Tropical Journal of Ophthalmology and Otolaryngology <div id="journalDescription-3" class="journalDescription"> <p><em><strong>ISSN: <a href="" target="_blank" rel="noopener">2456-6454 (Online)</a>,&nbsp; <a href="" target="_blank" rel="noopener">2581-4907 (Print)</a></strong></em></p> <p><em><strong>RNI: MPENG/2017/74152</strong></em></p> </div> Siddharth Health Research and Social Welfare Society en-US Tropical Journal of Ophthalmology and Otolaryngology 2581-4907 A clinical study to determine the effects of adenoidectomy in cases of secretory otitis media in school going children <p>Introduction: Secretory Otitis media (SOM) is the leading cause of hearing loss in children. Despite numerous studies on the prevention and treatment of SOM during the past decades, its management remains challenging and controversial. A study was conducted to find the effect of adenoidectomy in cases of SOM with hypertrophied adenoids and to determine the effect of adenoidectomy on hearing as assessed by the pure tone and impedance audiometry.</p> <p>Material and Methods: Children aged 5 – 12 years, diagnosed as SOM with adenoid hypertrophy were included. The study was conducted from April 2019 to May 2020, in the department of ENT, GSL Medical College. A detailed history and clinical examination were done. Investigations such as pure tone audiogram, impedance audiometry, X-ray nasopharynx, and diagnostic nasal endoscopy were carried out to confirm the diagnosis.</p> <p>Results: Out of the 50 participants, a maximum (60%) belonged to the 5 – 7 years age group, the male-female ratio was 1.2. Hard of hearing was a common symptom in 66%, tonsillitis, and sinusitis in 36% and 18% respectively. On pure tone audiometry, the average hearing loss was 24.95dB.</p> <p>Conclusion: Adenoidectomy in children having hypertrophied adenoids with SOM, not only relieves Eustachian tube obstruction but also removes the source of infection. This leads to clearance of middle ear effusion and improvement in hearing postoperatively.</p> Dr. B Krishna Santosh Dr. K Krishna Sumanth Dr. Panda Veeranjaneyulu Dr. B Deepthi Dr. K Mamatha Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 200 206 10.17511/jooo.2020.i08.01 Incidence, management, and outcome of complex cataracts in a tertiary eye set up <p>Aim: To study the incidence, management, and outcome of complex cataract cases in a tertiary eye care center.</p> <p>Material and methods: Retrospective observational study with analysis of records done for patients who were operated on for complex cataract from December 2019 to February 2020.</p> <p>Results: 300/10,000 patients had complex cataracts requiring additional surgical skills, advanced equipment, and better patient counseling. 5.3% (16/300) of patients needed intracameral adrenaline whereas 1.3% (4/300) needed Visco mydriasis. A capsular tension ring was implanted in 4.3%(13/300) of patients. 4% (12/300) underwent sphincterotomies whereas 2% (6/300) had to undergo synechiolysis. Iris hooks were used in only 0.6% of patients (2/300). Posterior capsular rent was seen in 1.6%(5/300) which was managed by placing a Posterior chamber IOL in the sulcus. 2.6% (8/300) had implantation of the iris-claw lens and 2.3% (7/300) were left aphakic for secondary IOL to be implanted at a later date. The visual outcome was better than 6/18 in 76% of patients. 24% of patients had an improvement in their visual acuity by a line or 2 but was less than 6/18 due to corneal degenerations, corneal scarring, Retinal pathologies, and colobomas.</p> <p>Conclusion: Although these cataracts demand more expertise on behalf of the surgeon, the outcome can be very rewarding if done with proper planning. The knowledge of small incision cataract surgery is highly valuable in such situations.</p> Dr. Ritu Verma Dr. Meghna Shrishrimal Dr. Shirali Gokharu Dr. Dhaivat Shah Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 207 215 10.17511/jooo.2020.i08.02 Analysis of visual outcome of Neodymium: Yttrium-Aluminum -Garnet (Nd: YAG) laser capsulotomy in patients with Posterior Capsule Opacification <p>Objective: Posterior capsular opacification (PCO) is a postoperative complication causing decreased visual acuity. This study aims to study the efficacy of Nd: YAG laser capsulotomy in posterior capsular opacification following cataract surgery by analyzing the visual outcome.</p> <p>Material and Methods: A prospective study included a sample size of 50 eyes of 37 patients with Posterior capsular opacification following uneventful cataract surgery with significantly decreased visual acuity. Detailed anterior and posterior segment examination was done, best-corrected visual acuity (BCVA) was recorded along with measurement of IOP. Posterior capsulotomy was performed using Nd: YAG laser (Neodymium: Yttrium-aluminum–garnet) and patients were followed up. Visual acuity was assessed and complications if any were recorded.