Papers by Suryasnata Rath
American Journal of Ophthalmology, 2008
Eye (London, England), 2014
Orbit (Amsterdam, Netherlands), 2015
To compare the outcome of evisceration with primary orbital implant in blind eyes with and withou... more To compare the outcome of evisceration with primary orbital implant in blind eyes with and without fulminant infection (endophthalmitis/panophthalmitis). Retrospective nonrandomized comparative interventional case series. Patients with a minimum postoperative follow-up of 6 months were considered for inclusion. Thirty-four eyes of 34 patients were included. Sixteen eyes were infective and 18 noninfective. Nonporous silicone implants were used for all cases and the main outcome measure was successful retention of the primary implant. Major and minor complications and successful prosthesis fitting were also noted. All except 3 cases were able to retain the primary implant successfully and all but 2 patients underwent successful prosthesis fitting. Major complications included implant extrusion in 3 cases (2 infective, 1 noninfective) and implant exposure in 1 case (noninfective). The difference in major complications between the groups was not statistically significant (p = 0.66, Fish...
Ophthalmic plastic and reconstructive surgery
Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society, 2013
Ocular surface squamous neoplasia (OSSN) has a varied clinical presentation, the diagnosis of whi... more Ocular surface squamous neoplasia (OSSN) has a varied clinical presentation, the diagnosis of which rests on the histopathological examination of the excised lesion. The term OSSN includes mild dysplasia on one end of the spectrum and invasive squamous cell carcinoma on the other end. This lesion has a multi factorial aetiology with interplay of several factors like exposure to ultraviolet radiation, various chemical carcinogens and viral infections, however role of individual agents is not well understood. With the upsurge of infection with human immunodeficiency virus, a changing trend is seen in the clinical presentation and prognosis of patients of OSSN even in developed countries. Anterior segment optical coherence tomography (OCT) and confocal microscopy, hold promise in in-vivo differentiation of intraepithelial neoplasia from invasive squamous cell carcinoma. Variants of squamous cell carcinoma like Mucoepidermoid carcinoma, spindle cell carcinoma and OSSN associated with HI...
Journal of Ophthalmic Inflammation and Infection, 2012
Purpose The purpose of this study is to report a case of nontuberculous mycobacterial infection a... more Purpose The purpose of this study is to report a case of nontuberculous mycobacterial infection after frontalis sling surgery. Method A 65-year-old man presented with bilateral painful, erythematous lesions in the brow and upper eyelids. He had a history of frontalis sling surgery for myopathic ptosis 2 years back and all lesions were found localized to the tract of the silicone rod used in the previous frontalis sling surgery.
Principles and Practice of Lacrimal Surgery, 2014
Journal of Cataract & Refractive Surgery, 2014
To determine whether an intracameral injection of cefuroxime sodium at the conclusion of cataract... more To determine whether an intracameral injection of cefuroxime sodium at the conclusion of cataract surgery lowers the incidence of acute-onset postoperative endophthalmitis. Tertiary eye care center, Bhubaneswar, India. Prospective comparative interventional cohort study. Under a uniform protocol, cataract surgery with posterior chamber intraocular lens (PC IOL) implantation was performed from September 27, 2006, to July 31, 2010 (Group 1). All eyes were evaluated 1 day, 7 days, and 5 weeks ± 1 (SD) postoperatively. Treatment of eyes suspected to have developed infectious endophthalmitis was managed by retina-vitreous surgeons. From August 1, 2010, to August 31, 2012, the same surgeons performed cataract surgery with PC IOL implantation in another group of eyes, in which they administered intracameral cefuroxime prophylaxis (Group 2). All other protocols of postoperative care and microbiological investigation of the vitreous samples were similar. The rate of clinical and culture-positive endophthalmitis was compared between the 2 study groups: eyes without intracameral cefuroxime (Group 1) and eyes with intracameral cefuroxime (Group 2). The incidence of clinical endophthalmitis in Group 1 (0.155% [12/7756 eyes]) and in Group 2 (0.108% [8/7366 eyes]) was not significantly different (P = .57). The culture positivity rate in Group 1 (0.09 % [7 eyes]) and in Group 2 (0.04% [3 eyes]) was also not significantly different (P = .38). In the treatment without intracameral cefuroxime, there was a minimal, statistically insignificant increase in postoperative acute endophthalmitis (odds ratio, 1.42; 95% confidence interval, 0.53-4.02; P = .506). There is not strong evidence to support use of intracameral cefuroxime to reduce the rate of acute endophthalmitis after cataract surgery; however, the marginal benefit might justify its use. No author has a financial or proprietary interest in any material or method mentioned.
