitioners. We are happy that he lived to enjoy the fruits of his labour--to see the amazing improvements and the expansive growth that evolved in the cataract-IOL technique, from early and unsatisfactory operations in previous decades, to the superb results attainable today. The invention of the IOL has not been just the addition of one new form of treatment, but rather, Sir Harold's tiny disc-shaped sliver of plastic has changed the world so that our patients may better see it. This article presents a brief biographical sketch of Sir Harold and lists his major inventions and contributions to ophthalmology.

Bipseudophakia. Clinicopathological findings of a pseudophakic human globe obtained postmortem implanted with an anterior chamber and a posterior chamber intraocular lens.

We report the clinicopathological findings of a human pseudophakic globe obtained postmortem, containing both anterior and posterior chamber intraocular lens, a condition we termed "bipseudophakia".