Analysis of the parental satisfaction for retinopathy of prematurity screening using binocular indirect ophthalmoscopy versus wide field retinal imaging.

Purpose: Analysis of the parental satisfaction for retinopathy of prematurity screening using binocular indirect ophthalmoscopy versus wide field retinal imaging. Methods: This was an observational, questionnaire survey-based study. The study cohort comprised of parents/legal guardians of consecutive Asian Indian premature infants enrolled for retinopathy of prematurity screening (for infants less than 2000 gms and/or 34-weeks gestational age) using binocular indirect ophthalmoscopy (BIO) with scleral depression and b) wide field retinal imaging using the 3Nethra Neo Camera (Forus Health, India). We evaluated the retina for the presence or absence of stages of ROP and plus disease. The survey analysis used closed-ended (multiple-choice) and open-ended questions for assessing 1) parents' experience/preference among the two screening modalities namely, BIO and wide field imaging used in the study, 2) knowledge prior to ROP screening, 3) knowledge gained post ROP screening, in the outpatient ophthalmologic care unit in our hospital. Results: Parents/legal guardians of 90 infants were included in the study. Among the 90 parents who filled in the questionnaire, 62.3% were referred by their pediatrician, 23.3% came for self check-up and 14.4% incidentally came to the hospital for complaints like ocular discharge and were screened. 93.3% parents were satisfied with either ROP screening modality in our study, with 54.4% stated a preference for retinal imaging. In the study 20% of the parents felt that retinal imaging was painful for the infant and 31.1% felt that BIO was painful for the infant. Conclusion: Wide field imaging is increasingly becoming an effective tool and screening tool in ROP screening and helps in better understanding of the disease amongst parents.

Anterior uveitis after transepithelial photorefractive keratectomy: Demographics and clinical characteristics - a one-year analysis.

PURPOSE: To report a case series of anterior uveitis after Transepithelial Photorefractive Keratectomy (TransPRK) and determine its incidence, demographics and associated clinical features over a study period of 1 year. METHODS: This retrospective case series comprised of 200 eyes (100 patients) which underwent elective TransPRK surgery for ametropia correction at a tertiary eye care center by two refractive surgeons over 1 year. TransPRK was performed on Streamlight software (EX500, Alcon Wavelight, Inc.). Postoperatively, all patients received topical antibiotic and steroid eye drops and tapered over 4 weeks. RESULTS: The mean age of study patients was 25.76 ± 4.29 years with a pre-operative mean refractive spherical equivalent (MRSE) of -3.49 ± 2.12 diopter (D); 11.76% eyes had simple myopia and 88.23% had compound myopic astigmatism, mean ablation depth of 61.99 ± 24.27 um. Four patients (seven eyes) developed anterior uveitis with mean age of 25 ± 3.53 years, mean MRSE -2.91 ± 0.32 D, ablation depth 44.75 ± 5.29 um with a mean onset at 33.28 days postoperatively after surgery and 5.28 days after the routine postoperative topical steroid withdrawal. Laboratory and immunological tests were negative in all four patients. The incidence of TransPRK-related anterior uveitis was 3.5% over 1 year. CONCLUSION: Anterior uveitis after TransPRK is infrequent. It could be due to intraocular transmittance of high frequency excimer laser beams used for longer durations to provide continuous, single step ablation in this novel type of PRK surgery. Further studies are needed to investigate the mechanisms of this association.

Role of anterior segment optical coherence tomography for safer management of mature white cataracts.

PURPOSE: Role of anterior segment optical coherence tomography (AS-OCT) for safer management of mature white cataracts. SETTING: Patients with mature white cataracts attending the outpatient department of a tertiary eye care hospital, aspiring to have cataract surgery performed, were scheduled for elective phacoemulsification and intraocular lens implantation by two surgeons during the period of October 2017 to March 2018. DESIGN: A prospective interventional study of 30 patients. METHODS: All patients with mature cataracts and absence of any retinal pathology had AS-OCT to assess the presence or absence of intralenticular subcapsular fluid pockets. The patients with the presence of subcapsular fluid pockets (Group 1) underwent 30-gauge needle aspiration fluid aspiration followed by capsulorhexis and phacoemulsification and those without any fluid (Group 2) underwent Utrata forceps-assisted capsulorhexis. RESULTS: The study comprised 30 eyes of 30 patients, of which 15 eyes (50%) had subcapsular fluid and 15 eyes (50%) had no fluid on AS-OCT. Of the 15 eyes in Group 1, 13 eyes (86.7%) underwent complete circular curvilinear capsulorhexis (P = .001), with a surgical success rate of 87%, whereas 2 eyes (13.3%) had capsular runaway complications. Of the 15 eyes with no subcapsular fluid, 13 eyes (86.7%) underwent complete circular curvilinear capsulorhexis (P = .001), whereas 2 eyes (13.3%) had posterior capsule rupture. Thus, 87% of the cases had uneventful capsular outcomes in each group. CONCLUSION: The detection of subcapsular fluid on AS-OCT allows better planning and management with 30-gauge assisted-needle drainage of fluid, thus decreasing the chances for capsular runaway complications with better surgical outcomes.