Orbit, 2012
A 32-year-old non-alcoholic, immunocompetent male with history of prior trauma presented with pai... more A 32-year-old non-alcoholic, immunocompetent male with history of prior trauma presented with pain and protrusion of the left eye of 8 months' duration. A firm nontender mass could be palpated in the superomedial orbit and the periocular skin had multiple discharging nodules. Computed tomography of the orbit showed an ill-defined lesion in the left orbit with preseptal soft tissue thickening, lacrimal gland infiltration and a moth eaten appearance of the left orbital roof. Tissue sampling from discharging cutaneous sinuses grew confluent colonies of Staphylococcus aureus and Nocardia cyriacigeorgica (16S rRNA gene sequencing; GQ376180). Histopathological examination showed mixed inflammatory infiltrates and eosinophilic granules showing Splendore-Hoeppli phenomenon. Despite an early response to treatment with intravenous amikacin, reactivation of left orbital inflammation led to eventual loss of vision. A prolonged treatment course with intravenous amikacin and oral trimethoprim-sulfamethoxazole over a period of 1 year showed clinical resolution with periocular scarring, hypoglobus, and sensory exotropia.
Orbit, 2009
Eyelid sebaceous carcinoma metastasizing to lacrimal sac is rare. A 65 year old female underwent ... more Eyelid sebaceous carcinoma metastasizing to lacrimal sac is rare. A 65 year old female underwent excision with 5 mm margins and Cutler-beard reconstruction for a nodulo-ulcerative mass showing eyelash loss in the middle third of the right upper eyelid. Histopathology confirmed it to be sebaceous carcinoma with uninvolved margins. Five years after primary excision, the patient presented with persistent epiphora and mass in the ipsilateral lacrimal sac region. Repeat excision biopsy and conjunctival map biopsy confirmed recurrent sebaceous carcinoma of the lacrimal sac. Thirteen months after adjuvant radiotherapy to the orbit, the patient is alive and well with no loco-regional recurrence.
Orbit, 2013
To evaluate efficacy of a trephination procedure for resolution of primary canalicular obstructio... more To evaluate efficacy of a trephination procedure for resolution of primary canalicular obstruction or obstruction secondary to failed dacryocystorhinostomy (DCR). Retrospective review of patients in a single surgeon's practice who underwent trephination with Crawford tube insertion between 2001 and 2011, with a minimum follow-up period of 12 months. Indications for surgery included symptomatic patients either with primary canalicular obstruction or secondary obstruction after a failed DCR. Trephination was carried out on 45 eyes of 43 patients; 78% were female, and average age at trephination was 61.0 years (range 32 to 89). Thirty-two eyes had previous DCR (75% endonasal, 25% external); mean interval of trephination after DCR was 1.4 years (range 0.3-9.1). Crawford stent tubes were left in-situ in 2 patients; in the remainder, tubes were removed at a mean interval of 5.6 months (range 0.3-20.6). The vast majority of presenting canalicular obstructions were in the common canalicus (73%). Sixteen eyes (36%) underwent a single trephination, and 29 eyes (64%) required repeat intervention; of these, 16 eyes had DCR (3 endonasal, 13 external) and 13 eyes had either repeat trephination with stenting (10 eyes) or repeat stenting alone (3 eyes). When separated into those with primary versus secondary obstruction, re-operation rate was similar in both groups (63% versus 69%). No patients developed complications after trephination. Trephination is a simple and effective intervention for canalicular obstruction that allowed 64% of patients, through one or two procedures, to avoid the morbidity of DCR.
Ophthalmology, 2010
Purpose: To describe the clinical manifestations, diagnosis, management, and outcome of orbital c... more Purpose: To describe the clinical manifestations, diagnosis, management, and outcome of orbital cysticercosis in a tertiary eye care center in Southern India.
Ophthalmic Plastic & Reconstructive Surgery, 2009
A 15-year-old boy presented with visual acuity of 20/200 OD and no light perception OS. The anter... more A 15-year-old boy presented with visual acuity of 20/200 OD and no light perception OS. The anterior segment of the left eye showed a relative afferent pupillary defect. A large (4.5 x 4.5 x 2.0 mm) infiltrative optic nerve head lesion with dilated vessels was seen OS with disc pallor OD. MRI of the brain and orbit revealed lobulated optic nerve thickening and chiasm. A biopsy revealed features consistent with germinoma and was positive for marker placental alkaline phosphatase. Systemic examination, chest x-ray, abdominal ultrasound, cerebrospinal fluid, and serology were normal. He received 27 Gy to the craniospinal region followed by a boost of 27 Gy to the left optic nerve. Eight months postirradiation, vision stabilization was achieved with 20/200 OD and light perception with inaccurate projection of rays OS.