</p> <p>Results: It was noted that 74% of the patients at the end of 1st week and 78% of the patients at the end of 1st and 3rd month had significant visual improvement following Nd: YAG laser capsulotomy. There was a statistically significant difference in Post Nd: YAG laser BCVA on follow up with P-value &lt;0.001. Complications encountered were the rise in IOP in 6% of the population at the end of 1 hour and 1st day of the procedure, iris bleeding was noted in 4% of the population, intraocular lens damage in 2 %, and cystoid macular edema in 2 % of the study population.</p> <p>Conclusion: Thus Nd: YAG laser posterior capsulotomy serves as an excellent treatment modality in patients with postoperative PCO.</p> Dr. Deepa R. Dr. V. Panimalar A. Veeramani Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 216 223 10.17511/jooo.2020.i08.03 Change to win - flapless external dacryocystorhinostomy (DCR) <p>Introduction: Nasolacrimal Duct obstruction (NLDO) is a common ophthalmic problem and the usual Treatment is Dacryocystorhinostomy (DCR), either external or endonasal. This study aims to evaluate the success of external DCR with neither anterior nor posterior flaps with Mitomycin c (MMC) syringing on the 5th post-operative day (early proliferative phase of wound healing). It was shown in the present study that a comparable good result can be achieved without tedious flaps making and anastomosis.</p> <p>Material and Methods: It is a retrospective, non-comparative observational Case series study done from March 2011 to August 2019. A total of 2165 patients were included in this study qualifying inclusion criterion. 8 to 10 mm Arruga’s bone trephine was used to make osteum in lacrimal bone and passage in the nasal mucosa. The anterior margin of the lateral side of the remaining sac was sutured to the subcutaneous tissue of the medial side adjacent to the nasal osteotomy. Syringing with 1 ml of 0.4 mg/ ml MMC was done in the newly formed passage on the 5th post-operative day. These patients were followed up for one year. The success criteria were symptomatic relief from epiphora subjectively. Objectively a patent nasolacrimal duct upon syringing and Nasal endoscopy.</p> <p>Results: 2136 (out of 2165) patients' eyes treated with this procedure showed resolution of epiphora with a success rate of 98.66%.</p> <p>Conclusion: The current study suggest that DCR without flap making is an effective and easy procedure in the management of NLDO obstruction and flap making is a futile step in the procedure as it has no impact on the outcome.</p> Dr. Ravi Ranjan Dr. Kumari Rupam Dr. Sudhir Kumar Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 224 230 10.17511/jooo.2020.i08.04 Comparative analysis of efficacy and safety of Bilastine 20 mg and Levocetirizine 5 mg in the treatment of Allergic Rhinoconjunctivitis <p>Objective: The present study was conducted to assess the efficacy and safety of bilastine 20 mg and compare the results with that of levocetirizine 5 mg in the treatment of allergic rhinoconjunctivitis.</p> <p>Material and Methods: It was a prospective study conducted in the Department of Ophthalmology and Department of Otorhinolaryngology at a tertiary institute of southern Rajasthan, India during the period of 6 months from September 2019 to February 2020. 100 patients of chronic allergic rhinoconjunctivitis were included in the study, of which 50 were treated with Bilastine 20 mg, and the rest 50 patients were treated with levocetirizine 5 mg. The primary assessment was done by calculating the total symptom score (TSS) before and after the 7th and 14th post-treatment day.</p> <p>Results: The age of the patients ranges from 10 years to 65 years with a mean age of 32±5.2 years. The primary efficacy parameter for assessment was a reduction in total symptom score (TSS). Both bilastine 20 mg and levocetirizine 5 mg significantly reduced the TSS on the 7th and 14th post-treatment days (p-value&lt; 0.001). There was no significant difference between TSS of bilastine and levocetirizine after 7 days (p-value= 0.41) and after 14 days treatment (p-value= 0.68). Adverse events were reported by 10% of patients in the bilastine group and by 38% of patients in the levocetirizine group.</p> <p>Conclusion: Bilastine is a selective H1 antihistamine with good efficacy and excellent safety profile and it is highly recommended to use it as a first-line treatment for allergic rhinoconjunctivitis.