1. Articles from Namrata Sharma

    1-15 of 15
    1. Assessment of optic edge and the posterior capsule junction on optical coherence tomography

      Assessment of optic edge and the posterior capsule junction on optical coherence tomography

      After cataract surgery, a frequent challenge faced by the anterior segment surgeon is posterior capsule opacification (PCO). Therefore, it is necessary to tackle this intraoperatively by thoroughly removing the lens capsule epithelial cells. 1 A square-edged intraocular lens (IOL) optic has also been shown to reduce the occurrence of PCO. 1 Determining the actual changes along the square edges of the IOL and the capsule junction is important in understanding why PCO develops.

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    2. Assessment of posterior capsular integrity on optical coherence tomography

      Assessment of posterior capsular integrity on optical coherence tomography

      The integrity of posterior capsule is of paramount importance to cataract surgeon. Careful preoperative assessment is routinely performed to avoid undesirable intraoperative complications. Routine slit-lamp-based assessment provides a detailed understanding of the posterior capsule, provided that lens matter is optically clear to an acceptable extent. However, the presence of opacity along the posterior capsule with a hidden defect such as posterior polar cataract may pose a challenge to decipher the intactness of the capsule. 1 Under such circumstances, noninvasive imaging modalities, such as anterior segment optical coherence tomography (OCT), is at surgeons rescue during the preoperative period. Therefore, here we ...

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    3. Intralenticular changes on optical coherence tomography in eyes with mature brown cataract

      Intralenticular changes on optical coherence tomography in eyes with mature brown cataract

      We modified the posterior segment optical coherence tomography (OCT) process to image anterior segment structures by keeping a 20.0 diopter lens along its aperture (Figure 1, A ). We were measuring the central corneal thickness using this technique and we noticed some empty pockets within the anterior lens matter. We discuss these findings in 2 cases.

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    4. Intraoperative assessment of corneal injuries using microscope-integrated optical coherence tomography

      Intraoperative assessment of corneal injuries using microscope-integrated optical coherence tomography

      A 2-year-old male child presented to the ocular emergency following penetrating injury with a metallic foreign body. Clinical examination revealed a nasal corneal perforation with iris tissue prolapse [ [Figure 1] , yellow arrow ]. To further delineate the extent of the corneal perforation and associated anterior segment changes, integrated optical coherence tomography (iOCT) was used. It showed corneal wound gaping for entire corneal thickness from the paracentral region to the periphery of the cornea. Within the gaping, prolapsing hyperreflective tissue was made out in continuity with the iris tissue onto the surface of the epithelium, suggestive of iris tissue [Figure 2] a ...

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    5. Intraoperative optical coherence tomography-guided scleral suture passage while performing surgery on extraocular muscles

      Intraoperative optical coherence tomography-guided scleral suture passage while performing surgery on extraocular muscles

      Sir, Microscope-integrated intraoperative optical coherence tomography (iOCT, 2 mm depth penetration) helps in achieving the optimal results by providing the real-time images of tissue manipulation during the surgery. The iOCT is of great value while performing lamellar corneal surgeries, cataract surgeries, and intraocular lens implantation surgery. [1] , [2] It has also been noted to provide an advantage during placement of the glaucoma drainage devices in cadaveric eyes and needling of the blebs. [3] , [4] Pasricha et al . described the four-dimensional visualizations of the muscle and the scleral wound while passing the scleral sutures. [5] A 45-year-old male patient with alternate ...

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    6. Spectral Domain Anterior Segment Optical Coherence Tomography in Fungal Keratitis

      Spectral Domain Anterior Segment Optical Coherence Tomography in Fungal Keratitis

      Purpose: To evaluate the use of spectral domain anterior segment optical coherence tomography (SD-ASOCT) in fungal keratitis . Methods: Fifty eyes of 50 patients with fungal keratitis were recruited. Serial ASOCT was performed on days 0, 7, 14, 21, 28, 42, and 56. Corneal thickness (CT) in the infiltrate area, infiltrate thickness (IT), and infiltrate width were measured at each follow-up. The presence of any specific feature on ASOCT was evaluated. Results: Mean CT and IT at presentation were 650.5 ± 108 μm and 401.1 ± 91 μm, which reduced significantly at each follow-up [on days 7, 14, 28, and 42 ...

