Ashish Bhojak

Abstract

Keratometry is the measurement of anterior surface of corneal curvature in its steepest and flattest axis by various methods. There are many advances in measurement of keratometric values. Corneal topography and Modern videokeratoscopes provide an accurate representation of the anterior corneal surface to allow assessment of corneal irregularities in keratoconus, pellucid marginal degeneration, preoperative cataract workup - IOL calculation/TORIC lens implantation, refractive surgery preoperative assessment and post-op evaluation, evaluating pathologies like coneal dystrophies, scars, pterigium, recurrent erosions and contact lens fitting and evaluating the corneal contribution to optical aberrations of the whole eye Astigmatism (more than 0.5 diopters) is a commonly encountered refractive error, accounting for about aprx. 13-40 per cent of the refractive errors of the human eye according to various studies. In our study, 200 eyes of patients were studied over period of 2 year, with autorefractometer which measures total astigmatism (corneal and lenticular) and Bausch and Lomb manual keratometer and oculus topographer which measures anterior corneal astigmatism and results were compared. In our study 92.5% of eyes had regular astigmatism while 7.5% of eyes had irregular astigmatism. Various causes of corneal astigmatism were pterygium, keratoconus, PMCD, corneal degeneration, corneal opacity in that order. No significant clinical cause was found in 74.5% of eyes. Maximum repeatability was found with oculus topographer followed by autorefractometer and Bausch and Lomb manual keratometer. Keywords: Keratometer, Pterygium.

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Abstract

Gonioscopy is the widely used technique of grading and evaluating the anterior chamber angle in current glaucoma evaluation practice. The grading of angle and open angle or narrow angle classification with gonioscopy is fairly accurate when done by an experienced ophthalmologist. In recent years, UBM and anterior segment OCT are advanced and in depth imaging tools for the anterior segment evaluation and accurate angle measurements. In our study, we have included 200 eyes for anterior chamber angle grading with gonioscopy and UBM and results are compared. Our study shows that some amount of estimation of angle depth by gonioscopy is overestimated in nearly closed and grade 1 angles. Estimation of grades 2 and 3 is nearly accurate with gonioscopy and comparable to UBM angle grading. Over diagnosis of occludable angles with gonioscopy which can be explained due to iris contour, inter-observer reliability or limitation to examine far periphery of the angle and this can be overcome by UBM examination. UBM provides accurate anterior chamber angle in degrees, peripheral iris configuration details and quantification of measurements is possible. Keywords: Gonioscopy, Ultrasound Biomicroscopy (UBM).

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Abstract

Surgical classical DCR with external approach is considered as mainstay treatment with higher success rates for nasolacrimal duct obstructions. But In certain conditions, Transcanalicular endonasal laser DCR is proven more advantageous than classical DCR due to less complications like bleeding and low morbidity with acceptable success rate. The purpose of this study is to study the success rate and complications of Transcanalicular laser-assisted endoscopic dacryocystorhinostomy. We present our experience of transcanalicular enonasal laser DCR done in 50 patients with 6 month follow-up period. Diode laser was used to create ostium in all cases. Success rate of surgery is defined by patent sac syringing at each follow-up visit in most cases. Complications observed like bleeding, lid edema and pain are minor and easily manageable. At the end of our study, the final success rate is around 60% which is acceptable and comparable to other studies. Transcanalicular laser-assisted DCR, is a newer approach for nasolacrimal duct obstruction with good success rate and minimal complications with Shorter surgical time, faster recovery and better cosmesis than external classical DCR. Keywords: Surgical classical DCR.

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