Open Access Original Research Article

Effect of Topical Proparacaine 0.5% on Tropicamide- Induced Mydriasis

Punit Kumar Singh, Ananya Singh

Ophthalmology Research: An International Journal, Page 1-5
DOI: 10.9734/or/2020/v12i230141

Purpose: The topical anesthetic proparacaine (0.5%) is recommended to enhance the rate and magnitude of pupillary dilatation if it is instilled before mydriatic tropicamide. However there is scarcity of data supporting this. Therefore we conducted a study to analyze if preinstillation of topical proparacaine (0.5%) can potentiate the mydriatic efficacy of 0.8% tropicamide.

Methods: The patients were divided into two groups for pupillary dilatation. The study group was given a drop 0.5% proparacaine before instilling one drop of tropicamide while the control group was given the tropicamide alone. The pupillary size was measured and recorded before the instillation of tropicamide at 0 min, 15 min, 30 min. The end point was taken as 6 mm pupillary size (clinically effective diameter).

Results: There was a statistically significant difference in rate of pupillary diameter between the control and the study group. The rate of pupillary dilatation at 15min and 30 min was statistically significantly different between the control and study group.

Conclusion: The study concluded that prior instillation of topical proparacaine produced a statistically significant difference in the rate of pupillary dilatation at 30 mins. Therefore, we suggest the use of a topical anesthetic before tropicamide induced mydriasis.

Open Access Original Research Article

Burden and Factors Associated with Refractive Errors Post Cataract Surgery at Kilimanjaro Christian Medical Center: A Hospital Based Retrospective Cross-sectional Study

Livin Uwemeye, William U. Makupa

Ophthalmology Research: An International Journal, Page 6-16
DOI: 10.9734/or/2020/v12i230142

Aims: To determine the burden and factors associated with refractive errors after cataract surgery in a training institution.

Study Design: A retrospective cross-sectional study.

Place and Duration of the Study: Kilimanjaro Christian Medical Center Eye department. Northern Tanzania, from January 2016 to December 2017.

Methods: A review of files of all adult patients who have had cataract surgery in 2016 and 2017 was conducted. A total of 626 eyes of 554 patients who had post-operative refraction by experienced optometrists were included. Information were extracted from patients’ files then entered into SPSS version 20 for analysis. The main outcomes were post-operative refraction and best corrected visual acuity. 

Results: Mean age was 69.3 years (SD=10.7) and ECCE accounted for 76% of surgeries. At least 84.6% had post-operative refractive error and astigmatism was the most common refractive error (56.8%). Spherical error accounted for 27.8%. Spherical error ranged from -12 to 4DS, mean = -0.42 (SD=1.3) DS and median = 0.00DS. The maximum cylindrical error was -7.5 DC, mean = -1.15 (SD=1.36) DC and median = -1.0DC. At least 56% had spherical equivalent within 1D of emmetropia. A BCVA of 6/18 or better was achieved in 92.8%. Age, poor pre-operative VA, poor presenting VA, astigmatism on keratometry, difference between recommended and inserted IOL, ECCE, grade of surgeon and suturing were associated with refractive errors.

Conclusion: Refractive errors following cataract surgery are common. Best corrected visual acuity outcome was in normal recommended range; however, the magnitude of refractive errors was high and the proportion of patients who achieved a final refraction within 1D of emmetropia was below the recommended range. An effort should be made to lower the prevalence and magnitude of refractive errors associated with cataract surgery in training institutions.

Open Access Original Research Article

The Effectiveness of Radiowave Surgery in the Treatment of Patients with Melanoma of Iris, Ciliary Body and Choroid

A. Maletsky, O. Khomyakova

Ophthalmology Research: An International Journal, Page 17-22
DOI: 10.9734/or/2020/v12i230143

The purpose of the study was to investigate the effectiveness of radiowave surgery in the treatment of uveal melanoma.

Materials and Methods: The study was performed on the basis of the oncoophthalmology department of the State Institution «Institute of Eye Diseases and Tissue Therapy named by academician V.P. Filatov of the NAMS of Ukraine» during 2009-2019.

