Soumyadeep Majumdar - Academia.edu (original) (raw)
Papers by Soumyadeep Majumdar
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Introduction: Emergence and subsequent exponential spread of Coronavirus Disease-2019 (COVID-19) ... more Introduction: Emergence and subsequent exponential spread of Coronavirus Disease-2019 (COVID-19) infection during 2020 forced the Government to issue countrywide lockdown from March 2020. Diabetic Retinopathy (DR) is one of the debilitating diseases of the eye which requires regular follow-ups and timely intervention to prevent permanent vision loss. The impact of countrywide lockdown on prevalence and progression of DR needs to be evaluated. Aim: To assess the effect of COVID-19 pandemic situation on the prevalence and progression of DR and analyse the possible risk factors for progression of DR in the ongoing pandemic period by comparing retrospective data from immediate prepandemic quarter with post lockdown quarter. Materials and Methods: This retrospective study was conducted in the Department of Opthalmology at Regional Institute of Ophthalmology, Kolkata, West Bengal, India. The study was done during the prepandemic period, from November 2019 to February 2020. In the present ...
StatPearls Publishing, Feb 14, 2021
StatPearls Publishing, Feb 14, 2021
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Intraocular Pressure (IOP) is one of the key physiological factors, which can regulate... more BACKGROUND Intraocular Pressure (IOP) is one of the key physiological factors, which can regulate the ocular health and homeostasis. Accurate measurement of IOP depends on several factors among which instrument factor plays significant role. Considering Goldmann Applanation Tonometer (GAT) as a "GOLD" standard, we have compared Noncontact Tonometers (NCT) with GAT taking Central Corneal Thickness (CCT) into consideration. MATERIALS AND METHODS In this comparative cross-sectional study in a tertiary care hospital, after inclusion and exclusion, patients were thoroughly examined clinically and GAT, NCT and CCT tests are performed using standard technique by single competent ophthalmologist on the same day. Values are tabulated in excel sheet and statistical calculations done using SPSS version 20. RESULTS In the study population, 57.7% were males and 42.3% females (M:F = 187:137). The mean age of the population is 45.16 ± 19.58 years (SD) and mean intraocular pressure of males was found to be 16.63 ± 3.72 (SD) mm of Hg by GAT method and 16.75 ± 3.53 (SD) mm of Hg by NCT, and in females, it was found to be 16.12 ± 3.51 (SD) mm of Hg by GAT method and 16.29 ± 3.28 (SD) mm of Hg by NCT. The difference between methods was statistically significant (P <0.05). Mean central corneal thickness of the study population was found to be 546.10 ± 34.87 (SD) µm, whereas central corneal thickness of males 547.11 ± 33.93 (SD) µm and females were 544.71 ± 36.13 (SD) µm. The difference in IOP measurement between methods was statistically significant (P<0.05) for the entire group and in the subgroup with central corneal thickness more than 575 µm. The reliability indices for the noncontact tonometer considering the Goldmann applanation tonometer as gold standard are highly correlating as coefficient of correlation is near to +1 in all the subgroups in respect to central corneal thickness. CONCLUSION The difference in measurements by noncontact tonometer and the Goldmann applanation method was statistically significant. The measurements by noncontact tonometer were reasonably accurate (coefficient of correlation is near to +1).
