suresh rasaly - Academia.edu (original) (raw)

Papers by suresh rasaly

PubMed, Mar 22, 2024

Background: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are oft... more Background: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are often performed by general ophthalmologists in developing countries. The aim of this study is to estimate the clinical burden, surgeon's experience, and outcome of dacryocystorhinostomy surgery. Methods: A cross-sectional survey of Nepalese Ophthalmologists registered with the Nepal Ophthalmic Society was conducted after ethical clearance from Nepal Health Research Council. The survey form consisted of a single mail-shot questionnaire information including the age and experience, average case per month, and participant-reported post-operative complications and failures. Data were entered onto Microsoft excel (Microsoft Corp) and analyzed using SPSS 22.0. The data were presented in graphical and tabular format and appropriate statistical tools were employed for the analysis. Results: Out of 300 practicing ophthalmologist, 135 (45%) comprising male 60 (44.4%) and female 75(55.6%) responded to the survey. Majority of respondents were general ophthalmologists (37 ,41.6%) followed by oculoplastic surgeons (27,30.3%) and other subspecialties (25,28.1%). More than 70% respondents perform 1-10 surgeries /month and only 3% perform >50 surgeries /month. The success rate of 75-90% was reported by 45(50%) respondents whereas > 90% success rate by 41 (46.1%). More than 80% surgeons experienced an infection rate of <1% regardless of the intubation status. Conclusions: This survey revealed huge differences in surgery practice patterns among ophthalmologists in Nepal. The surgical success rate and post-operative infection rate depends upon surgeon experience. Moreover, uniform surgery protocols and training budding ophthalmologists/ young Oculoplastic surgeons in the best modern dacryocystorhinostomy surgery are required.

Journal of Nepal Health Research Council , 2024

Background: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are oft... more Background: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are often performed by general ophthalmologists in developing countries. The aim of this study is to estimate the clinical burden, surgeon's experience, and outcome of dacryocystorhinostomy surgery. Methods: A cross-sectional survey of Nepalese Ophthalmologists registered with the Nepal Ophthalmic Society was conducted after ethical clearance from Nepal Health Research Council. The survey form consisted of a single mail-shot questionnaire information including the age and experience, average case per month, and participantreported post-operative complications and failures. Data were entered onto Microsoft excel (Microsoft Corp) and analyzed using SPSS 22.0. The data were presented in graphical and tabular format and appropriate statistical tools were employed for the analysis. Results: Out of 300 practicing ophthalmologist, 135 (45%) comprising male 60 (44.4%) and female 75(55.6%) responded to the survey. Majority of respondents were general ophthalmologists (37 ,41.6%) followed by oculoplastic surgeons (27,30.3%) and other subspecialties (25,28.1%). More than 70% respondents perform 1-10 surgeries /month and only 3% perform >50 surgeries /month. The success rate of 75-90% was reported by 45(50%) respondents whereas > 90% success rate by 41 (46.1%). More than 80% surgeons experienced an infection rate of <1% regardless of the intubation status. Conclusions: This survey revealed huge differences in surgery practice patterns among ophthalmologists in Nepal. The surgical success rate and post-operative infection rate depends upon surgeon experience. Moreover, uniform surgery protocols and training budding ophthalmologists/ young Oculoplastic surgeons in the best modern dacryocystorhinostomy surgery are required.

Asian Journal of Research and Reports in Ophthalmology, Jul 27, 2021

Aims: To evaluate etiological factors for unsuccessful Dacryocystorhinostomy (DCR) surgeries and ... more Aims: To evaluate etiological factors for unsuccessful Dacryocystorhinostomy (DCR) surgeries and surgical outcome after revisional endoscopic endonasal dacryocystorhinostomy (Re-EEDCR) surgery. Study Design: Retrospective study. Place and Duration of Study: Department of Oculoplastic surgery, Tilganga Institute of Ophthalmology, between December 2017 to November 2019. Methods: All the consecutive cases of previously failed DCRs who underwent revisional endoscopic endonasal DCR under local anesthesia were included. Patients' medical records were reviewed for demographic profile, pre and intra-operative endoscopic findings during revisional surgery, post, the outcome of surgery. The potential causative factors for unsuccessful DCR were assessed and the surgical outcome of Re-EEDCR was evaluated. Results: A total of 15 patients, 13 (86.7%) female and 2 (13.3%) male with failed DCR, who had undergone revisional En-DCR were evaluated. The mean age at revisional surgery was 40.53

