Background: Dexmedetomidine is a potent non-opioid analgesic that may enhance analgesia for cataract surgery under topical anaesthesia. This study was undertaken to assess sedation and analgesia provided by dexmedetomidine and evaluating patients' satisfaction. Secondary aims were: (1) To study the effect of dexmedetomidine in decreasing the intraocular pressure. (2) The impact on surgeons' satisfaction. (3) Hemodynamic effects. Methods: We conducted a prospective randomized study on ASA I/II patients presenting for cataract surgery under topical anesthesia. Patients were randomly assigned to two groups: group D received dexmedetomidine premedication 1 mcg/kg over 10 minutes and group C received saline at the same rate. Sedation and pain score, intraocular pressure, patient and surgeon satisfaction score and hemodynamics were monitored and compared. Results: There was a significant increase in sedation assessed by the Ramsay sedation score at all times in group D after receiving dexmedetomidine (p < 0.0001). However, pain scores (numeric rating scale) were similar in both groups (p > 0.05). Dexmedetomidine decreased the intraocular pressure and the difference was statistically highly significant (p < 0.0001). Group D had better patient and surgeon satisfaction score as against group C (p = 0.0001). Noticeably, the incidence of dry mouth was higher in group D. Hemodynamic parameters were well maintained in both groups with no adverse events in either group. Conclusions: Dexmedetomidine can be used safely for cataract surgery under topical anesthesia. Administration of dexmedetomidine was associated with better patient and surgeon satisfaction.

To evaluate the tear film and calculate the prevalence of dry eye in Rheumatoid Arthritis patients based on disease activity. Materials and Methods: A cross-sectional study of 50 Rheumatoid Arthritis patients was performed in the Department of Ophthalmology, Smt. Kashibai Navale Medical College and Hospital, Pune. C-Reactive Protein (CRP), and Rheumatoid Factor (RF) labs were done. All patients underwent complete ophthalmic evaluation including assessment of visual acuity. Tear film assessment was done by calculating the Tear Meniscus Height (TMH) on Anterior Segment-Optical Coherence Tomography (AS-OCT).Results: Fifty patients were studied. 44 were females and 6 were males with a mean age of 47.34 ± 10.33years. TMH was abnormal (≤300 microns) in 31 (62%) patients. RF was positive in 31 (62%) patients while CRP was raised (>3.0mg/L) in 30 (60%) patients. RF Positivity had a significant correlation with abnormal TMH values (χ 2 = 5.15, p=.02). Raised CRP was not significantly associated with abnormal TMH values (χ 2 = 0.39, p=.54).Conclusion: Dry eye evaluation should be considered in RA patients irrespective of the disease activity.

OBJECTIVES:To study and compare pre and post-operative keratometry in phacoemulsication surgery with rigid posterior chamber intraocular lens (PCIOL) implantation. METHOD:Hospital based prospective observational study which included 100 presenile and senile cataract cases with superior scleral incision(5.5mm) phacoemulsication surgery and rigid PCIOL implantation. The data was analyzed by paired 't' test and 'p' value <0.05 considered signicant. The preoperative and postoperative keratometry was compared at 6 weeks. RESULT: There was signicant difference between pre operative and post operative Keratometry (P<0.05) at 6 weeks. Postoperatively majority of patients developed against the rule astigmatism (76% of patients).