Relationship of the Van Herick grading system with peripheral iris configuration and level of iris insertion

Objective: To determine the relationship of the van Herick angle grading system with the level of iris insertion and peripheral iris configuration

Study Design: Observational study

Place and Duration of Study: Eye department, Combined Military Hospital, Malir Cantt., Karachi, from May to October 2015

Methodology: Sixty-five eyes of 65 patients were recruited. Anterior chamber depth at the temporal limbus was measured as a fraction of corneal section thickness using van Herick technique and graded on the standard 4-point scale of the van Herick grading system. Gonioscopy of the temporal quadrant was performed with a Posner 4 mirror goniolens and both the true level of iris insertion and peripheral iris configuration were recorded on a 4-point scale so as to equate with the van Herick 4-point grading system. Spearman's rho test was applied to determine the relationship of the van Herick grading system with level of iris root insertion and peripheral iris configuration

Results: A moderate positive correlation between van Herick grade and peripheral iris configuration was found which was statistically significant [rs=0.42, p < 0.001]. A statistically significant and moderate positive correlation was also detected between van Herick grade and the level of iris insertion [rs=0.45, p < 0.001]

Conclusion: The van Herick grade has a moderately positive relationship with the peripheral iris configuration and true level of iris insertion

Ocular manifestation, complications and aetiological factors in Stevens Johnson syndrome/toxic epidermal necrolysis

To describe the ocular manifestations of Stevens-Johnson Syndrome/Toxic Epidermal Necrosis among inpatients at a tertiary care hospital. The retrospective observational descriptive study was carried out at the Aga Khan University Hospital, Karachi, and comprised data on age, gender, aetiology and ocular findings related to patients diagnosed with Stevens-Johnson Syndrome/Toxic Epidermal Necrosis between January 2000 and December 2011. SPSS 19 was used for statistical analysis. There were 87 patients; 48[55.2%] of them being males. The overall mean age was 33.2 +/- 22.2 years, ranging from 1 month to 84 years. The most common aetiology was idiopathic 20[23%] followed by non-steroidal inflammatory drugs and anti-epileptics 11[12.6%] each. Besides, 84[96.6%] patients had oral mucosal involvement whereas 45[51.7%] had ocular and 27[31.0%] had genital-mucosal involvement. Glassroding was performed in 16[18.4%] patients due to minor conjunctival adhesions. Ocular manifestations of varying severity were frequent, with drugs being the most common aetiology

Visual outcome of cataract surgery

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 - 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract surgery, 58% were female. Overall, 93.3% of the operated eyes had good visual outcome, while 4.4% and 2.2% had borderline and poor outcomes, respectively. Pre-existing diseases accounted for 93.9% of the borderline/poor outcome. The study showed good visual outcome of cataract surgeries performed using phacoemulsification with intraocular lens [IOL] insertion

Long-term outcome of primary external dacryocystorhinostomy

To assess the long-term functional outcome of external dacryocystorhinostomy [DCR] in terms of epiphora. Single-group cohort study. Section of Ophthalmology, The Aga Khan University Hospital, Karachi, from January 2000 to June 2010. This study included adults who underwent external DCR surgery at the AKUH during January 2000 to June 2010. The main outcome measure was the proportion of patients reporting to have developed epiphora after surgery. During the telephonic interviews participants were asked if they had a recurrence [symptoms such as watering or discharge] after surgery. Individuals answering in affirmative were asked when the symptoms started. Data on age at surgery, gender and pre-operative symptoms were collected from medical records. Recurrence-free curves were calculated according to the Kaplan-Meier method. A total of 44 persons who underwent DCR surgery were contactable by telephone in 2011 and all agreed to participate in the study. The mean age of the patients at the time of surgery was 48.0 +/- 15.8 years. Overall, 38.6% [17/44] participants reported having developed epiphora after surgery. The overall median recurrence-free time was 1.7 years; there was no statistically significant difference in the median recurrence-free time between men and women. The long-term functional outcome of external DCR surgery does not appear to be optimal and, in fact, far worse than the short-term results reported in the international literature