Publications by authors named "Tushar Kanti Sinha"

5 Publications

  • Page 1 of 1

Modified surgical technique for lamellar macular holes with lamellar hole-associated epiretinal proliferation (LHEP).

Int Ophthalmol 2021 Jun 17;41(6):2197-2204. Epub 2021 Mar 17.

Vitreo-Retina Consultant, DISHA Eye Hospital, 88(63A), Ghoshpara Road, Barrackpore, Kolkata, 700120, West Bengal, India.

Purpose: To evaluate the efficacy and safety of lamellar hole-associated epiretinal proliferation embedding technique with modification in the surgical management of degenerative lamellar macular hole (LMH).

Methods: There is retrospective case series of consecutive eyes who underwent pars plana vitrectomy with LHEP embedding with internal limiting membrane (ILM) inversion technique for degenerative LMH. Primary outcome measure was improvement in foveal contour and central foveal thickness (CFT). Secondary outcome measures were changes in best corrected visual acuity (BCVA), status of outer retinal layers (external limiting membrane-ELM & ellipsoid zone-EZ) and complications.

Results: Ten eyes were operated by modified LHEP embedding technique. Mean age was 65.8 ± 5.3 years with 1:1 male to female ratio. Simultaneous cataract surgery was done in 70% cases. Mean follow-up duration was 7.9 ± 0.87 months. 80% (8/10) eyes had improvement in foveal contour to normal appearance with increase in residual foveal thickness from 90.2 ± 26.83 microns to CFT of 226 ± 35.44 microns at 6 months (p  =  0.0054). Mean BCVA improved from 0.69 ± 0.19 logMAR to 0.32 ± 0.29 logMAR (p  =  0.012). External limiting membrane (ELM) and ellipsoid zone (EZ) defects were present in four eyes (40%) pre-operatively. At the final visit 2 eyes (20%) had persistent defect in both ELM & EZ. None of the eyes progressed to full-thickness macular hole following surgery.

Conclusions: The modified surgical technique of LHEP Embedding with ILM inversion is demonstrated to provide satisfactory results with reduced risk of complications for degenerative LMH. Larger and long-term follow-up studies are needed to establish this technique as standard surgical procedure for LMH with LHEP.
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June 2021

A novel video overlay guided enlargement of area of ILM peeled versus inverted flap technique: A long-term study in large macular holes.

Eur J Ophthalmol 2021 Nov 14;31(6):3277-3283. Epub 2020 Dec 14.

Department of Vitreoretina, Disha Eye Hospitals Pvt Ltd, Kolkata, West Bengal, India.

Background/aim: To compare the intra-operative video overlay guided enlargement of Area of ILM peeled (AIP) more than three Disc Diameter (DD) versus the inverted flap technique in large (>400 µm ) Full Thickness Macular Holes (FTMH).

Methods: Retrospectively, 127 cases of large FTMHs divided into two groups (i) Group A ( = 62)-intra-operative video-overlay guided enlargement of AIP > 3DD performed and (ii) Group B ( = 65)-Inverted flap technique was done. Mean Best Corrected Visual Acuity (BCVA), hole closure rate and postoperative foveal anatomy were noted on Optical Coherence Tomography (OCT).

Results: Mean Minimal Diameter of Macular Hole (MDMH) were 632.05 ± 146.62 µm (A) and 677.24 ± 152.08 µm (B). Hole closure rate were 93.55% (A) and 96.92% (B). Mean preoperative BCVA was 1.07 ± 0.37 Log MAR (A) and 0.94 ± 0.23 Log MAR (B). Mean postoperative BCVA at 3 months were 0.73 ± 0.22 Log MAR (A) and 0.83 ± 0.24 Log MAR (B). One-way ANOVA test showed statistically better visual improvement in Group A at 3 months ( = 0.02), 6 months ( = 0.045), 12 months ( = 0.002), and 24 months ( = 0.011). Chi square test revealed Type I pattern of hole closure was statistically more in Group B ( < 0.001). Delayed Recovery of Outer Retinal Layers was more in group B (Pearson Chi square test,  = 0.039).