</p> Dr. Devendra Sharma Dr. Hemendra Bamaniya Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 231 236 10.17511/jooo.2020.i08.06 Randomized Controlled Trial of varied incision sites in Manual Small Incision Cataract Surgery done in a Medical College Hospital in Kancheepuram District, Tamil Nadu, India <p>Aim: To compare visual outcome, postoperative surgically induced astigmatism (SIA), and postoperative complications of superior and temporal scleral incision in manual small incision cataract surgery (MSICS).</p> <p>Materials and Methods: A Prospective Randomized, parallel-group, active-controlled Trial Study of 80 cases of senile/pre-senile cataract. 40 cases were randomly assigned (computer-generated randomization) to superior incision and 40 cases to the temporal incision.</p> <p>Results: The majority of patients (38 patients- 47.5%) were in the age group of 56-65years. The next common age group was 66-75 years(31 patients-38.75%). In the superior MSICS group, the majority of patients (28 patients-70%) had a moderate post-operative unaided visual acuity of 6/18-6/12. In the temporal MSICS group, majority of patients(33patients-82.5%) had a good post-operative unaided visual acuity of 6/9-6/6. The mean surgically induced astigmatism(SIA) in the superior MSICS group was 1.12 and in the temporal MSICS group was 0.45 with a difference of 0.67. The SIA values were analyzed using the unpaired T-test which showed a value of 9.967 which was statistically significant(P value of 0.0001).</p> <p>Conclusion: This study has shown that the temporal approach for Manual small incision cataract surgery(MSICS) has less postoperative astigmatism and better postoperative unaided visual acuity compared to the superior approach.</p> Dr. J. Samuel Cornelius Gnanadurai Dr. S. Vimala Karunanidhi Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 237 242 10.17511/jooo.2020.i08.07 Eye donation awareness and willingness among patients attending ophthalmology OPD at Goa medical college and hospital <p>INTRODUCTION: Significant cause of corneal blindness in India is due to trauma and corneal ulcers. India needs 2.5lakh donated corneas every year, the country’s eye banks manage to collect only about 44806, out of these only some are utilized for sight restoration as the others do not meet the standard for transplantation. The present study aimed to evaluate the awareness regarding eye donation among the patients and their relatives attending the outpatient department (OPD) at Goa Medical College and hospital, giving them the knowledge and thus encouraging them to pledge their eyes for donation, which is the need of the hour.</p> <p>MATERIAL AND METHODS: This study was conducted on 300 patients who attended ophthalmology OPD (outpatient department) at Goa medical college and hospital. This is a closed-end type of study wherein the patients who were willing to participate in the study were requested to fill the form and answer 10 questions related to the awareness of eye donation and willingness to donate eyes. The questionnaire had the first few questions regarding brief details about each participant followed by 10 questions which had multiple options and participants were requested to answer as per their choice. It was a pretested questionnaire that included questions on eye donation awareness, knowledge regarding the subject, and willingness to donate eyes. All participants were well informed about the study type and written informed consent was taken for the same. No patients were harmed during the study.</p> <p>RESULTS: The results showed that 252 (84%)among 300 patients were aware of eye donation. Awareness was maximum through mass media and hospitals. 68% of responders were not aware that there is an eye bank in Goa. 79% of responders were not aware that only cornea is removed from the donor’s eye. Only about 32% of the patients were willing to donate their eyes.</p> Dr. Ankita Gaunekar Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 243 249 10.17511/jooo.2020.i08.08 Wriggly creatures coming out of eye: case report on human ocular thelaziasis <p>Ocular Thelaziasis is an arthropod-borne, zoonotic disease of the eye affecting the conjunctival sac, lacrimal duct, and lacrimal gland caused by a nematode of the genus Thelazia. Thelazia species are transmitted by different species of Muscidae, which are a family of flies with worldwide distribution. The present study reports a case of human ocular Thelaziasis in a 13-year-old female patient. Species Thelazia callipaeda was confirmed based on microbiological examination. The patient was treated with anti-helminthic drugs and was relieved of the symptoms without recurrence.</p> Dr. Anchal Tripathi Dr. Sonali Bhalla Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2020-12-31 2020-12-31 5 8 250 253 10.17511/jooo.2020.i08.05