Ophthalmic Plastic & Reconstructive Surgery, 2011
A 26-year-old woman with congenital lamellar ichthyosis presented with bilateral cicatricial ectr... more A 26-year-old woman with congenital lamellar ichthyosis presented with bilateral cicatricial ectropion of the upper and lower eyelids. There was severe exposure keratopathy with corneal perforation in the left eye. The generalized skin involvement necessitated the use of an alternative to correct the cicatricial ectropion. Mucous membrane graft harvested from the oral cavity was used to correct the cicatricial ectropion of upper and lower eyelid of both eyes. Six months after treatment, the mucous membrane graft was keratinized and a significant reduction in lagophthalmos was seen. Mucous membrane graft offers a promising alternative to correct cicatricial ectropion in lamellar ichthyosis.
Ophthalmic Plastic and Reconstructive Surgery, 2014
A 41-year-old woman previously diagnosed with generalized eruptive keratoacanthomas of Grzybowski... more A 41-year-old woman previously diagnosed with generalized eruptive keratoacanthomas of Grzybowski type presented with bilateral lower eyelid cicatrical ectropions. She had previously undergone multiple resections of syringomatous adenomas of both nipples, facial keratoacanthomas, and a lower left lip squamous cell carcinoma. Her facial and periocular skin was thickened with a cobblestone appearance. Cicatricial ectropions involved both upper and lower eyelids. Donor skin was harvested from the dorsum of the foot as this was the only disease-free area on her body, and she achieved a stable result with reduced tearing and improved appearance.
Ophthalmic Plastic & Reconstructive Surgery, 2009
A 55-year-old man presented with profound swelling of the upper face and fever with a history of ... more A 55-year-old man presented with profound swelling of the upper face and fever with a history of preceding insect bite. He was nonalcoholic and immunocompetent. Orbital CT showed a predominantly preseptal soft-tissue swelling. Empiric treatment with broad-spectrum antibiotics resulted in partial response. Surgical debridement and microbiologic evaluation of the necrotic tissue were performed. Gram stain showed budding yeast cells. Candida and Aspergillus spp. grew in culture after 48 hours. The patient received oral fluconazole, 200 mg once a day for 8 weeks. Complete resolution was documented at 16 weeks. In tropical regions, Candida and Aspergillus spp. may cause periorbital necrotizing fasciitis in immunocompetent adults.
Ophthalmic Plastic & Reconstructive Surgery, 2010
A 35-year-old man presented with a recurrent temporal conjunctival mass (25 × 12 mm) involving ab... more A 35-year-old man presented with a recurrent temporal conjunctival mass (25 × 12 mm) involving about six-clock hours of the limbus in the left eye. The mass encroached onto the temporal half of cornea and showed surface keratin, large intrinsic and feeder vessels. It infiltrated the deep corneal stroma. There were no cells in the anterior chamber. Ultrasound biomicroscopy confirmed infiltration of deep corneal stroma without intraocular invasion. Surgery involved excision of the conjunctival component with 4-mm margin, lamellar sclerectomy and a penetrating sclerokeratoplasty with 3 mm of healthy corneal margin. Cryotherapy (double-freeze-thaw) was done to the conjunctival margins. Histopathology showed it to be invasive sebaceous cell carcinoma. A thin layer of deep corneal stroma and all conjunctival margins were uninvolved. At thirty-six weeks after treatment the left eye recorded a visual acuity of finger counting at 1 meter distance and no recurrence.
Ophthalmic Plastic & Reconstructive Surgery, 2011
A 35-year-old man presented with a recurrent temporal conjunctival mass (25 × 12 mm) involving ab... more A 35-year-old man presented with a recurrent temporal conjunctival mass (25 × 12 mm) involving about 6 clock hours of the limbus in the left eye. The mass encroached onto the temporal half of the cornea and showed surface keratin, intrinsic vasculature, and large feeder vessels. There was deep stromal infiltration. There were no cells in the anterior chamber. Ultrasound biomicroscopy confirmed infiltration of deep corneal stroma without intraocular extension. Surgery involved excision of the conjunctival component with a 4-mm margin, lamellar sclerectomy, and a penetrating sclerokeratoplasty with 3 mm of healthy corneal margin. Cryotherapy (double freeze-thaw) was done to the conjunctival margins. Histopathology showed it to be invasive squamous cell carcinoma. A thin layer of deep corneal stroma and all conjunctival margins were uninvolved. Twelve months after treatment, there was no recurrence, and the left eye recorded a visual acuity allowing finger counting at a 1-meter distance.
Journal of ophthalmic inflammation and infection, 2012
The diagnosis of extra-pulmonary tuberculosis can be challenging, even in highly endemic countrie... more The diagnosis of extra-pulmonary tuberculosis can be challenging, even in highly endemic countries. We report a case of irido-ciliary granuloma, where initial screening for TB was negative, but further investigations revealed multiple organ involvement with acid-fast bacillus (AFB), confirmed as Mycobacterium tuberculosis (MTB) by polymerase chain reaction (PCR).
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Papers by Suryasnata Rath