PURPOSE: To report the incidence, management and complications of nucleus dislocation into the vitreous during phacoemulsification. METHODS: Retrospective review of 1250 consecutive phacoemulsification performed by consultants and residents in a teaching hospital. RESULTS: The incidence of nucleus drops was 0.8% (10 out of 1250). Loss of nuclear fragments occurred during phacoemulsification in 9 patients. In one, the dislocation was caused by hydro-dissection. All except one patient (who refused further intervention) underwent pars plana vitrectomy with removal of nuclear fragments. Eight of them had intraocular lens (IOL) inserted at the time of cataract surgery or at vitrectomy; one patient was scheduled for a secondary IOL. Postoperative best corrected visual acuity ranged from 6/24-6/6; 8 patients achieved a vision of 6/12 or better. Complications included cystoid macular oedema (5 patients), retinal break (1 patient) and retinal detachment (1 patient). CONCLUSION: Appropriate management of posteriorly dislocated nucleus can restore good visual acuity. The use of phacoemulsification mandates availability of referral facilities for management of complications.

Australian and New Zealand Journal of OphthalmologyVolume 26, Issue 2 p. 159-160 Intravitreal cysticercosis: How did it get there? Thomas George DOMS, Thomas George DOMS Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorAnnie Mathai MS, Annie Mathai MS Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorJK Challa MD, JK Challa MD Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorAndrew Braganza MS, Andrew Braganza MS Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorRavi Thomas MD, Corresponding Author Ravi Thomas MD Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, India Schell Eye Hospital, Arni Road, Vellore 632 001, India. Email:<[email protected]>Search for more papers by this author Thomas George DOMS, Thomas George DOMS Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorAnnie Mathai MS, Annie Mathai MS Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorJK Challa MD, JK Challa MD Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorAndrew Braganza MS, Andrew Braganza MS Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, IndiaSearch for more papers by this authorRavi Thomas MD, Corresponding Author Ravi Thomas MD Schell Eye Hospital (Department of Ophthalmology), Christian Medical College, Vellore, India Schell Eye Hospital, Arni Road, Vellore 632 001, India. Email:<[email protected]>Search for more papers by this author First published: 07 December 2009 https://doi.org/10.1111/j.1442-9071.1998.tb01533.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume26, Issue2May 1998Pages 159-160 RelatedInformation

Contrast sensitivity has been recommended as a screening and diagnostic test in primary open angle glaucoma (POAG). We tested contrast sensitivity (CS) using Vistech charts in 184 eyes of 95 patients. Three groups were examined--established primary open angle glaucoma, glaucoma suspects and age matched controls. The distribution of contrast sensitivities amongst the three groups were similar. The median contrast sensitivity of glaucoma suspects and controls were well within normal limits while that of the POAG group fell along the lower limit of normal. In all three groups the younger subjects scored better than the older, indicating a depression of contrast sensitivity with increasing age. Even if depression of any one spatial frequency was considered abnormal, the test yielded a sensitivity of 55.4% and specificity of 69.5%. Similarly contrast sensitivity testing was found to be of little use in detecting field defects a maximum sensitivity of 47.3% and specificity of 73.3%. Vistech contrast sensitivity testing is not a useful test in POAG screening or diagnosis.

As an alternative to conventional medical and surgical modalities that have met little success in the treatment of paralytic strabismus and essential blepharospasm, we explored the use of botulinum toxin as a treatment of choice in these two disorders. We used botulinum toxin in three patients with paralytic strabismus and in nine patients with essential blepharospasm. In three patients with paralytic strabismus, the botulinum toxin was injected into the ipsilateral antagonist of the paralysed muscle. The preinjection deviations ranged from 18 to 60 prism diopters. Two of these three patients achieved orthotropia around the thirtieth day and thereafter maintained it. The third patient became orthotropic on the eighteenth day, but deviation recurred and therefore required another injection of toxin. In nine patients with essential blepharospasm, botulinum toxin was injected into the orbicularis oculi muscles. Both objective and subjective improvement occurred in all nine patients within seven days and the effect lasted 12 to 15 weeks. Further injection of the toxin produced extremely beneficial results. However, the only significant complication that we encountered in both groups of strabismus and blepharospasm was ptosis, which was usually partial and temporary. From our experience, we advocate the use of botulinum toxin in the treatment of essential blepharospasm.

We studied the effect of the releasable suture technique on immediate postoperative intraocular pressure (IOP). Nine eyes of nine patients with glaucoma had trabeculectomy with a releasable suture. In the six eyes that did not receive antimitotics, the suture was released by the fifth postoperative day; in the others suture release was delayed up to the fourteenth day. Of the nine patients, one had an acceptable postoperative IOP and did not need suture release; in another the suture broke and could not be released. In the remaining seven patients, the difference between the pre-release and post-release IOP was statistically significant (p < 0.001). The complications of this technique include failed suture release, subconjunctival hematoma and a distinctive "windshield wiper" keratopathy.