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    7. Ocular toxicity due to colours used during Holi celebration in India: Correlation of clinical findings with the anterior segment OCT

      Ocular toxicity due to colours used during Holi celebration in India: Correlation of clinical findings with the anterior segment OCT

      Purpose: To correlate the anatomical extent of ocular surface toxicity due to colours using anterior segment optical coherence tomography with the clinical findings. Methods: Patients presenting to our emergency department with ocular colour toxicity during the Holi festival celebrations from 2 nd March 2018 to 5 th March 2018 were assessed for any adnexal, conjunctival, corneal and anterior chamber findings, as well as findings on anterior segment optical coherence tomography (ASOCT). Results: A total of 21 patients were observed. The average age was 23 years with 16 patients being male (76.19%). Bilateral ocular involvement was more common (in 13 ...

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    8. Continuous intraoperative optical coherence tomography-guided shield ulcer debridement with tuck in multilayered amniotic membrane transplantation

      Continuous intraoperative optical coherence tomography-guided shield ulcer debridement with tuck in multilayered amniotic membrane transplantation

      Purpose: The aim of this study is to describe a modified surgical technique of continuous intraoperative optical coherence tomography (iOCT)-guided shield ulcer debridement with tuck-in multilayered Amniotic membrane transplantation (ML AMT) in vernal keratoconjunctivitis (VKC) with shield ulcer with plaque. Methods: Seven eyes of seven patients presenting with VKC with shield ulcer with plaque were enrolled in this prospective case series and planned for shield ulcer debridement with ML AMT. Debridement of the ulcer base with double-layered AMT was done under the continuous guidance of iOCT. The main outcome measure was the time for complete reepithelialization. Statistical analysis was ...

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    9. Intraoperative Optical Coherence Tomography–Guided Management of Cap–Lenticule Adhesion During SMILE

      Intraoperative Optical Coherence Tomography–Guided Management of Cap–Lenticule Adhesion During SMILE

      PURPOSE: To report successful lenticule extraction using intraoperative optical coherence tomography (OCT) in a case of cap–lenticule adhesion during small incision lenticule extraction (SMILE). METHODS: Case report. RESULTS: A 22-year-old patient with a refractive error of −5.00 −0.50 × 120° and −5.00 −0.75 × 60° in the right and left eyes, respectively, was scheduled for SMILE. The lenticule was created using the VisuMax femtosecond laser system (Carl Zeiss Meditec, Jena, Germany). The surgeon experienced difficulty while extracting the lenticule in the right eye. The patient was immediately shifted under the surgical microscope integrated with intraoperative OCT. The ...

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    10. Rescuing the host Descemets membrane in full-thickness traumatic wound dehiscence in deep anterior lamellar keratoplasty: intraoperative optical coherence tomography (iOCT)-guided technique

      Rescuing the host Descemets membrane in full-thickness traumatic wound dehiscence in deep anterior lamellar keratoplasty: intraoperative optical coherence tomography (iOCT)-guided technique

      Optimal visual recovery following full-thickness traumatic wound dehiscence in a case of operated deep anterior lamellar keratoplasty (DALK) is rarely seen. Here we report a case of 22-year-old male patient presented to our casualty department with complaint of sudden-onset diminution of vision in his right eye following blunt trauma of 1 day duration. DALK had been performed 11 months ago for advanced keratoconus in the same eye. Best-corrected visual acuity (BCVA) in the right eye was hand movement close to face with accurate projection of rays and in the left eye was 20/20. Slit-lamp examination showed the presence of ...

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    11. Microscope-integrated intraoperative optical coherence tomography-guided small-incision lenticule extraction: New surgical technique

      Microscope-integrated intraoperative optical coherence tomography-guided small-incision lenticule extraction: New surgical technique

      We describe the surgical technique of microscope-integrated intraoperative optical coherence tomography (OCT)-guided small-incision lenticule extraction. The technique enables manual tracking of surgical instruments and identification of the desired dissection plane. It also helps discern the relation between the dissector and the intrastromal lenticule. The dissection plane becomes hyperreflective on dissection, ensuring complete separation of the intrastromal lenticule from the overlying and underlying stroma. Inadvertent posterior plane entry, cap–lenticule adhesion, incomplete separation of the lenticule, creation of a false plane, and lenticule remnants may be recognized intraoperatively so corrective steps can be taken immediately. In cases with a hazy ...

