Notes

Differential incremental worth of sonography carotid intima-media fullness, carotid back plate, as well as cardiovascular calcium to predict angiographic heart disease throughout Framingham threat report strata inside the APRES multicentre examine.
To report the risk factors, clinical characteristics, and outcomes of Candida keratitis following corneal transplantation in India.

On retrospective review of medical records of 789 patients, 31 eyes developed a graft infection following corneal transplantation or keratoprosthesis and we could identify the Candida infection in only five. These cases were operated at two tertiary care centers in India. These five records were reviewed for demographics, risk factors (local and systemic) for graft infection, characteristics of infective lesion, corneal scraping results, treatment plan, and the final outcome following management.

The median age of the subjects with the Candida graft infection was 62.4 ± 10.33 years (range, 62-71 years). All patients were males. The predominant risk factors included repeat corneal transplantation (5/5), prolonged usage of topical steroids (5/5), and epithelial defects (4/5). The clinical characteristics included infiltrates of variable configuration like powdery deposits, white plaque, fluffy white infiltrate, and crystalline keratopathy. The smear showed budding yeasts in all five cases whereas culture was positive in four out of five cases. The final outcome with antifungals (systemic [4/5] and topical [5/5]) is variable. Two eyes underwent evisceration, two eyes had scar formation in the failed grafts, and one patient succumbed to the systemic disease 1-month post-corneal infection.

Candida keratitis, in India, seems to be an emerging pathology following corneal transplantation and has a varied presentation. Though the outcomes following management seem to be grim, however, such infection can easily be avoided by a timely reduction of the risk factors.
Candida keratitis, in India, seems to be an emerging pathology following corneal transplantation and has a varied presentation. Though the outcomes following management seem to be grim, however, such infection can easily be avoided by a timely reduction of the risk factors.
To analyze the early changes in host and donor lenticule thickness after Descemet Stripping Endothelial Keratoplasty (DSEK).

DSEK was performed on 32 eyes of 31 patients. Pre- and post- operative slit lamp examination and anterior segment Optical Coherence Tomography (OCT) was done on day-1, day-7, 1 month, and 3 months.

There were significant changes in host, lenticule, and total corneal thicknesses between day-1 and day-7, and day-7 and 1 month. There were significant changes in host thickness and total corneal thickness between 1 month and 3 months. Thickness changes were significant between day-1 and day-7, and 1 month and 3 months for thick and thin host, respectively, whereas these changes were observed both for thick and thin host between day-7 and 1 month. Similarly, significant changes were observed between day-7 and 1 month, and day-7 and 1 month in thin lenticule whereas in case of thick lenticule, it was observed till the 3 months follow-up period. There was a significant improvement in visual acuity till the 3 months follow-up period. No significant correlation was observed between visual acuity and host and lenticule thickness.

The thicknesses of host and lenticule decrease continuously. Lenticule thickness stabilizes before host. Thinner cornea stabilizes earlier compared to thicker cornea.
The thicknesses of host and lenticule decrease continuously. Lenticule thickness stabilizes before host. Thinner cornea stabilizes earlier compared to thicker cornea.
To evaluate and compare the biomechanical properties of the eye bank-prepared and surgeon prepared Descemet stripping automated endothelial keratoplasty (DSAEK) tissues.

In this laboratory study, corneal tissues for research were randomly allocated in the following groups a) surgeon-cut DSAEK and b) eye bank-prepared (pre-cut and pre-loaded) DSAEK. Endothelial cell loss (ECL), immunostaining for tight junction protein ZO-1, elastic modulus, and adhesion force were investigated.

ECL was not found to be significantly different between surgeon-cut DSAEK (7.8% ±6.5%), pre-cut DSAEK (8.6% ±2.3%), and pre-loaded DSAEK (11.1% ±4.8%) (P = 0.5910). ZO-1 was expressed equally across all groups. Surgeon-cut DSAEK grafts showed a significantly higher elastic modulus compared to pre-cut and pre-loaded DSAEK groups (P = 0.0047 and P < 0.0001, respectively). Adhesion force was significantly greater in the surgeon-cut DSAEK compared to pre-cut (P < 0.0001) or pre-loaded DSAEK groups (P = 0.0101).

The laboratory data on the biomechanics of DSAEK grafts suggests that surgeon-cut DSAEK grafts present higher elastic modulus and adhesion force compared to eye bank-prepared DSAEK grafts.
The laboratory data on the biomechanics of DSAEK grafts suggests that surgeon-cut DSAEK grafts present higher elastic modulus and adhesion force compared to eye bank-prepared DSAEK grafts.
To compare various counseling methods for improving patient education, compliance, and administration of eye drops prescribed for post-optical keratoplasty patients and assess the most efficient counseling method.

A prospective, questionnaire-based pilot study was conducted among 60 post-optical keratoplasty patients who were randomly assigned into three groups for postoperative eye drop counseling, namely group 1 (video counseling), group 2 (chart counseling), and group 3 (verbal counseling at Cornea department). The questionnaire was answered by the patients/attendants applying the eye drops on the first 3 consecutive visits. McNemar-Bowker test was used to compare responses in each group and the Kruskal-Wallis test was used to compare responses among the three groups. The Institutional Ethics Committee of Aravind Eye Hospital, Tirunelveli (Registration number ECR 816/Inst/Tn/2016) approved this study.

