Sameer Kaushal | All India Institute of Medical Sciences, New Delhi (original) (raw)
Papers by Sameer Kaushal
British Journal of Ophthalmology, 2008
Aims: Evaluation of a new surgical technique for the management of corneal ectasia with periphera... more Aims: Evaluation of a new surgical technique for the management of corneal ectasia with peripheral corneal involvement. Methods: Twelve eyes of 12 patients with corneal ectasias and peripheral corneal thinning requiring surgical intervention, including eight patients with combined keratoconus and PMD and four patients of keratoglobus, were enrolled for the study in a tertiary care hospital. All patients were contact lens intolerant and had a best corrected visual acuity (BCVA) (20/120 with nine patients (75%) having BCVA (20/200. ''Tuck In'' Lamellar Keratoplasty (TILK) that included a central lamellar keratoplasty with intrastromal tucking of the peripheral flange was performed in these patients. The main outcome measures analysed were uncorrected visual acuity (UCVA), BCVA, keratometry, refractive status and time for epithelial healing. Results: At the last follow-up (mean: 1.7 years (range 13-48 months)), six patients (50.0%) had BCVA >20/60, and all patients had BCVA >20/80. The mean keratometry decreased from 57.54 (SD 6.89) D preoperatively to 46.36 (2.39) D (p = 0.003), and the mean spherical equivalent (SEQ) refractive error decreased from-7.8 (4.6) D preoperatively to 1.23 (1.88) D (p = 0.007). A significant decrease was also seen in mean refractive astigmatism which decreased from 5.93 (3.06) D preoperatively to 3.23 (1.14) D (p = 0.037). Conclusion: Our technique of TILK is an effective surgical modality for the management of ectatic corneal dystrophies with peripheral corneal thinning.
Eye, 2008
Purpose Comparative evaluation of 'flap on' and 'flap off' techniques of Epi-LASIK in lowto-moder... more Purpose Comparative evaluation of 'flap on' and 'flap off' techniques of Epi-LASIK in lowto-moderate myopia. Methods Sixteen eyes of eight consecutive patients with myopia p6 D were selected for this prospective, randomized, comparative, interventional case series. Epi-LASIK surgery was performed in all eyes. In one eye of each patient, the epithelial flap was retained after excimer laser ablation (flap on). In the fellow eye, the epithelial flap was discarded (flap off) after ablation. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), spherical equivalent (SEQ), postoperative pain score, time to epithelization, and corneal haze were recorded on postoperative visits. Results The mean preoperative SEQ in the two groups was À3.61 ± 1.32 D (flap on) and À3.49±1.86 D (flap off; P ¼ 0.752). The mean follow-up period was 8.5±4.9 months. The mean pain score was comparable on all postoperative days except the second postoperative day when the group with flap off had a lesser mean pain score (P ¼ 0.053). Time for epithelial healing was 3.63 ± 0.52 days in cases with flap off and 4.13 ± 0.64 days in cases with flap on (P ¼ 0.113). Eyes with flap off had a better UCVA on the first postoperative day (0.19±0.11 logMAR) compared with eyes with flap on (0.41 ± 0.28logMAR; P ¼ 0.032). There was no significant difference in UCVA, BSCVA, SEQ, contrast sensitivity, corneal haze, and higher order aberrations at any other postoperative visit. Conclusions There is no difference between flap on and flap off techniques of Epi-LASIK with regards to overall outcome of surgery.
Clinical & Experimental Ophthalmology, 2007
We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intr... more We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intrastromal cleft in a case of pellucid marginal degeneration with keratoglobus. Acute hydrops in a 36-year-old man with pellucid marginal degeneration with keratoglobus was treated with intracameral injection of 0.3 mL isoexpansile C(3)F(8) (14%). Reduction in corneal haze was seen beginning from the third postoperative day. Significant clearing had taken place by the end of the second week with the closure of intrastromal cleft. Best corrected visual acuity improved from finger counting at 1 foot preoperatively to 6/18 after 2 weeks. There was no postoperative rise in intraocular pressure or cataract formation. Intracameral injection of C(3)F(8) may possibly be a viable treatment option for acute hydrops in a case of corneal ectasia. Larger studies are required to clarify the role of intracameral gas injection in the treatment of acute hydrops in corneal ectasia.
