Effect of Asanas in Yoga on Intraocular Pressure of Practicing Healthy Individuals: a Prospective Observational Study.

Introduction: Yoga is focused attention by breath and mantra. This forms the basis for a scientific investigation of its effect on various physiological functions such as intraocular pressure (IOP). Objective: To evaluate the effect of asanas in Yoga on the IOP of practicing individuals. Methods:A prospective, observational study was performed on 107 volunteers practising the asanas such as Sun salutation exercise (Surya Namaskar), Skull shining breath (Kapalabhati Pranayama), Downward facing dog (Adho Mukha Svanasana), Standing forward bend (Uttanasana), Legs up the wall pose (Viparita Karani), Alternate breathing technique (Anulom Vilom), Deep meditation (Dhyana), Bellows breath (Bhastrika Pranayama), Yoga head stand (Shirshasana) and control of breathing exercise (Pranayama) each for five minutes/day (40-60 minutes) for at least five days in a week for 12 weeks. The IOP measurement was performed for each asana (before and after) at baseline and every four weeks. The primary outcome was the change in IOP. Statistical analyses were performed using Statistical Package for Social Sciences version 23.0. A p-value of less than 0.05 was considered statistically significant. Results:The mean age of the participants was 42.64±7 years, and the male to female ratio was 1.2:1. Skull shinning breath, Sun salutation, Downward facing dog, Standing forward bend, Legs up the wall pose, Deep meditation and alternate breathing techniques showed a significant mean reduction in IOP at baseline, followed by every four weeks, till week 12, while Yoga head stand, Bellows breath and control of breath led to a significant increase in IOP. Conclusion:Yoga head stand, Bellows breath and control of breathing technique worsen IOP transiently.

A clinical trial on phakic intraocular lens for the treatment of refractive amblyopia in children and adolescents.

Purpose: To analyze the demographics and clinical outcomes of posterior chamber phakic intraocular (IOL) implantation for refractive amblyopia in children and adolescents. Methods: A prospective interventional study was performed on children and adolescents with amblyopia at a tertiary eye care center from January 2021 to August 2022. Twenty-three eyes of 21 anisomyopic and isomyopic amblyopia patients operated for posterior chamber phakic IOL (Eyecryl phakic IOL) as a treatment for amblyopia were included in the study. Patient demographics, pre- and postoperative visual acuity, cycloplegic refraction, anterior and posterior segment examination, intraocular pressure, pachymetry, contrast sensitivity, endothelial count, and patient satisfaction scores were evaluated. Patients were followed up at day 1, 6 weeks, 3 months, and 1 year after surgery, and visual outcomes and complications were documented. Results: The mean age of patients was 14.16 ± 3.49 years (range: 10-19 years). The mean intraocular lens power was - 12.20 diopter spherical (DS) in 23 eyes and - 2.25 diopter cylindrical (DC) in four patients. The mean unaided distant visual acuity (UDVA) and best-corrected visual acuity (BCVA) were 1.39 ± 0.25 and 0.40 ± 0.21 preoperatively on the log of minimum angle of resolution (logMAR) chart. Postoperatively, the visual acuity improved by 2.6 lines in 3 months period and maintained till 1 year. Postsurgery, contrast sensitivity in the amblyopic eyes significantly improved, and the average endothelial loss recorded was 5.78% at 1 year, which was statistically insignificant. Patient satisfaction score was statistically significant, with 4.736/5 recorded on the Likert scale. Conclusion: Posterior chamber phakic IOL is a safe, effective, and alternative method for treating amblyopia patients who are noncompliant with glasses, contact lenses, and keratorefractive procedures.

Comparison of corneal endothelial cell loss during manual small-incision cataract surgery using viscoelastic-assisted nucleus removal versus continuous balanced salt solution plus technique - Randomized controlled trial.

Purpose: The purpose of this study was to compare and analyze the endothelial cell loss during manual small-incision cataract surgery (MSICS) using the viscoelastic-assisted nucleus removal versus basal salt solution plus technique. Methods: This was a prospective randomized trial of 204 patients who underwent MSICS using viscoelastic-assisted nucleus removal (Group 1- OVD) versus basal salt solution plus technique (Group 2- BSS) at a tertiary eye care hospital in North India from January 2018 to 2021. Of these 204 patients, 103 (50.5%) and 101 (49.5%) were allocated to Group 1 and 2, respectively. The parameters assessed were detailed history, demographics, and anterior and posterior segment details. Visual acuity, intraocular pressure (IOP), keratometry, pachymetry, and endothelial cell density were evaluated preoperatively and postoperatively on day 1 and 30. Results: The mean age of the patients was 64.5 ± 8.2 years (range 48-82 years). There were 129 (63.2%) males and 75 (36.8%) females. The mean LogMAR visual acuity for both groups on day 1 (Group 1- 0.3 ± 0.1, Group 2- 0.5 ± 0.2) and day 30 (Group 1- 0.1 ± 0.2, Group 2- 0.1 ± 0.1) was statistically significant (P < 0.001), and the mean IOP value showed a statistically significant value (P < 0.009) on day 1 in Group 2 (15.0 ± 2.4 mmHg) and on day 30 (P < 0.001) in both the groups (Group 1- 13.6 ± 1.8 mmHg, Group 2- 13.5 ± 2 mmHg). The horizontal and vertical k values also showed a statistically significant difference on day 1 and day 30 (P < 0.001). The mean percentage change of central corneal thickness (CCT) in Group 1 was 17.7% and in Group 2 was 17.4% on day 1, and it was 1.1% on day 30 in both the groups, which was statistically significant (P < 0.001) compared to preoperative values. The percentage change in endothelial cell density on day 1 was 9% in Group 1 and 4.6% in Group 2, which was statistically significant (P < 0.001). On day 30, it was 9.7% and 4.8%, respectively, which was statistically significant (P < 0.001). Conclusion: Our study highlights statistically significant endothelial cell loss with viscoelastic-assisted nuclear delivery compared to BSS-assisted nuclear delivery during MSICS in a short follow-up of 1 month. The CCT values showed a slight increase, and the keratometry and IOP were unaffected compared to the preoperative parameters in both the groups.