Journal of Evidence Based Medicine and Healthcare, Oct 10, 2017
BACKGROUND Diabetes mellitus is one of the major component of metabolic syndrome and a leading ca... more BACKGROUND Diabetes mellitus is one of the major component of metabolic syndrome and a leading cause of ocular morbidity in modern era and India will be considered to be the diabetes capital of the world. Before the onset of diabetic retinopathy, other structural and functional changes may predict the visual diminution of the individual. MATERIALS AND METHODS In this cross-sectional study in a tertiary care hospital, after inclusion and exclusion, the age-gender matched groups (diagnosed type 2 diabetes patients without diabetic retinopathy and controls without diabetes) were thoroughly examined clinically and by noninvasive and invasive examination (after proper counselling of the patient and informed consent). Then, they are tested for functional loss of retina by Humphrey FDT, GDx VCC. Comparison done between cases and controls as well as poorly-controlled and well-controlled diabetic groups. RESULTS It was found that the average RNFL thickness was significantly reduced in diabetics (mean 53.48, SD 2.69) compared to controls (mean 60.21, SD 1.87) (p<0.05). Also, in patients with uncontrolled diabetes (HbA1c >7%), the RNFL thickness was significantly reduced (mean 52.23, SD 1.31) compared to diabetics with good metabolic control (mean 56.38, SD 2.92) (p<0.05). In retinal functional testing, it was found that the Humphrey FDT mean deviation (FDT MD) and pattern standard deviation (FDT PSD) were significantly worse in diabetics (FDT MD-1.478, SD 0.386), (FDT PSD-3.485, SD 0.403) compared to normal controls (FDT MD-0.442, SD 0.536), (FDT PSD-1.438, SD 0.404). The parameters were also found to be significantly worse in uncontrolled diabetics (p<0.05). CONCLUSION To conclude, without diabetic retinopathy, functional and structural loss in retina in diabetes patients compared to age-sex matched individual and especially in poorly-controlled diabetes should be of concern as there are no detectable vasculopathy. So, early diagnosis and control of diabetes is advocated to control this functional loss.
StatPearls Publishing, Feb 14, 2021
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Retinopathy of prematurity (ROP) is one of the leading causes of ocular morbidity and ... more BACKGROUND Retinopathy of prematurity (ROP) is one of the leading causes of ocular morbidity and mortality throughout the world. Prematurity, low–birth, and oxygen therapy are considered to be the common risk factors. The maldeveloped retina in those affected are very much prone to develop refractive error, neo-vasculopathy, and neurosensory detachment. The purpose of our study was to find out the incidence and ascertain the risk factors of retinopathy of prematurity among the neonates attending the sick neonatal care unit and OPD of Calcutta National Medical College & Hospital. METHODS This is an institution based cross-sectional observational study conducted in the sick newborn care unit of a tertiary care hospital. Informed consent was obtained from the parents along with proper birth history. Indirect ophthalmoscopy with a + 20 dioptre (+ 20 D) lens with a paediatric scleral depressor was performed in each eye under the guidance of the neonatologist after pupillary dilatation. I...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Orbital tumour, benign or malignant, comprises of a fair number of patients presenting... more BACKGROUND Orbital tumour, benign or malignant, comprises of a fair number of patients presenting in hospitals with a mass lesion or proptosis. Its early diagnosis and treatment is necessary especially in malignant cases even it can save patient's life. MATERIALS AND METHODS We have recruited the patients presenting in our oculoplasty OPD in RIO with orbital mass lesion or any patient who has symptoms suggestive of orbital mass lesion after applying inclusion and exclusion criteria. Clinical and radiological diagnosis has been made and diagnostic/therapeutic surgical procedures have been performed in order to reach a histopathological diagnosis. Then, excel data sheet is prepared and statistical analysis done.