Treatment with radio wave knife "Surgitron" manufactured by "Ellman International", was performed in 71 patients with melanoma of the iridociliary and chorioid (mean age 55.7 ± 1.6 years, minimum age 20 years, maximum age 77 years, Me (25%, 75%) = 59.0 (46.0; 65.0). These patients were split into two groups: 45 (61.6%) patients with melanoma localization in the iris and ciliary body (I group) and 28 (38.4%) patients with melanoma mostly affecting the ciliary body and choroidea (II group). In patients with melanoma of the ciliary choroidal region, a 40-day course of external β-therapy (Sr90+ Y90) was performed (25-30‘, RD = 40 Gy, LAD = 400 Gy). The follow-up period after the intervention was 10 years. Statistical analysis was performed by analysis of variance using Statistica 13.0 software (Dell StatSoft Inc, USA).

Results and Discussion: The use of a radio wave knife in resection of the UM allowed to maintain the ascending visual acuity in 100% operated for 12 months. The frequency of eye subatrophy in the subsequent stages of observation did not exceed 5%. The frequency of tumor recurrence when using a radio wave knife within 24 months of observation does not exceed 15%. The incidence of postoperative complications with the use of a radio wave knife does not exceed 5%. Low incidence of complications and recurrences, better five-year survival rate using radiowave surgical method allows to recommend it for wide use in combined treatment of uveal melanoma.

Conclusion: Radiowave knife is safe and clinically effective method of surgical treatment of uveal melanoma.

Open Access Original Research Article

New Marker for Suspected Open Globe Injury (Perforation or Penetration): Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio

Kenan Yiğit, Reşat Duman, Rahmi Duman, Zubeyir Yozgat, Ersan Çetinkaya, Mehmet Cem Sabaner

Ophthalmology Research: An International Journal, Page 31-36
DOI: 10.9734/or/2020/v12i230145

Purpose: To compare the strength of the relationship between the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio(PLR) results of patients with or without open globe injury (perforation and penetration) in the acute period of orbital trauma.

Materials and Methods: Forty patients with open globe injuryand twenty-five patients without open globe injury in the acute period of orbital trauma were enrolled in this retrospective study. Complete blood count measurement results of all subjects were assessed.

Results: There was a significant difference in neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio between orbital trauma with open globe injury group and without open globe injury group (p=0.001, p=0.006).

Conclusion: Our results of the blood count measurements suggest that the NLR and PLR at first three hours may predict ocular perforation/penetration and the clinicians have to alert are a risk factor of open globe injury.

Open Access Review Article

A Review of Learning Effect in Perimetry

Aristeidis Chandrinos, Dorotheos-Dimitrios Tzamouranis

Ophthalmology Research: An International Journal, Page 23-30
DOI: 10.9734/or/2020/v12i230144

Glaucoma is the second most common cause of visual impairment in the UK, with visual impairment registrations have increased by 22% since 2010. Glaucoma refers to a group of optic neuropathies leading to visual impairment and blindness. If glaucoma remains untreated, it may produce optic nerve damage, leading to vision loss. Consequently, visual field tests can be extremely valuable for glaucoma. At the same time, visual field assessment should be performed at baseline and periodically in the glaucoma follow-up or monitor the effectiveness of adopted therapeutic schemes. Any visual field test can be masked by one or more artefacts, which can either lead to the incorrect result of visual field loss or to the possible deterioration of existing loss. One of the most important factors is the perimetric learning effect that is present in almost all types of perimetry. To minimize the learning effect, we either have to conduct a practice test procedure, as a demonstration for the patient without collecting data, or to calculate and establish a learning index of the specific patient. By the establishment of such an index, assist the clinician in detecting possible masked or overestimated visual field defects or progression of glaucoma damage.

Conclusion: Potentially, the intense data collection at a large number of locations throughout the field in a larger cohort of subjects (visually healthy and glaucomatous) would be required for a better index establishment. The incorporation of fatigue also may be required to form a robust index enough to simulate procedures of glaucoma prognosis. The low signal to noise ratio associated with perimetric testing suggests that improvements will always be difficult to make.