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    12. Continuous intraoperative OCT guided management of post-deep anterior lamellar keratoplasty descemet’s membrane detachment

      Continuous intraoperative OCT guided management of post-deep anterior lamellar keratoplasty descemet’s membrane detachment

      Continuous intraoperative optical coherence tomography (iOCT) integrated into the operating microscope is a new modification in the current operating microscope to aid in the surgical procedures involving both the anterior and the posterior segment. This helps in intraoperative planning, modification of the surgical steps if required and confirmation of the surgical endpoint in the operating room itself. iOCT was used for the successful management of descemet’s membrane detachment (DMD) following deep anterior lamellar keratoplasty (DALK) with intracameral injection of 20% Sulphur hexafluoride. The gas was injected under direct visualization through the microscope with continuous real time monitoring of the ...

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    13. Evaluation of Time to Donor Lenticule Apposition Using Intraoperative Optical Coherence Tomography in Descemet Stripping Automated Endothelial Keratoplasty

      Evaluation of Time to Donor Lenticule Apposition Using Intraoperative Optical Coherence Tomography in Descemet Stripping Automated Endothelial Keratoplasty

      Purpose: To evaluate the time to donor lenticule apposition in cases of Descemet stripping automated endothelial keratoplasty (DSAEK) using microscope-integrated intraoperative optical coherence tomography (iOCT). Methods: Thirty eyes of 27 patients planned to undergo Descemet stripping automated endothelial keratoplasty were enrolled in this prospective study. In group I (n = 10), continuous intracameral positive pressure was maintained for 8 minutes. In group II (n = 10) and group III (n = 10), external corneal massage was initiated simultaneously with positive intracameral air pressure. The external corneal massage was continued till complete resolution of interface fluid; the positive intracameral pressure was maintained for 8 ...

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    14. Anterior Segment Optical Coherence Tomography-Guided Management Algorithm for Descemet Membrane Detachment After Intraocular Surgery

      Anterior Segment Optical Coherence Tomography-Guided Management Algorithm for Descemet Membrane Detachment After Intraocular Surgery

      Purpose: To evaluate the role of anterior segment optical coherence tomography (ASOCT) in the detection and management of Descemet membrane detachment (DMD) in cases of persistent corneal edema after intraocular surgery. An ASOCT-guided new algorithm for the management of such DMDs is described. Methods: Thirty-seven consecutive cases of persistent corneal edema of more than 2-week duration after intraocular surgery were included. All cases referred had no response to medical therapy. ASOCT was performed in all eyes. DMDs that were in the superior half of the cornea with a planar configuration alone were managed using intracameral air, and those with scrolled ...

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    15. Intrastromal fluid drainage with air tamponade: anterior segment optical coherence tomography guided technique for the management of acute corneal hydrops

      Intrastromal fluid drainage with air tamponade: anterior segment optical coherence tomography guided technique for the management of acute corneal hydrops

      Aims To describe a new technique of corneal stab incision with intracameral air injection for management of patients with acute corneal hydrops. Methods Five patients with acute corneal hydrops with large Descemet's membrane (DM) detachment and multiple stromal clefts underwent the procedure. The technique entailed anterior segment optical coherence tomography guided intrastromal fluid drainage through multiple corneal stromal venting incisions along with anterior chamber air tamponade. The time taken for the DM to reattach, resolution of corneal oedema and the best-corrected visual acuity (BCVA) were assessed postoperatively. Results Five patients (age range, 10–25 years) with large DM detachment ...

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    1-15 of 15
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    Intrastromal fluid drainage with air tamponade: anterior segment optical coherence tomography guided technique for the management of acute corneal hydrops Anterior Segment Optical Coherence Tomography-Guided Management Algorithm for Descemet Membrane Detachment After Intraocular Surgery Evaluation of Time to Donor Lenticule Apposition Using Intraoperative Optical Coherence Tomography in Descemet Stripping Automated Endothelial Keratoplasty Continuous intraoperative OCT guided management of post-deep anterior lamellar keratoplasty descemet’s membrane detachment Rescuing the host Descemets membrane in full-thickness traumatic wound dehiscence in deep anterior lamellar keratoplasty: intraoperative optical coherence tomography (iOCT)-guided technique Microscope-integrated intraoperative optical coherence tomography-guided small-incision lenticule extraction: New surgical technique Intraoperative Optical Coherence Tomography–Guided Management of Cap–Lenticule Adhesion During SMILE Ocular toxicity due to colours used during Holi celebration in India: Correlation of clinical findings with the anterior segment OCT Spectral Domain Anterior Segment Optical Coherence Tomography in Fungal Keratitis Assessment of posterior capsular integrity on optical coherence tomography Optical Coherence Tomography Angiography in Myopic Patients Quantification of retinal microvasculature and neurodegeneration changes in branch retinal vein occlusion after resolution of cystoid macular edema on optical coherence tomography angiography