Conclusion: Anatomically, macular hole closure rate as well as closure pattern was better in Group B. But functional improvement was better in Group A.
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November 2021

Long-term clinical outcomes of submacular blood removal with isolated autologous retinal pigment epithelium-choroid patch graft transplantation in long-standing large-sized submacular hematomas: An Indian experience.

Indian J Ophthalmol 2020 10;68(10):2148-2153

Vitreo Retina Department, Disha Eye Hospitals Pvt Ltd, Barrackpore, West Bengal, Kolkata, West Bengal, India.

Purpose: To study the outcomes of submacular blood removal with isolated autologous full-thickness retinal pigment epithelial (RPE)-choroid patch graft transplantation in long-standing large-sized submacular hematomas in Indian population.

Methods: A retrospective study was done on eight consecutive patients of long-standing large-sized submacular hematoma from east India. In all cases, 23G vitrectomy was performed with the induction of retinal detachment (performed with or without 38G or 41G subretinal cannula) and a temporal 180° retinectomy was done. Submacular blood along with choroidal neovascular tissue was removed. A full-thickness RPE-choroid autologous patch graft was taken from a relatively healthy quadrant at the mid periphery and then the graft transferred under perfluorocarbon liquid (PFCL) to place it in the subfoveal area. Then, retina was re-attached using PFCL and laser completed. Silicone oil (5000 cst) was used as a tamponade. Post-operatively, wide-field fundus photographs (Optos), serial optical coherence tomography (OCT), indocyanine green angiography (ICGA), and multifocal electroretinography (ERG) were done.

Results: The mean age of the patients at presentation was 67.88 ± 10.03 years. Mean pre-operative best corrected visual acquity (BCVA) was 2.64 ± 0.3 log MAR and mean postoperative BCVA was 1.095 ± 0.27 log MAR (P < 0.05). The mean follow-up was 20 ± 16.57 months. ICG showed re-vascularization of translocated graft in all at 2 months. Multifocal ERG (after 6 months) showed some waveform in all. None of the cases developed re-bleed.

Conclusion: Removal of submacular blood and neovascular membrane with autologous RPE-choroid graft is a viable option in cases with long-standing large submacular hematomas.
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October 2020

Lenticular burns following PASCAL photocoagulation.

Indian J Ophthalmol 2020 05;68(5):908-909

Department of Vitreo-Retina, Disha Eye Hospital, Kolkata, West Bengal, India.

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May 2020

New Innovative Approaches for Difficult Retained Intraocular Foreign Bodies.

Ophthalmologica 2018 10;240(3):179-180. Epub 2018 Apr 10.

Disha Eye Hospitals, Sheoraphully, India.

Purpose: To describe innovative ways of removal of complicated difficult large retained intraocular foreign bodies (RIOFBs).

Settings: Both cases were treated at Disha Eye Hospitals, Kolkata, a tertiary eye hospital in eastern India.

Methods: Innovative approaches were taken to remove 2 difficult RIOFBs. In the first case, a large RIOFB was just beyond the posterior exit wound, trapped in the sclera. A 23-G MVR blade was used to create multiple radial releasing scleral nicks and bimanually moving the RIOFB into the vitreous cavity using a bent-tip 24G needle and magnet, and the RIOFB was removed through the limbal section. In the second case, a 21-mm long thick nail was deeply embedded in the superior sclera with partial localised retinal detachment with its bulbous end just behind the clear lens. A lasso technique was used to remove the RIOFB without lens touch.

Results: In the first case, the patient finally achieved logMAR 0.2 vision after silicone oil removal and glued scleral fixation of the intraocular lens. In the second case, the patient finally achieved logMAR 0.3 vision after silicone oil removal and phacoemulsification with intraocular lens implantation.

Conclusion: Each case of RIOFB is unique and challenging. Here, innovative techniques are helpful to rescue these difficult RIOFB situations, which can result in excellent outcomes.
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October 2018