Open Access Systematic Review Article
Background- The primary goal of cataract extraction surgery is immediate visual recovery and the best uncorrected visual acuity (UCVA) post operatively. Aim: To compare the surgically induced astigmatism (SIA) after phacoemulsification surgery with superior clear corneal incision (SCCI) and temporal clear corneal incision (TCCI). Materials & method: 11 articles were reviewed on PubMed related to SIA & a review was made on the factors that are responsible to reduce the post-operative astigmatism. The outcome measures were SIA and UCVA at 2 and 6 weeks, post‐operatively. Results - In this study we expect to have better visual outcome and reduce incidence of SIA in TCCI than SCCI. Conclusion: TCCI appears to have better visual outcome and reduced incidence of SIA.
Open Access Original Research Article
Aims: Main objective of this study was to describe the diagnosis, treatment, outcomes, and associated factors of presumed ocular tuberculosis patients attending Central Chest Clinic, Colombo.
Study Design, Place and Duration: A cross sectional descriptive study was conducted among all ocular tuberculosis patients referred to Central Chest Clinic, Colombo for treatment from 1st of January 2016 to 31st June 2018.
Methodology: Pretested content validated secondary data extraction form was used. Socio-demographic and work-related characteristics were analysed using frequency distributions. Association between socio-demographic characteristics and factors associated with diagnosis, treatment and outcomes were analysed using Fisher-extract test.
Results: Among study respondents, 52.6% showed abnormal ESR finding (>20mm), 17.8% displayed Chest X-ray abnormalities and 89.5% reported positive Tuberculin skin test (>14mm in diameter). Uveitis was the most common diagnosis (87.9%). Among Uveitis patients, 36.5% presented with posterior uveitis. Out of all ocular TB patients who have completed the treatment, 77.6% reported improvement of vision following the anti-TB treatment regimen. Duration of the treatment with anti-TB drugs was similar across all types of ocular diseases among Ocular TB patients (p=0.590).
Conclusions: Large number of patients received treatment for 6 months with majority reported as improved vision on completion of treatment. Further prospective studies using primary data need to be conducted to have greater insight of the ocular tuberculosis in Sri Lanka.
Open Access Original Research Article
Aims: Image-guided systems are the gold standard for determining toric intraocular lens (IOL) axis alignment. However, their high cost prevents widespread use of these systems. As an alternative, a simpler and affordable method could be performed manually using a slit-lamp biomicroscope. This study aims to compare the accuracy of manual toric IOL axis marking using a slit-lamp compared to the CALLISTO eye image-guided system.
Study Design: Prospective comparative
Methods: In this prospective study, toric IOL axis alignment of 42 eyes with cataract and coexisting corneal astigmatism were evaluated using manual slitlamp method and CALLISTO eye image-guided method. Preoperative and postoperative uncorrected visual acuity, best corrected visual acuity, amount of spherical and astigmatic refractive errors, and postoperative IOL axis alignment were evaluated. Intraclass correlation of the manual method was calculated and the difference of IOL axis alignment to the image-guided method was compared.
Results: Toric IOL implantation reduced the amount of astigmatic refractive error from -1.63 ± 0.65 D to -0.50 ± 0.19 D in the image-guided group and from -1.93 ± -0.90 D to -0.87 ± 0.26 D in the manual slitlamp group. As many as 90.5% of eyes in the image-guided group and 81.0% of eyes in the manual slitlamp group reached the target induced astigmatism (p=0.38). Manual axis marking showed intraclass correlation of 99.3%. However, when the manual method was compared to the image-guided method a mean difference in axis alignment of 10.98o (95% confidence interval: 9.32o - 12.63o) was observed.
Conclusions: Alignment of toric IOL axis using the manual method demonstrated a consistent result; yet producing a considerable difference to the result of the image-guided method.
Open Access Review Article
The cataractogenesis process and the novel mechanisms involved in its progression make us question that the only solution today presented for its resolution is through a surgical procedure. The unveiling of such interesting and intricate machinery in the lens opacification occupies not only the ophthalmologists field, but also biology, molecular, and biochemistry areas. The animal models, experimental and theoretically, have done their best try to present what appears to be an irreparable and unstoppable process nowadays. The crystalline lens opacification is chronic and progressively damaged due to the loss of balance between the production and elimination of free reactive oxygen species (ROS), the attempts to stop or slow down this overproduction or lack of elimination lie in study material from disciplines as complex as cancer pathways. The execution of this review article was possible through metasearch engines like Wiley Online Library, EBSCO, Cochrane, Clinical key and MEDLINE PubMed (National Library of Medicine, National Institutes of Health), to retrieve studies from January 2021 to January 2022, following PRISMA guidelines, with a special affinity to systematic reviews and meta-analysis. MeSH Terms associated with "Cataract AND Reactive Oxygen Species". This work constitutes an integral cataractogenesis view in the development of future therapeutic scopes. The world population especially in Europe is aging at a rapid rate, in this sense is necessary to consider a root potential solution and not palliative strategies in ophthalmology for the next generations. The compendium of procedures presented already supposed to open a new panorama to a clearer world, a world without senile cataracts. Time is vision.