ABSTRACT:In developing country like India, the primary goal is to provide all the benefits to common man at minimal possible cost in visual rehabilitation of cataract. In achieving this goal, the surgery (MICS) described in this article can be extremely helpful. It has almost all the advantages of phacoemulsification, at the same time it is inexpensive. The wound construction, various techniques of nucleus delivery in MSICS are described precisely. This may stimulate the reader towards this surgery, which is the only way to tackle the huge backlog of cataract in developing countries, particularly in India, where 60% of rural people live in less than thirty rupees a day.

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Pseudoexfoliation (PEX) syndrome is an age-related systemic disorder with major ocular manifestations. It is characterized by the production and deposition of fibrillogranular amyloid-like extracellular material within many ocular tissues. Pseudoexfoliation is also a risk factor for glaucoma and also correlated to an increased incidence of cataract formation. Cataract surgery in eyes with pseudoexfoliation is connected with many complications and presents challenges that require careful preoperative planning and intraoperative care to ensure safe surgery and successful postoperative outcome. Zonular weakness and poor pupillary dilation are the two major risk factors for surgical complications and poor visual acuity after surgery. With proper preparation and the use of specialized adjunctive devices, phacoemulsification is the preferred procedure of cataract extraction in this group of patients. Postoperatively, patients require frequent and detailed follow-up to monitor for complications such as intraocular pressure rise, inflammation and intraocular lens dislocation. In conclusion, with appropriate preoperative, intraoperative and postoperative care, the risk of complications can be minimized and favorable outcomes may be achieved in cataract surgery in eyes with pseudoexfoliation syndrome. KEYWORDS: Pseudoexfoliation syndrome, Cataract surgery, Complications, CTR, Pupillary ring. INTRODUCTION:Pseudoexfoliation (PEX) syndrome is an age-related systemic disease which have primarily ocular manifestations characterized by the deposition of a whitish-gray pseudoexfoliation fibrillogranular amyloid-like material on the anterior lens capsule (Fig. 1), zonules, ciliary body, pupillary margin, corneal endothelium, anterior vitreous and trabecular meshwork. 1, 2 The most important diagnostic sign of PEX is whitish-grey flaky material on the pupillaryborder of the iris (Fig. 2) and the anterior surface of lens. The lens usually demonstrates three zones on the anterior lens capsule which consists of a relatively homogeneous central zone and a granular cloudy peripheral zone with a clear zone in between. For detecting these signs a careful clinical examination using dilated slit-lamp bio-microscopy and additionally un dilated gonioscopy are done. Undiagnosed PEX can lead to unexpected problems in management and during surgery.PEX is a risk factor for open-angle glaucoma, angle-closure glaucoma, lens subluxation, bloodaqueous barrier impairment, and serious intraoperative and postoperative complication and has been correlated with an increased incidence of cataract formation. Jonasson et al. reported a 10% annual increase for both open-angle glaucoma and PEX in persons of 50 years and over in Iceland. 3 Although the exact etiology of the condition as well as the exact structure of the material is still unknown. It is presumed that the production of pseudoexfoliation material is associated with abnormal metabolism of glycosaminoglycans and thus abnormalities of the basement membrane in the epithelial cells. Pse...

Most GDDs have been developed in a virtual publication vacuum, with little available data to substantiate manufacturers' claims for flow performance or biocompatibility. Clinical data are largely restricted to uncontrolled retrospective case series with variable follow up and differing definitions of surgical success. Evaluation is further complicated by the heterogeneity of inclusion criteria. This review article highlights various GDDs, which will be a great help to ophthalmologists as well as post graduate students in Ophthalmology.

Amniotic Membrane Transplantation is currently being used for a continuously widening spectrum of ophthalmic indications. It has gained widespread attention as an effective method of reconstruction of the ocular surface. Amniotic membrane has a unique combination of properties, including the facilitation of migration of epithelial cells, the reinforcement of basal cellular adhesion and the encouragement of epithelial differentiation. Its ability to modulate stromal scarring and its anti-inflammatory activity has led to its use in the treatment of ocular surface pathology as well as an adjunct to limbal stem cell grafts. Amniotic membrane transplantation has been used for reconstruction of the corneal surface in the setting of persistent epithelial defects, partial limbal stem cell deficiency, bullous keratopathy and corneoscleral ulcers. It has also been used in conjunction with limbal stem cell transplantation for total limbal stem cell deficiency. Amniotic membrane grafts have been effectively used as a conjunctival substitute for reconstruction of conjunctival defects following removal of pterygia, conjunctival lesions and symblephara. More recently, amniotic membrane has been used as a substrate for ex vivo cultivation of limbal, corneal and conjunctival epithelial cells. This article reviews the current literature on the applications of amniotic membrane transplantation and its outcome in pterygium surgery.