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Eyelid and conjunctival tumours (benign and malignant) are very common in a tropical c... more BACKGROUND Eyelid and conjunctival tumours (benign and malignant) are very common in a tropical country like India causing not only cosmetic deformity, but also endangering patients' life. The aim of our study is to determine the sociodemographic factors and clinicopathological assessment in order to early diagnosis and treatment. MATERIALS AND METHODS The present study is an observational study involving the cases with primary eyelid and/or conjunctival tumours. After thorough clinical history including detailed demographic details and clinical examination, the cases are admitted in the hospital. After undergoing thorough preoperative evaluation, FNAB or partial excision biopsy or total excision biopsy of the tumour mass is done by single competent ophthalmic surgeon and sent for histopathological analysis. The cases were classified into two major groups, eyelid neoplasm group and conjunctival neoplasm group. Each major group was subdivided into benign neoplasm and malignant neoplasm groups. The demographic details, clinical history, examination findings and results of the histopathological analysis is documented, appropriately tabulated and reported and statistical calculations done.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Ocular trauma has been one of the notorious causes of monocular blindness and visual d... more BACKGROUND Ocular trauma has been one of the notorious causes of monocular blindness and visual disability amongst children worldwide. In a booming populous country like India with a high birth rate, children often remain unguarded in many situations. Epidemiological factors leading to such injuries have often been implicated as common familiar objects having unexpected adverse consequences mostly due to faulty handling or lack of caring attitude. METHODS All patients below 14 yrs., with a history of ocular trauma and without any ocular co-morbidities admitted to the Department of Ophthalmology, North Bengal Medical College, during the study period of one year were grouped as per age and clinical diagnosis as per BETTS classification system. Management was done as per standard treatment protocols. Data was reviewed using SPSS version 20 software and outcomes were systematically assembled. Patients were followed up for 6 months on an outpatient basis after discharge. RESULTS Our study revealed that the most affected age group was from 1-5 years (n=19, 39%) followed by 11-14 years (37%). Boys were predominantly involved in ocular injuries in our study (n=39, 79.6%). Open globe injury was seen in 34.7% (n=17) cases, sole closed globe injury (without any breach in anatomy) in 24.5% (n=12) cases, isolated eyelid injury in 26.5% (n=13), chemical injury in 8.2% (n=4) children. Injury during play was the most common way of injury (n=17, 34.7%), followed by household trauma (n=11, 22.4%) while firecracker/chemical injury was seen in 8.2% of cases (n=4). Outdoor activities in school also contributed 10.2% of cases (n=5) among the injuries. CONCLUSIONS Ocular injury is one of the most catastrophic events in the lifetime of a child which can be mostly prevented by proper awareness and parental education. Epidemiological factors leading to ocular trauma must be ascertained, triaged, and properly taken care of.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Glaucoma is the leading cause of irreversible blindness in India with around 12 millio... more BACKGROUND Glaucoma is the leading cause of irreversible blindness in India with around 12 million being affected. Primary Open Angle Glaucoma accounts for majority of these patients. With the choice of drugs to reduce intraocular pressure being plenty, confusion persists on which therapy is best for the patients. Our study aims to compare the efficacy of Fixed-Dose Combination of Brimonidine 0.2% and Timolol 0.5% vs. Monotherapy Brimonidine or Timolol with respect to lowering of intraocular pressure and also its effect on vertical cup disc ratio, mean deviation in automated perimetry, retinal nerve fibre layer thickness and their side effect profile. METHODS This is a prospective, parallel group, open label, randomized intervention trial conducted over 16 months among 180 patients with primary open angle glaucoma attending the glaucoma clinic of the Regional Institute of Ophthalmology, Kolkata. The patients were randomized into three groups 1) Brimonidine 0.2% and Timolol 0.5% fixed-dose combination, twice daily 2) Brimonidine monotherapy, thrice