Journal of refractive surgery, 2009
To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-... more To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-year-old woman underwent epi-LASIK surgery to correct refractive error of -4.00 -3.00 x 165 degrees in the right eye and -2.50 -2.00 x 15 degrees in the left eye. Preoperatively, the specular count was 2896 cells/mm2 in the right eye and 3046 cells/mm2 in the left eye. Central corneal thickness (CCT) was 490 microm and 493 microm in the right and left eyes, respectively. Examination on the first postoperative day revealed diffuse corneal edema with radiating Descemet's folds in the right eye with best spectacle-corrected visual acuity of 20/80. Central corneal thickness was 493 microm and 373 microm in the right and left eyes, respectively, 1 week after surgery. Corneal edema resolved over a period of 3 weeks with healing of the epithelial defect. Endothelial cell count 3 weeks after surgery was 1310 cells/mm2 in the right eye. Epi-LASIK can cause significant endothelial cell loss wi...
Journal of Pediatric Ophthalmology and Strabismus, 2010
Congenital horizontal tarsal kink is extremely rare. Only one case of associated microphthalmos h... more Congenital horizontal tarsal kink is extremely rare. Only one case of associated microphthalmos has been reported. Various surgical techniques have been described with successful results. Few reported cases have been managed with intermarginal suture tarsorrhaphy. The current case is probably the third patient with severe tarsal kink to be managed with this simple technique.
Corneal Transplantation, 2010
The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (... more The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (IOL) in a cadaveric donor eye with posterior capsular opacification (PCO), following report of high PCO rates with this IOL. A cadaveric donor eye implanted with ThinOptX IOL and received at our eye bank was fixed in 10% formalin after retrieval of corneoscleral button. The globe was sectioned at equator and evaluated from the posterior (Miyake-Apple) view. Complete iridectomy was performed and IOL evaluated from the anterior (surgeon's) view. The IOL was well centered in the bag. A thick (Grade 4) Sommering ring was seen with centripetal extension across the IOL edge margin. The anterior capsule showed fibrosis and distortion of the capsulorrhexis margin. It seems from our findings that in some cases, the edge of the ThinOptX IOL may not provide an adequate barrier to epithelial cell migration and PCO formation. This can have clinical implications which need evaluation in large clinical and histopathological studies.
Journal of refractive surgery (Thorofare, N.J. : 1995), 2009
To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-... more To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-year-old woman underwent epi-LASIK surgery to correct refractive error of -4.00 -3.00 x 165 degrees in the right eye and -2.50 -2.00 x 15 degrees in the left eye. Preoperatively, the specular count was 2896 cells/mm2 in the right eye and 3046 cells/mm2 in the left eye. Central corneal thickness (CCT) was 490 microm and 493 microm in the right and left eyes, respectively. Examination on the first postoperative day revealed diffuse corneal edema with radiating Descemet's folds in the right eye with best spectacle-corrected visual acuity of 20/80. Central corneal thickness was 493 microm and 373 microm in the right and left eyes, respectively, 1 week after surgery. Corneal edema resolved over a period of 3 weeks with healing of the epithelial defect. Endothelial cell count 3 weeks after surgery was 1310 cells/mm2 in the right eye. Epi-LASIK can cause significant endothelial cell loss wi...
Eye & Contact Lens: Science & Clinical Practice, 2011
Contact Lens and Anterior Eye, 2009
The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (... more The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (IOL) in a cadaveric donor eye with posterior capsular opacification (PCO), following report of high PCO rates with this IOL. A cadaveric donor eye implanted with ThinOptX IOL and received at our eye bank was fixed in 10% formalin after retrieval of corneoscleral button. The globe was sectioned at equator and evaluated from the posterior (Miyake-Apple) view. Complete iridectomy was performed and IOL evaluated from the anterior (surgeon's) view. The IOL was well centered in the bag. A thick (Grade 4) Sommering ring was seen with centripetal extension across the IOL edge margin. The anterior capsule showed fibrosis and distortion of the capsulorrhexis margin. It seems from our findings that in some cases, the edge of the ThinOptX IOL may not provide an adequate barrier to epithelial cell migration and PCO formation. This can have clinical implications which need evaluation in large clinical and histopathological studies.
Clinical & Experimental Ophthalmology, 2007
We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intr... more We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intrastromal cleft in a case of pellucid marginal degeneration with keratoglobus. Acute hydrops in a 36-year-old man with pellucid marginal degeneration with keratoglobus was treated with intracameral injection of 0.3 mL isoexpansile C(3)F(8) (14%). Reduction in corneal haze was seen beginning from the third postoperative day. Significant clearing had taken place by the end of the second week with the closure of intrastromal cleft. Best corrected visual acuity improved from finger counting at 1 foot preoperatively to 6/18 after 2 weeks. There was no postoperative rise in intraocular pressure or cataract formation. Intracameral injection of C(3)F(8) may possibly be a viable treatment option for acute hydrops in a case of corneal ectasia. Larger studies are required to clarify the role of intracameral gas injection in the treatment of acute hydrops in corneal ectasia.