Results demonstrated improvement in various categories assessed regarding drop administration in all three groups, which assessed patients' knowledge, attitude, and hygiene. Although all three groups showed improvements during subsequent follow-up visits, the video-counseling method was found to be an effective means of communication.

Our study emphasizes that the nonverbal and noncontact means of communication by video demonstration would be an effective way of counseling. It can be considered in the present scenario of the pandemic as well.
Our study emphasizes that the nonverbal and noncontact means of communication by video demonstration would be an effective way of counseling. It can be considered in the present scenario of the pandemic as well.
To examine the utilization patterns of cornea procured from diseased individuals ≥75 years of age at an eye bank in western India.

In this retrospective study, data from 1,217 eyes of 653 donors with age ≥75 years were reviewed from October 2008 to December 2019. Donor age, lens status, endothelial cell count (ECD), utilization of the tissue for transplantation or non-clinical purposes (e.g., research, training/discarded), and causes of non-utilization were noted.

The mean age of the donors was 80.9 ± 4.6 years and the tissue utilization rate was 36.5% (445 out of 1,217 eyes). The eyes used for keratoplasty procedures had a lower donor age (79.6 ± 5.7 vs. 81.5 ± 5.1; P < 0.001), a higher endothelial cell count (2493 ± 531 vs. 2034 ± 581; P < 0.001), and were more often phakic (61% vs. 36.6%) compared to the unused group. A multivariable logistic regression analysis showed that the likelihood of tissue utilization for keratoplasty was 13% higher with every 100-cell increment in donor ECD (odds ratio [OR] = 1.13, 95% CI = 1.10-1.16, P < 0.001) and 33% lower with having a pseudophakic status in the donor eye (OR = 0.67, 95% CI = 0.52-0.87, P = 0.03). Age was not a significant determinant of tissue utilization when used in the same multivariable model.

More than one-third of the eyes (36.5%) can be utilized even when the donors are above 75 years of age. Eyes that were more likely to be utilized for keratoplasty were phakic and had a significantly higher ECD; age was not a determinant in tissue utilization.
More than one-third of the eyes (36.5%) can be utilized even when the donors are above 75 years of age. Eyes that were more likely to be utilized for keratoplasty were phakic and had a significantly higher ECD; age was not a determinant in tissue utilization.
To compare the corneal epithelial thickness among various age groups of normal Indians with 9-mm-wide optical coherence tomography scans.

This cross sectional, observational study recruited patients in the age groups of 5-20 years (group 1), 21-35 years (group 2), 36-50 years (group 3), and more than 51 years (group 4). They underwent a detailed ophthalmic examination and were excluded if found to have any ocular surface or intraocular disease (except cataract and refractive error), undergone any ophthalmic surgery, corneal topography changes suggestive of corneal ectasias, or been continuously using any topical medication in either eye for a period of 3 months or more with the last instillation being within 1 month of inclusion in the study. Corneal epithelial thickness (CET) was measured using anterior segment optical coherence tomography (AS-OCT). The CET data from 25 sectors in each eye were analyzed for each age group.

There were 71 subjects in group 1, 76 subjects in group 2, 59 subjects in group 3, and 57 subjects in group 4. The mean (± standard deviation) ages in the groups 1, 2, 3, and 4 were 14.04 ± 5.10, 26.63 ± 4.71, 42.66 ± 3.92, and 61.65 ± 7.47 years, respectively. The central corneal thickness in all age groups was comparable. Maximum variance in CET parameters was seen in superior cornea.

Central corneal thickness remains fairly stable over various age groups. The maximum variance in CET over age is seen in superior cornea. The findings from the Indian population correlate well with racially and geographically distinct subjects.
Central corneal thickness remains fairly stable over various age groups. The maximum variance in CET over age is seen in superior cornea. The findings from the Indian population correlate well with racially and geographically distinct subjects.
A study of the association between vitamin D deficiency and dry eye syndrome (DES) in the Indian population.

This was a cross-sectional, hospital-based observational study. Sixty patients diagnosed with vitamin D deficiency (<20 ng/dl) who met the inclusion criteria were sent to the Eye OPD from the Endocrinology OPD (case) were compared to 60 subjects with normal vitamin D levels (≥20 ng/dl) who attended the Eye OPD (controls). 3',3'-cGAMP The examination of the tear film was done using Whatman filter paper in Schirmer test I and Schirmer test I (with anesthesia). The tear film break-up time (TFBUT) was determined by slit-lamp examination using the fluorescein stain, and scoring using the ocular surface disease index (OSDI) was done.

A significant difference in the mean values of Schirmer I and Schirmer I test (with anesthesia) (P < 0.001) was seen between the case and control groups. A significant difference in the mean values of TFBUT (P < 0.001) and OSDI scores (P < 0.01) was also seen between the two groups.

A positive association was found between vitamin D deficiency and dry eye on comparing the above parameters.
A positive association was found between vitamin D deficiency and dry eye on comparing the above parameters.
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