daily and 3) Timolol monotherapy, twice daily and followed up at 1, 3 and 6 months. RESULTS The mean reduction in intra ocular pressure was higher in the fixed-dose combination group (mean reduction-9.3 ± 2.9) compared to the other two groups (mean change in Timolol group-5.0 ± 2.0 and mean change in Brimonidine group-4.5 ± 1.8) at 6 months follow up. The mean loss of retinal nerve fibre layer thickness was significant in the timolol group but not in the other two groups at 6 months. The changes in mean deviation from baseline to 6 months in Humphrey field analysis was not statistically significant in any of the groups. There was statistically significant progression of vertical cup disc ratio from baseline to 6 months in the timolol and brimonidine monotherapy groups. CONCLUSIONS Fixed-Dose Combination of Brimonidine and Timolol had superior efficacy in intraocular pressure reduction in patients with primary open angle glaucoma compared to the monotherapy with brimonidine or timolol. Fixed-Dose combination also decreased the progression of glaucoma compared to the other groups
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Variations in the IOP beyond the normal range can lead to different pathologies that a... more BACKGROUND Variations in the IOP beyond the normal range can lead to different pathologies that are associated with difficulty in vision. Inside the closed space of the globe, cataractous changes along with never ending growth of crystalline lens have been theoretically thought to be associated with a rise in IOP. Distribution of different types of cataracts and the sequential change of IOP in different morphological types of cataract after phacoemulsification with foldable PCIOL implantation in the capsular bag is the sole aim of this study. METHODS This is a prospective observational study. Selected patients with no features of glaucoma, after meeting proper inclusion and exclusion criteria were included in the study. 426 eyes underwent phacoemulsification with PCIOL implantation (by a single competent surgeon using same phacoemulsification machine with similar parameters) were subjected to measurement of IOP by Goldmann Applanation Tonometry 3 days prior to surgery and postoperative day 14 and 28 respectively. Before surgery, dilated pupillary examination was performed to assess the grade of cataract. Data was collected and results analysed thereafter. RESULTS Among 426 eyes evaluated (M:F=1.8:1), with mean age of 54.49 (±6.975) yrs., commonest type of cataract found was Nuclear Sclerosis Grade III (19.9%) followed by Nuclear Sclerosis Grade II (16.4%). Mean preoperative IOP was 16.55 (±1.953) mmHg. Mean postoperative IOP on day 14 and day 28 was 15.11 (±1.755) mmHg and 15.04 (±1.800) mmHg respectively. Nuclear Sclerosis grade V had the least preoperative IOP among all the groups whereas mature cataracts with highest preoperative IOP showed highest fall of IOP after surgery. 8.2% patients who had traumatic cataract which did not show significant postoperative reduction of IOP. CONCLUSIONS Cataract surgery by phacoemulsification and PCIOL implantation reduces IOP in majority of non-glaucomatous patients. Non-diabetic, non-traumatic cataracts and mature cataracts show maximum postoperative reduction of IOP.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Introduction: Emergence and subsequent exponential spread of Coronavirus Disease-2019 (COVID-19) ... more Introduction: Emergence and subsequent exponential spread of Coronavirus Disease-2019 (COVID-19) infection during 2020 forced the Government to issue countrywide lockdown from March 2020. Diabetic Retinopathy (DR) is one of the debilitating diseases of the eye which requires regular follow-ups and timely intervention to prevent permanent vision loss. The impact of countrywide lockdown on prevalence and progression of DR needs to be evaluated. Aim: To assess the effect of COVID-19 pandemic situation on the prevalence and progression of DR and analyse the possible risk factors for progression of DR in the ongoing pandemic period by comparing retrospective data from immediate prepandemic quarter with post lockdown quarter. Materials and Methods: This retrospective study was conducted in the Department of Opthalmology at Regional Institute of Ophthalmology, Kolkata, West Bengal, India. The study was done during the prepandemic period, from November 2019 to February 2020. In the present ...