British Journal of Ophthalmology, 2008
Aims: Evaluation of a new surgical technique for the management of corneal ectasia with periphera... more Aims: Evaluation of a new surgical technique for the management of corneal ectasia with peripheral corneal involvement. Methods: Twelve eyes of 12 patients with corneal ectasias and peripheral corneal thinning requiring surgical intervention, including eight patients with combined keratoconus and PMD and four patients of keratoglobus, were enrolled for the study in a tertiary care hospital. All patients were contact lens intolerant and had a best corrected visual acuity (BCVA) (20/120 with nine patients (75%) having BCVA (20/200. ''Tuck In'' Lamellar Keratoplasty (TILK) that included a central lamellar keratoplasty with intrastromal tucking of the peripheral flange was performed in these patients. The main outcome measures analysed were uncorrected visual acuity (UCVA), BCVA, keratometry, refractive status and time for epithelial healing. Results: At the last follow-up (mean: 1.7 years (range 13-48 months)), six patients (50.0%) had BCVA >20/60, and all patients had BCVA >20/80. The mean keratometry decreased from 57.54 (SD 6.89) D preoperatively to 46.36 (2.39) D (p = 0.003), and the mean spherical equivalent (SEQ) refractive error decreased from-7.8 (4.6) D preoperatively to 1.23 (1.88) D (p = 0.007). A significant decrease was also seen in mean refractive astigmatism which decreased from 5.93 (3.06) D preoperatively to 3.23 (1.14) D (p = 0.037). Conclusion: Our technique of TILK is an effective surgical modality for the management of ectatic corneal dystrophies with peripheral corneal thinning.
Eye, 2008
Purpose Comparative evaluation of 'flap on' and 'flap off' techniques of Epi-LASIK in lowto-moder... more Purpose Comparative evaluation of 'flap on' and 'flap off' techniques of Epi-LASIK in lowto-moderate myopia. Methods Sixteen eyes of eight consecutive patients with myopia p6 D were selected for this prospective, randomized, comparative, interventional case series. Epi-LASIK surgery was performed in all eyes. In one eye of each patient, the epithelial flap was retained after excimer laser ablation (flap on). In the fellow eye, the epithelial flap was discarded (flap off) after ablation. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), spherical equivalent (SEQ), postoperative pain score, time to epithelization, and corneal haze were recorded on postoperative visits. Results The mean preoperative SEQ in the two groups was À3.61 ± 1.32 D (flap on) and À3.49±1.86 D (flap off; P ¼ 0.752). The mean follow-up period was 8.5±4.9 months. The mean pain score was comparable on all postoperative days except the second postoperative day when the group with flap off had a lesser mean pain score (P ¼ 0.053). Time for epithelial healing was 3.63 ± 0.52 days in cases with flap off and 4.13 ± 0.64 days in cases with flap on (P ¼ 0.113). Eyes with flap off had a better UCVA on the first postoperative day (0.19±0.11 logMAR) compared with eyes with flap on (0.41 ± 0.28logMAR; P ¼ 0.032). There was no significant difference in UCVA, BSCVA, SEQ, contrast sensitivity, corneal haze, and higher order aberrations at any other postoperative visit. Conclusions There is no difference between flap on and flap off techniques of Epi-LASIK with regards to overall outcome of surgery.
Clinical & Experimental Ophthalmology, 2007
We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intr... more We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intrastromal cleft in a case of pellucid marginal degeneration with keratoglobus. Acute hydrops in a 36-year-old man with pellucid marginal degeneration with keratoglobus was treated with intracameral injection of 0.3 mL isoexpansile C(3)F(8) (14%). Reduction in corneal haze was seen beginning from the third postoperative day. Significant clearing had taken place by the end of the second week with the closure of intrastromal cleft. Best corrected visual acuity improved from finger counting at 1 foot preoperatively to 6/18 after 2 weeks. There was no postoperative rise in intraocular pressure or cataract formation. Intracameral injection of C(3)F(8) may possibly be a viable treatment option for acute hydrops in a case of corneal ectasia. Larger studies are required to clarify the role of intracameral gas injection in the treatment of acute hydrops in corneal ectasia.
Journal of refractive surgery, 2009
To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-... more To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-year-old woman underwent epi-LASIK surgery to correct refractive error of -4.00 -3.00 x 165 degrees in the right eye and -2.50 -2.00 x 15 degrees in the left eye. Preoperatively, the specular count was 2896 cells/mm2 in the right eye and 3046 cells/mm2 in the left eye. Central corneal thickness (CCT) was 490 microm and 493 microm in the right and left eyes, respectively. Examination on the first postoperative day revealed diffuse corneal edema with radiating Descemet's folds in the right eye with best spectacle-corrected visual acuity of 20/80. Central corneal thickness was 493 microm and 373 microm in the right and left eyes, respectively, 1 week after surgery. Corneal edema resolved over a period of 3 weeks with healing of the epithelial defect. Endothelial cell count 3 weeks after surgery was 1310 cells/mm2 in the right eye. Epi-LASIK can cause significant endothelial cell loss wi...