Quick Response Code Abstract: Purpose: Retinoblastoma is rare disease but potentially fatal if le... more Quick Response Code Abstract: Purpose: Retinoblastoma is rare disease but potentially fatal if left untreated. This study aimed to evaluate demographic profile, treatment and complications in survivors of retinoblastoma in tertiary care center in 2019. Method: This is multicentric hospital based cross sectional study conducted from January 2019 to December 2019 after ethical clearance from National Health Research Council. All post-treatment cases of retinoblastoma who had completed at least 1-year follow-up examination in any of our retinoblastoma (RB) center in 2019 were included whereas newly diagnosed and ongoing treatment cases and those failed to consent were excluded. Data based on demographic profile, ethnic and geographical distribution of RB survivors was collected and entered into Microsoft Excel 2016. Statistical analysis was performed using Statistical Package for Social Sciences version 20. Result: A total of 37 RB survivors that included 24(64.9%) female and 13(35.1%)...

indian journal of community ophthalmology , 2020

Purpose: To report ethnic variation in utilization and visual outcome of hospital-based free cata... more Purpose: To report ethnic variation in utilization and visual outcome of hospital-based free cataract surgery in mid-western
region of Nepal.
Methodology: Prospective cross-sectional study was conducted from January 2018 to December 2019 in which all
consecutive cases who were screened at diagnostic, screening, and treatment(DST) camps transported to and operated in the
base hospitals free of cost were included. Each patient was categorized ethnically as per the ethnic code defined by the health
management information system. The utilization of free surgery, visual outcome, complications, and intraocular lens power
implanted in various ethnic groups were evaluated. Visual outcome of each operated case, on day 1 of operation and 6 weeks
post-operatively was categorized as per World health organization guidelines and variation among various ethnic groups was
statistically analyzed.
Results: A total of 2383 operations (Male 48.8% and Female 51.2%) were performed in 3 base hospitals. The mean age of
patients was 65.88 ± 10(12-100 years). Out of the total, upper-caste occupied767(32.2%) operations, followed by disadvantaged
Janjatis 717(30.1%), Madhesis 385(16.2%), Dalits 261(11%), Muslims 172(7.2%), and advantaged Janjatis 18(0.8%). Preoperatively,1129(44.4%) eyes were blind, followed by 552(23.2%) and 749(31.4%) severely and moderately impaired. Six weeks post-operatively, the visual outcome was good (95%), borderline (4.1%), and poor (0.9%). The mean intraocular
lens(IOL) power was 21.8± 2.1 ranging from 6-30 diopter. However, differences in visual outcome and mean IOL power
among various ethnic groups was not statistically significant.
Conclusion: Hospital based free cataract surgery was proportionately utilized by various ethnic groups with excellent visual
the outcome with minimal complications.

East African Scholars Publisher, Kenya, 2021

Purpose: Retinoblastoma is a rare disease but potentially fatal if left untreated. This study aim... more Purpose: Retinoblastoma is a rare disease but potentially fatal if left untreated. This study aimed to evaluate demographic profile, treatment, and complications in survivors of retinoblastoma in tertiary care centers in 2019. Method: This is a multicentric hospital-based cross-sectional study conducted from January 2019 to December 2019 after ethical clearance from National Health Research Council. All post-treatment cases of retinoblastoma who had completed at least 1-year follow-up examination in any of our retinoblastoma (RB) centers in 2019 were included whereas newly diagnosed and ongoing treatment cases and those who failed to consent were excluded. Data based on demographic profile, ethnic and geographical distribution of RB survivors were collected and entered into Microsoft Excel 2016. Statistical analysis was performed using Statistical Package for Social Sciences version 20. Result: A total of 37 RB survivors included 24(64.9%) females and 13(35.1%) males. Of the total, 34 (91.8%) survivors had unilateral (Right Eye 18, Left Eye 16) involvement whereas 3(8.1%) bilateral involvement. The mean age at diagnosis and study time was 38.65 ± 37.43 months (3-214 months) and 93.46 ± 65.58 months (16-252 months) respectively. Primary enucleation was the commonest mode of treatment (64.9%). The majority of survivors belonged to the upper-caste group 20(54.1%) and mostly from Bagmati 15(40.5%) followed by province-2 (21.6%). Conclusion: Descriptive study showed that most of the survivors had undergone enucleation due to delayed presentation with a poor prognosis. Early diagnosis and appropriate treatment modality are prerequisites for salvaging the life of a child, sight, and eyeball.