StatPearls Publishing, Feb 14, 2021
StatPearls Publishing, Feb 14, 2021
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Intraocular Pressure (IOP) is one of the key physiological factors, which can regulate... more BACKGROUND Intraocular Pressure (IOP) is one of the key physiological factors, which can regulate the ocular health and homeostasis. Accurate measurement of IOP depends on several factors among which instrument factor plays significant role. Considering Goldmann Applanation Tonometer (GAT) as a "GOLD" standard, we have compared Noncontact Tonometers (NCT) with GAT taking Central Corneal Thickness (CCT) into consideration. MATERIALS AND METHODS In this comparative cross-sectional study in a tertiary care hospital, after inclusion and exclusion, patients were thoroughly examined clinically and GAT, NCT and CCT tests are performed using standard technique by single competent ophthalmologist on the same day. Values are tabulated in excel sheet and statistical calculations done using SPSS version 20. RESULTS In the study population, 57.7% were males and 42.3% females (M:F = 187:137). The mean age of the population is 45.16 ± 19.58 years (SD) and mean intraocular pressure of males was found to be 16.63 ± 3.72 (SD) mm of Hg by GAT method and 16.75 ± 3.53 (SD) mm of Hg by NCT, and in females, it was found to be 16.12 ± 3.51 (SD) mm of Hg by GAT method and 16.29 ± 3.28 (SD) mm of Hg by NCT. The difference between methods was statistically significant (P <0.05). Mean central corneal thickness of the study population was found to be 546.10 ± 34.87 (SD) µm, whereas central corneal thickness of males 547.11 ± 33.93 (SD) µm and females were 544.71 ± 36.13 (SD) µm. The difference in IOP measurement between methods was statistically significant (P<0.05) for the entire group and in the subgroup with central corneal thickness more than 575 µm. The reliability indices for the noncontact tonometer considering the Goldmann applanation tonometer as gold standard are highly correlating as coefficient of correlation is near to +1 in all the subgroups in respect to central corneal thickness. CONCLUSION The difference in measurements by noncontact tonometer and the Goldmann applanation method was statistically significant. The measurements by noncontact tonometer were reasonably accurate (coefficient of correlation is near to +1).
Journal of Evidence Based Medicine and Healthcare, Oct 10, 2017
BACKGROUND Diabetes mellitus is one of the major component of metabolic syndrome and a leading ca... more BACKGROUND Diabetes mellitus is one of the major component of metabolic syndrome and a leading cause of ocular morbidity in modern era and India will be considered to be the diabetes capital of the world. Before the onset of diabetic retinopathy, other structural and functional changes may predict the visual diminution of the individual. MATERIALS AND METHODS In this cross-sectional study in a tertiary care hospital, after inclusion and exclusion, the age-gender matched groups (diagnosed type 2 diabetes patients without diabetic retinopathy and controls without diabetes) were thoroughly examined clinically and by noninvasive and invasive examination (after proper counselling of the patient and informed consent). Then, they are tested for functional loss of retina by Humphrey FDT, GDx VCC. Comparison done between cases and controls as well as poorly-controlled and well-controlled diabetic groups. RESULTS It was found that the average RNFL thickness was significantly reduced in diabetics (mean 53.48, SD 2.69) compared to controls (mean 60.21, SD 1.87) (p<0.05). Also, in patients with uncontrolled diabetes (HbA1c >7%), the RNFL thickness was significantly reduced (mean 52.23, SD 1.31) compared to diabetics with good metabolic control (mean 56.38, SD 2.92) (p<0.05). In retinal functional testing, it was found that the Humphrey FDT mean deviation (FDT MD) and pattern standard deviation (FDT PSD) were significantly worse in diabetics (FDT MD-1.478, SD 0.386), (FDT PSD-3.485, SD 0.403) compared to normal controls (FDT MD-0.442, SD 0.536), (FDT PSD-1.438, SD 0.404). The parameters were also found to be significantly worse in uncontrolled diabetics (p<0.05). CONCLUSION To conclude, without diabetic retinopathy, functional and structural loss in retina in diabetes patients compared to age-sex matched individual and especially in poorly-controlled diabetes should be of concern as there are no detectable vasculopathy. So, early diagnosis and control of diabetes is advocated to control this functional loss.