Journal of Pediatric Ophthalmology and Strabismus, 2010
Congenital horizontal tarsal kink is extremely rare. Only one case of associated microphthalmos h... more Congenital horizontal tarsal kink is extremely rare. Only one case of associated microphthalmos has been reported. Various surgical techniques have been described with successful results. Few reported cases have been managed with intermarginal suture tarsorrhaphy. The current case is probably the third patient with severe tarsal kink to be managed with this simple technique.
Corneal Transplantation, 2010
The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (... more The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (IOL) in a cadaveric donor eye with posterior capsular opacification (PCO), following report of high PCO rates with this IOL. A cadaveric donor eye implanted with ThinOptX IOL and received at our eye bank was fixed in 10% formalin after retrieval of corneoscleral button. The globe was sectioned at equator and evaluated from the posterior (Miyake-Apple) view. Complete iridectomy was performed and IOL evaluated from the anterior (surgeon's) view. The IOL was well centered in the bag. A thick (Grade 4) Sommering ring was seen with centripetal extension across the IOL edge margin. The anterior capsule showed fibrosis and distortion of the capsulorrhexis margin. It seems from our findings that in some cases, the edge of the ThinOptX IOL may not provide an adequate barrier to epithelial cell migration and PCO formation. This can have clinical implications which need evaluation in large clinical and histopathological studies.
Journal of refractive surgery (Thorofare, N.J. : 1995), 2009
To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-... more To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK). A 23-year-old woman underwent epi-LASIK surgery to correct refractive error of -4.00 -3.00 x 165 degrees in the right eye and -2.50 -2.00 x 15 degrees in the left eye. Preoperatively, the specular count was 2896 cells/mm2 in the right eye and 3046 cells/mm2 in the left eye. Central corneal thickness (CCT) was 490 microm and 493 microm in the right and left eyes, respectively. Examination on the first postoperative day revealed diffuse corneal edema with radiating Descemet's folds in the right eye with best spectacle-corrected visual acuity of 20/80. Central corneal thickness was 493 microm and 373 microm in the right and left eyes, respectively, 1 week after surgery. Corneal edema resolved over a period of 3 weeks with healing of the epithelial defect. Endothelial cell count 3 weeks after surgery was 1310 cells/mm2 in the right eye. Epi-LASIK can cause significant endothelial cell loss wi...
Eye & Contact Lens: Science & Clinical Practice, 2011
Contact Lens and Anterior Eye, 2009
The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (... more The purpose of this study was to evaluate the in situ relationship of ThinOptX intraocular lens (IOL) in a cadaveric donor eye with posterior capsular opacification (PCO), following report of high PCO rates with this IOL. A cadaveric donor eye implanted with ThinOptX IOL and received at our eye bank was fixed in 10% formalin after retrieval of corneoscleral button. The globe was sectioned at equator and evaluated from the posterior (Miyake-Apple) view. Complete iridectomy was performed and IOL evaluated from the anterior (surgeon's) view. The IOL was well centered in the bag. A thick (Grade 4) Sommering ring was seen with centripetal extension across the IOL edge margin. The anterior capsule showed fibrosis and distortion of the capsulorrhexis margin. It seems from our findings that in some cases, the edge of the ThinOptX IOL may not provide an adequate barrier to epithelial cell migration and PCO formation. This can have clinical implications which need evaluation in large clinical and histopathological studies.
Clinical & Experimental Ophthalmology, 2007
We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intr... more We report the use of perfluoropropane (C(3)F(8)) gas for the treatment of acute hydrops with intrastromal cleft in a case of pellucid marginal degeneration with keratoglobus. Acute hydrops in a 36-year-old man with pellucid marginal degeneration with keratoglobus was treated with intracameral injection of 0.3 mL isoexpansile C(3)F(8) (14%). Reduction in corneal haze was seen beginning from the third postoperative day. Significant clearing had taken place by the end of the second week with the closure of intrastromal cleft. Best corrected visual acuity improved from finger counting at 1 foot preoperatively to 6/18 after 2 weeks. There was no postoperative rise in intraocular pressure or cataract formation. Intracameral injection of C(3)F(8) may possibly be a viable treatment option for acute hydrops in a case of corneal ectasia. Larger studies are required to clarify the role of intracameral gas injection in the treatment of acute hydrops in corneal ectasia.