Asian Journal of Research and Reports in Ophthalmology, 2021

IAR Journal of Medicine and Surgery Research, 2021

The aim was to describe the epidemiology of primary benign eyelid tumors over a 10-year period a... more The aim was to describe the epidemiology of primary benign eyelid
tumors over a 10-year period at one of the tertiary eye care centers in Nepal.
Method: This is a retrospective, hospital-based study in which we reviewed the medical records of all patients with histologically confirmed benign eyelid tumors who were operated on at our institute over a period of 10 years from January 2006 to December 2016. Data were collected based on age, gender, location of the lesion, clinical and histological diagnosis, types of surgery, and recurrence. A total of 477 patients with histopathology reports were included in the study and benign eyelid tumors were categorized as epidermal, Adnexal, and Stromal. Data analysis was done using SPSS 16.0. The study was conducted after ethical approval from Institutional Review Committee, and adhered to the tenets of the Declaration of Helsinki.
Results: Out of a total of 477, 214 (44.9%) patients were male and 263 (55. 1%) were female. The mean age of presentation was 35.36± 19.6 (range 1 -93) years. The most common complaint was eyelid mass (91.2%) and the mean duration of presentation and follow-up was 43.46 ±78.55 and 15.88± 13.87 months respectively. The lower lid 206 (43.2%) was the most common site for tumor and local excision with direct closure was commonly performed procedure 291(61%). Overall, the most common histopathological diagnosis was Nevus 108 (22.6%) followed by Squamous Papilloma 58 (12.1%), epidermal cyst 52 (10. 9%), capillary hemangioma 37(7.7%), and sebaceous cyst 36 (7.5%). We found clinical diagnosis matched with a histopathological report in 326 (68.3%) patients. However, 18 patients (3.77%) clinically judged as malignant were confirmed to be benign on the histopathological report. R recurrence of eyelid tumor was seen among 7 (1.5%) and out of which capillary hemangioma reoccurred in 2 (28.6%).
Conclusions: The majority of our patients presented with eyelid mass
frequently located in the lower lid and were diagnosed as nevi on the histopathological
report. However, clinical misdiagnosis was found in 31.7% of cases where clinically
suspected malignant tumors 3.77% turned to be benign on histopathology. We
recommend routine histopathological evaluation of all the surgically excised eyelid
tumors and also aware patients of the possibility of recurrence of benign eyelid
tumors.

Journal of Community Medicine and Public Health Reports

Globally, 36•0 million people were estimated to be blind in 2015, whereas 216•6 million people ha... more Globally, 36•0 million people were estimated to be blind in 2015, whereas 216•6 million people had moderate or severe vision impairment [1]. Ninety percent of the blind and visually impaired hailed the developing world, with particular concentrations seen in South Asia and sub-Saharan Africa (SSA). The elderly people (> 50 years) are usually affected necessitating children and/or grandchildren to stay with them to worry for the blind thereby compelling children for school dropout and adult out of work [2].

Aim: The aim was to describe the epi demi ology of primary benign eyeli d tumors over a 10-year p... more Aim: The aim was to describe the epi demi ology of primary benign eyeli d tumors over a 10-year period at one of t he terti ary eye care cent ers in Nepal. Meth od: This is a ret ros pecti ve, a hospit al-bas ed st udy i n whi ch we revi ewed the m edi cal records of all pati ents with hist ologicall y confi rm ed beni gn eyelid tumors who were operat ed on at our institut e over a period of 10 years from J anuary 2006 to December 2016. Dat a were coll ect ed based on age, gender, locati on of the l esion, cli nical and histologi cal di agnosi s, types of surgery, and recurrence. A tot al of 477 pat ients wit h histopathology reports were i ncluded i n the study and beni gn eyelid t umors were categorized as epiderm al, Adnexal, and Stromal. Dat a analysis was done using SPSS 16.0. The study was conduct ed aft er et hical approval from Instit utional R evi ew Committ ee, and adhered to the t enets of the Decl arati on of Helsi nki. Results: Out of a total of 477, 214 (44.9%) pat ients were mal e and 263 (55. 1%) were fem al e. The mean age of pres ent ation was 35.36± 19.6 (range 1-93) years. The most common compl aint was eyelid m ass (91.2%) and the m ean durati on of pres ent ati on and follow-up was 43.46 ±78.55 and 15.88± 13.87 months respect ively. The lower lid 206 (43.2%) was the m ost common sit e for tumor and l ocal excisi on with direct closure was com monl y perform ed procedure 291(61%). Overall, the most comm on histopathol ogi cal diagnosi s was Nevus 108 (22.6%) followed by Squamous Papillom a 58 (12.1%), epiderm al cyst 52 (10. 9%), capill ary hem angi oma 37(7.7%), and s ebaceous cyst 36 (7.5%). W e found cli nical diagnosis m atched wi th a histopathol ogi cal report i n 326 (68.3%) pati ent s. However, 18 pati ent s (3.77%) clini cally j udged a s m alignant were confi rm ed to be benign on t he histopathol ogi cal report. R ecurrence of eyelid t umor was s een among 7 (1.5%) and out of which capill ary hem angiom a reoccurred in 2 (28.6%). Conclus ions : The m ajority of our pati ents pres ent ed with eyelid m as s frequently locat ed in the lower lid and di agnos ed as nevi on the histopathol ogi cal report. However, clinical misdi agnosi s was found in 31.7% of cas es where clinicall y suspected malignant tumors 3.77% turned to be beni gn on histopat hology. We recommend routine hi stopathological eval uat ion of all the s urgicall y excis ed eyeli d tumors and also aware pati ents of the possibility of recurrence of beni gn eyeli d tumors.