StatPearls Publishing, Feb 14, 2021
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Retinopathy of prematurity (ROP) is one of the leading causes of ocular morbidity and ... more BACKGROUND Retinopathy of prematurity (ROP) is one of the leading causes of ocular morbidity and mortality throughout the world. Prematurity, low–birth, and oxygen therapy are considered to be the common risk factors. The maldeveloped retina in those affected are very much prone to develop refractive error, neo-vasculopathy, and neurosensory detachment. The purpose of our study was to find out the incidence and ascertain the risk factors of retinopathy of prematurity among the neonates attending the sick neonatal care unit and OPD of Calcutta National Medical College & Hospital. METHODS This is an institution based cross-sectional observational study conducted in the sick newborn care unit of a tertiary care hospital. Informed consent was obtained from the parents along with proper birth history. Indirect ophthalmoscopy with a + 20 dioptre (+ 20 D) lens with a paediatric scleral depressor was performed in each eye under the guidance of the neonatologist after pupillary dilatation. I...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Orbital tumour, benign or malignant, comprises of a fair number of patients presenting... more BACKGROUND Orbital tumour, benign or malignant, comprises of a fair number of patients presenting in hospitals with a mass lesion or proptosis. Its early diagnosis and treatment is necessary especially in malignant cases even it can save patient's life. MATERIALS AND METHODS We have recruited the patients presenting in our oculoplasty OPD in RIO with orbital mass lesion or any patient who has symptoms suggestive of orbital mass lesion after applying inclusion and exclusion criteria. Clinical and radiological diagnosis has been made and diagnostic/therapeutic surgical procedures have been performed in order to reach a histopathological diagnosis. Then, excel data sheet is prepared and statistical analysis done.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Eyelid and conjunctival tumours (benign and malignant) are very common in a tropical c... more BACKGROUND Eyelid and conjunctival tumours (benign and malignant) are very common in a tropical country like India causing not only cosmetic deformity, but also endangering patients' life. The aim of our study is to determine the sociodemographic factors and clinicopathological assessment in order to early diagnosis and treatment. MATERIALS AND METHODS The present study is an observational study involving the cases with primary eyelid and/or conjunctival tumours. After thorough clinical history including detailed demographic details and clinical examination, the cases are admitted in the hospital. After undergoing thorough preoperative evaluation, FNAB or partial excision biopsy or total excision biopsy of the tumour mass is done by single competent ophthalmic surgeon and sent for histopathological analysis. The cases were classified into two major groups, eyelid neoplasm group and conjunctival neoplasm group. Each major group was subdivided into benign neoplasm and malignant neoplasm groups. The demographic details, clinical history, examination findings and results of the histopathological analysis is documented, appropriately tabulated and reported and statistical calculations done.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Ocular trauma has been one of the notorious causes of monocular blindness and visual d... more BACKGROUND Ocular trauma has been one of the notorious causes of monocular blindness and visual disability amongst children worldwide. In a booming populous country like India with a high birth rate, children often remain unguarded in many situations. Epidemiological factors leading to such injuries have often been implicated as common familiar objects having unexpected adverse consequences mostly due to faulty handling or lack of caring attitude. METHODS All patients below 14 yrs., with a history of ocular trauma and without any ocular co-morbidities admitted to the Department of Ophthalmology, North Bengal Medical College, during the study period of one year were grouped as per age and clinical diagnosis as per BETTS classification system. Management was done as per standard treatment protocols. Data was reviewed using SPSS version 20 software and outcomes were systematically assembled. Patients were followed up for 6 months on an outpatient basis after discharge. RESULTS Our study revealed that the most affected age group was from 1-5 years (n=19, 39%) followed by 11-14 years (37%). Boys were predominantly involved in ocular injuries in our study (n=39, 79.6%). Open globe injury was seen in 34.7% (n=17) cases, sole closed globe injury (without any breach in anatomy) in 24.5% (n=12) cases, isolated eyelid injury in 26.5% (n=13), chemical injury in 8.2% (n=4) children. Injury during play was the most common way of injury (n=17, 34.7%), followed by household trauma (n=11, 22.4%) while firecracker/chemical injury was seen in 8.2% of cases (n=4). Outdoor activities in school also contributed 10.2% of cases (n=5) among the injuries. CONCLUSIONS Ocular injury is one of the most catastrophic events in the lifetime of a child which can be mostly prevented by proper awareness and parental education. Epidemiological factors leading to ocular trauma must be ascertained, triaged, and properly taken care of.