ABSTRACT
Objective: To evaluate the visual outcomes of 27-gauge transconjunctival sutureless vitrectomy surgery and its complications in patients with diabetic vitreous hemorrhage
Methods: A quasi-experimental study was conducted where eighty seven eyes of 87 uncontrolled type II diabetes mellitus patients presenting with diabetic vitreous hemorrhage were selected to undergo 27-gauge transconjunctival sutureless micro-incision vitrectomy surgery. Main outcome measured was best corrected visual acuity [BCVA]. Post-operative complications were also screened for at each visit. The follow ups were at post-operative day one, one month, three months and six months respectively
Results: Out of 87 patients, 52 [59.8%] were males and 35 [40.2%] were females. The mean age of the patients was 52.32 +/- 6.78 years [95% CI: 53.13 - 55.57]. For most of the patients, the BCVA improved progressively with each subsequent follow up visit. Pre-operative BCVA was 1.01 +/- 0.206 logMar, compared to BCVA at final follow up of 0.44 +/- 0.231 [p-value < 0.001]. Six [6.9%] patients developed recurrent vitreous hemorrhage during the study period, four [4.6%] developed cataract, one [1.1%] had increased intraocular pressure and sub conjunctival hemorrhage was present in two [2.3%]
Conclusion: 27-gauge micro-incision vitrectomy surgery is an effective sutureless surgery with favorable outcomes, in terms of vision, in patients with diabetic vitreous hemorrhage. The associated complications are few which can be easily managed
ABSTRACT
Objective: To assess the visual and topographical outcomes following accelerated trans-epithelial corneal crosslinking [TE-CXL] in progressive keratoconus
Study Design: Case series
Place and Duration of Study: Laser Vision Centre, Karachi, from January 2015 to December 2016
Methodology: Forty-five eyes of 25 patients affected with progressive keratoconus and treated with accelerated TE-CXL with riboflavin [vitamin B2] and ultra-violet A [UV-A] irradiation were enrolled in this study. The visual outcome was measured by ETDRS chart as improvement in best corrected visual acuity [BCVA] of at least one line or more as compared to pre-CXL BCVA. The topographical outcome was measured as decrease in maximum simulated keratometry values, astigmatism and spherical equivalent [SE] and an increase in central corneal thickness [CCT]. K-max was defined as the steepest radius of curvature of the anterior corneal surface. SE was measured by subjective refraction, and K-max, astigmatism and CCT by scanning-slit corneal topography. Patients were followed-up 12 months post-treatment
Results: At the end of follow-ups, mean BCVA showed improvement of one line from LogMAR 0.58 +/- 0.067 to LogMAR 0.48 +/- 0.077. Seven [15.5%] eyes showed two lines of improvement while 3 [6.7%] eyes showed worsening of one line in BCVA. The mean K-max flattened by 0.7D. Mean astigmatism and SE decreased up to -0.5D and -0.4D, respectively. Mean preoperative CCT was 454.31 +/- 36.34 micro m, whereas mean postoperative CCT was 456.47 +/- 35.60 micro m with an average increase of 2.15 micro m. No postoperative complications were reported
Conclusion: Based on topographical outcomes, accelerated TE-CXL is effective in preventing the progression of keratoconus without any safety concerns with improvement of vision in majority of cases
ABSTRACT
Objective: To assess the visual and anatomical outcomes following idiopathic macular epiretinal membrane [IERM] surgery
Study Design: Case series
Place and Duration of Study: Layton Rehmatulla Benevolent Trust [L.R.B.T], Free Base Eye Hospital, Karachi, from January 2015 to June 2016
Methodology: Thirty eyes of thirty patients affected with idiopathic macular epiretinal membrane stage 2 were enrolled in this study. They subsequently underwent 23-gauge pars plana vitrectomy [PPV] with epiretinal membrane removal without internal limiting membrane peeling. The visual outcome was measured as improvement in best corrected visual acuity [BCVA] of at least two or more lines on ETDRS chart as compared to preoperative BCVA. The anatomical outcome was measured as decrease in foveal thickness on Spectral Domain-Optical Coherence Tomography [SD-OCT]. Patients were followed for a period of 06 months
Results: At the end of follow-ups, 23 [76%] eyes out of 30 gained 2 or more lines of vision. In 05 [16%] eyes, BCVA remained same and only 02 [6.6%] eyes showed worsening of vision. Mean preoperative foveal thickness was 392 +/- 20 micro m, whereas mean postoperative thickness was 305 +/- 16 micro m with an average decrease of 87 micro m, in foveal thickness. Recurrence of ERM was found to be the most frequent complication
Conclusion: IERM surgery is a safe procedure and beneficial in achieving significant visual acuity improvement and anatomical recovery in the majority of cases