Acquaint , 2021

Background: Globally, 36 million people were estimated blind in 2015. The first national blindnes... more Background: Globally, 36 million people were estimated blind in 2015. The first national blindness survey (1981) reported the prevalence of
blindness 0.87% in the Rapti zone which was reduced to 0.13 % (RAAB 2010). Cataract blindness is higher in a marginalized community. Free
surgical camp targeting marginalized communities in remote areas is the most cost-effective method of ensuring universal access to eye care.
So, our primary aim is to evaluate the accessibility of free surgical camps for marginalized communities in rural areas of Nepal.
Methodology: All the patients operated in free surgical camps during the period from January 2018 to December 2019 in rural areas of the
mid-western region of Nepal were included in this study. The detailed information including age, sex, ethnic group, presenting visual acuity
was recorded in files and Microsoft excel. The data were analyzed using SPSS version 20.
Results: A total of 3520 cataract surgery, 1709 (48.6 %) were male and 1811(51.4 %) female with a male: female ratio of 1:1.1. The mean age
was 66. 87 (SD 9.7 with range 10- 105) and 2604 (74 %) of total operations were done in the age above 60 years. Out of 3520
operations,729(20.7 %) were from disadvantaged Adibashi/Janjatis, 548(15.6%) from Dalits of Hill and Terai, 341 (9.7 %) from Terai
Madhesis, and 219(6.2 %) from Muslims aggregating 1837(52.18%) from marginalized communities. However, major portions of 1617(45.9%)
are occupied by the upper caste (Chhetri and Bahun).
Conclusions: Cataract backlog still remains public health problems especially in marginalized communities in remote areas which need the
continuation of free surgical eye camps in order to reduce blindness and ensure universal access to eye care.
Keywords: ethnicity, marginalized community, cataract surgery, blindness, eye camp

PubMed, Mar 22, 2024

Journal of Nepal Health Research Council , 2024

Background: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are oft... more Background: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are often performed by general ophthalmologists in developing countries. The aim of this study is to estimate the clinical burden, surgeon's experience, and outcome of dacryocystorhinostomy surgery. Methods: A cross-sectional survey of Nepalese Ophthalmologists registered with the Nepal Ophthalmic Society was conducted after ethical clearance from Nepal Health Research Council. The survey form consisted of a single mail-shot questionnaire information including the age and experience, average case per month, and participantreported post-operative complications and failures. Data were entered onto Microsoft excel (Microsoft Corp) and analyzed using SPSS 22.0. The data were presented in graphical and tabular format and appropriate statistical tools were employed for the analysis. Results: Out of 300 practicing ophthalmologist, 135 (45%) comprising male 60 (44.4%) and female 75(55.6%) responded to the survey. Majority of respondents were general ophthalmologists (37 ,41.6%) followed by oculoplastic surgeons (27,30.3%) and other subspecialties (25,28.1%). More than 70% respondents perform 1-10 surgeries /month and only 3% perform >50 surgeries /month. The success rate of 75-90% was reported by 45(50%) respondents whereas > 90% success rate by 41 (46.1%). More than 80% surgeons experienced an infection rate of <1% regardless of the intubation status. Conclusions: This survey revealed huge differences in surgery practice patterns among ophthalmologists in Nepal. The surgical success rate and post-operative infection rate depends upon surgeon experience. Moreover, uniform surgery protocols and training budding ophthalmologists/ young Oculoplastic surgeons in the best modern dacryocystorhinostomy surgery are required.