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Glaucoma is the leading cause of irreversible blindness in India with around 12 millio... more BACKGROUND Glaucoma is the leading cause of irreversible blindness in India with around 12 million being affected. Primary Open Angle Glaucoma accounts for majority of these patients. With the choice of drugs to reduce intraocular pressure being plenty, confusion persists on which therapy is best for the patients. Our study aims to compare the efficacy of Fixed-Dose Combination of Brimonidine 0.2% and Timolol 0.5% vs. Monotherapy Brimonidine or Timolol with respect to lowering of intraocular pressure and also its effect on vertical cup disc ratio, mean deviation in automated perimetry, retinal nerve fibre layer thickness and their side effect profile. METHODS This is a prospective, parallel group, open label, randomized intervention trial conducted over 16 months among 180 patients with primary open angle glaucoma attending the glaucoma clinic of the Regional Institute of Ophthalmology, Kolkata. The patients were randomized into three groups 1) Brimonidine 0.2% and Timolol 0.5% fixed-dose combination, twice daily 2) Brimonidine monotherapy, thrice daily and 3) Timolol monotherapy, twice daily and followed up at 1, 3 and 6 months. RESULTS The mean reduction in intra ocular pressure was higher in the fixed-dose combination group (mean reduction-9.3 ± 2.9) compared to the other two groups (mean change in Timolol group-5.0 ± 2.0 and mean change in Brimonidine group-4.5 ± 1.8) at 6 months follow up. The mean loss of retinal nerve fibre layer thickness was significant in the timolol group but not in the other two groups at 6 months. The changes in mean deviation from baseline to 6 months in Humphrey field analysis was not statistically significant in any of the groups. There was statistically significant progression of vertical cup disc ratio from baseline to 6 months in the timolol and brimonidine monotherapy groups. CONCLUSIONS Fixed-Dose Combination of Brimonidine and Timolol had superior efficacy in intraocular pressure reduction in patients with primary open angle glaucoma compared to the monotherapy with brimonidine or timolol. Fixed-Dose combination also decreased the progression of glaucoma compared to the other groups
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Variations in the IOP beyond the normal range can lead to different pathologies that a... more BACKGROUND Variations in the IOP beyond the normal range can lead to different pathologies that are associated with difficulty in vision. Inside the closed space of the globe, cataractous changes along with never ending growth of crystalline lens have been theoretically thought to be associated with a rise in IOP. Distribution of different types of cataracts and the sequential change of IOP in different morphological types of cataract after phacoemulsification with foldable PCIOL implantation in the capsular bag is the sole aim of this study. METHODS This is a prospective observational study. Selected patients with no features of glaucoma, after meeting proper inclusion and exclusion criteria were included in the study. 426 eyes underwent phacoemulsification with PCIOL implantation (by a single competent surgeon using same phacoemulsification machine with similar parameters) were subjected to measurement of IOP by Goldmann Applanation Tonometry 3 days prior to surgery and postoperative day 14 and 28 respectively. Before surgery, dilated pupillary examination was performed to assess the grade of cataract. Data was collected and results analysed thereafter. RESULTS Among 426 eyes evaluated (M:F=1.8:1), with mean age of 54.49 (±6.975) yrs., commonest type of cataract found was Nuclear Sclerosis Grade III (19.9%) followed by Nuclear Sclerosis Grade II (16.4%). Mean preoperative IOP was 16.55 (±1.953) mmHg. Mean postoperative IOP on day 14 and day 28 was 15.11 (±1.755) mmHg and 15.04 (±1.800) mmHg respectively. Nuclear Sclerosis grade V had the least preoperative IOP among all the groups whereas mature cataracts with highest preoperative IOP showed highest fall of IOP after surgery. 8.2% patients who had traumatic cataract which did not show significant postoperative reduction of IOP. CONCLUSIONS Cataract surgery by phacoemulsification and PCIOL implantation reduces IOP in majority of non-glaucomatous patients. Non-diabetic, non-traumatic cataracts and mature cataracts show maximum postoperative reduction of IOP.