AIM:To compare the primary success rate of external DCR and endoscopic DCR MATERIALS AND METHODS: In a prospective randomized controlled study, 50 cases of lower lacrimal passage obstruction were divided into two groups of 25 each. These two groups were surgically treated. Group I underwent External DCR and Group II underwent Endoscopic DCR after investigation and evaluation as per the predesigned proforma RESULTS: 50 cases (14 male, 36 female)of lower nasolacrimal passage obstruction admitted in M. S. Ramaiah Medical College, Bangalore, were operated.25 cases underwent External DCR and 25 cases Endoscopic DCR. The mean age of the patients was 38.86 years (Range 8 to 70 years).In 5 cases (10% of the cases) septoplasty was required. The success was defined by anatomical patency by sac syringing. At the end of follow up of 3 months, the success rate in group I was 92% (23 cases) and in group II was 76% (19 cases). The average surgical duration required was 74.8 minutes in group I and 36.3 minutes in group II. CONCLUSION: Both the procedures represent good alternative for the treatment of lower nasolacrimal passage obstruction.

Hereditary hemorrhagic telangeiectasia (HHT) is an autosomal dominant genetic disorder that leads to vascular malformations. It was first recognized in the 19th century as a familial disorder with abnormal vascular structures causing bleeding from the nose and gastrointestinal tract. HHT is characterized by telangiectatic lesions of the nose, lips, lungs, brain, and spinal cord. The reported incidence in Europe and Japan is between 1:5000 and 1:8000; but is widely variable in other regions. It is seen more frequently in whites. Ocular involvement has been reported in patients with HHT. Although conjunctival telangiectasia is the most common manifestation, rarely intraocular vascular lesions such as retinal telangiectasia and arteriovenous malformations in the retina, are seen. We describe a patient with HHT who had an abnormal unilateral retinal vascular abnormality along with tortuous conjunctival vasculature in the other eye, which has not been reported till date.

AIM:To determine the proportion of ocular abnormalities in renal transplant patients and to correlate them with the: Underlying cause of renal insufficiency. Post-transplant duration. Immune suppressive regimens. MATERIALS AND METHODS: This cross sectional study was performed on 100 patients in M S Ramaiah Hospital between Nov 2010 to May 2012 who had received a renal transplant of at least 3 months duration with serum creatinine levels <3 mg/dl. All patients underwent a complete ophthalmologic examination. Clinical variables related to the transplant included cause of renal failure, duration of renal transplantation and immunosuppressive regimen. RESULTS: Overall, 83 male and 17 female patients with mean age of 43.22 ± 9.34 years were included. Ocular abnormality could be detected in 65%. The most common primary etiology of renal failure in patients was DM Nephropathy found in 37 (37%). Visual acuity < 6/9 seen in 48%, Conjunctival degenerative changes is seen in 24%, Cataractous changes mainly PSC seen in 34%, Clinically Significant Macular Edema (CSME) was seen in 4%, Central Serous Retinopathy changes seen in 3%, Hypertensive Retinopathy changes seen in 15%, Branch Retinal Vein Occlusion (BRVO) was seen in 4%, Mild NPDR changes was seen in 6%, Moderate NPDR changes was seen in 11%. Severe NPDR changes were seen in 15%, Proliferative Diabetic Retinopathy (PDR) changes was seen in 11%, Ocular HTN seen in 2%. Abnormal ocular findings were not correlated with the renal disorder or use of post-transplant immunosuppressive regimen but correlated with post-transplant duration. CONCLUSION: All patients undergoing renal transplant at should undergo complete ocular examination post renal transplantation for early detection, better management of ophthalmic complications for good visual outcome and improved quality of life.

AIM:To study the early post-operative corneal complications arising from the 4 techniques of nucleus expression. To study the resultant post-operative visual acuity from the 4 techniques of nucleus expression. MATERIALS AND METHODS: 100 patients with senile cataract were selected from those attending ophthalmology OPD, M. S. Ramaiah Medical College and those attending camps. They were divided by simple random sampling into 4 groups of 25 patients each. The 1 st group underwent standard small incision cataract surgery by phacosandwich technique. The 2 nd group by vectis with counter pressure, 3 rd group by phacofracture and the last group by irrigating vectis technique. The resultant corneal complications and visual acuity were studied on postoperative day 1 and day 7 RESULTS: Chi square test was used for comparison of corneal complications and ANOVA test was applied for comparison of visual acuity by the 4 different techniques. The commonly encountered corneal complications were striate keratopathy and corneal edema. On the first post-operative day, corneal complications were seen in 36% of cases each in phaco sandwich and vectis with counter pressure groups, 40% in the irrigating vectis group and 56% in the phaco fracture groups. Although not statistically significant, the phaco fracture group was associated with more corneal complications. By day 7, only 4% each in the phaco sandwich group and irrigating vectis group had faint SK. None of the patients in the vectis with counter pressure group had any corneal complications. In the phaco fracture group, 16% had faint SK and 4% had pigments on the endothelium. The post-operative visual acuity was studied on day 1 and 7. On day 1, Visual acuity of 6/12 or better was seen in 24% of the patients each in the phacosandwich and irrigating vectis groups, 20% in the vectis with counter pressure group and 16% in the phacofracture group. Visual acuity of 6/60 or less was seen in 8% in the phacosandwich group, 4% in the vectis with counter pressure group, 28% in the phaco fracture group and 4% in the irrigating vectis group. The phacofracture group had a higher incidence of poor vision on day 1. By the 7 day, visual acuity of 6/12 or better was seen in 76% in the phacosandwich group, 88% in the vectis with counter pressure group, 84% in the irrigating vectis group and only 44% in the phacofracture group. CONCLUSION: In the management of senile immature cataracts with nuclear sclerosis grade 2 or less, phacosandwich, vectis with counterpressure and irrigating vectis are equally effective. Phacofracture technique was associated with higher rate of corneal complications in the early post-operative period. Vectis with counterpressure gave the best results causing the least corneal complications. Hence vectis with counterpressure is a safe and effective technique in the management of soft cataracts. Phacosandwich and irrigating vectis techniques also gave comparable results with few corneal complications and fast visual recovery.