Change in pre existing corneal astigmatism after phacoemulsification through clear corneal incision

OBJECTIVE: To compare the change in pre existing corneal astigmatism after closing superonasal incisions by single 10/0 suture and by simple hydration at the time of cataract surgery with phacoemulsification through clear corneal incision

DESIGN: Prospective, comparative and interventional

SETTING: Department of Ophthalmology, Liaquat University of Medical and Health Sciences Jamshoro, during the period from Jan 2011 to Sept 2011

METHODS: This prospective study included 244 left eyes. All eyes went phacoemulsification through a clear corneal incision [3.0 mm] superonasally. First 122 eyes were closed with single 10/0 sutures and remaining 122 with simple hydration. Magnitude of astigmatism was measured by keratometer at 1 week, 4 and 8 weeks postoperatively. Vector analysis method was used to calculate the surgical induced astigmatism. SPSS version 11.0 was used to analyze the data. P value 0.05 was considered significant

RESULT: Out of 244 patients 59.42% were males and 40.57% were female. The mean pre operative astigmatism was >1.0 D. In early days there no significant change in post operative astigmatism [0.50 +/- 0.45 D / 0.75 +/- 0.50 D, p value < 0.001] was found, but statistically significant change in magnitude of astigmatism [0.84 +/- 0.69 D / 2.25 +/- 0.70 D, p value 0.05] and Surgically Induced Astigmatism [0.81 +/- 0.62D / 1.12 +/- 0.94D] was found in first and second group respectively at the end of follow-up

CONCLUSION: Closing of clear corneal incision superonasally with our technique in the left eyes is easy during phacoemulsification for right-handed surgeon without fear of increase in pre existing astigmatism

Frequency and types of diabetic retinopathy in type II diabetes; a hospital base study

Objectives: To determine the frequency and type of diabetic retinopathy in different age groups

Study Design: Descriptive Case series study

Place and duration of study: Department of Ophthalmology Liaquat University of Medical and Health Sciences [LUMHS] Hyderabad, from February 2009 to January 2010

Methods: Two hundred and forty four patients of diabetes mellitus [DM] were randomly selected and grouped out into 30-40 years, 41-50 years, 51-60 years, 61-70 years and more than 70 years of age. Each patient was evaluated for diabetic retinopathy [DR] by fundoscopy and Fundus Fluorescence Angiography [FFA]. The retinopathy was graded as 0-3 grade; grade 0= no DR, grade 1= mild DR, grade 2= moderate to severe DR and grade 3= proliferative DR. The different risk factors [age, gender, duration of DM, treatment type and hypertension] were evaluated in relation to diabetic retinopathy

Result: Among 244 patients, 149 were males and 95 were females. Diabetic retinopathy was detected in 100 [40.94%] patients. Mean duration of DM was 13 years in patients with DR and 7.5 years in patients without DR. Most of the DR was found in 40-60 years of age. Out of 244 subjects 25% patients were found with grade 1, 6.96% patients with grade 2 and 9.01% patients were found with grade 3 diabetic retinopathy

Conclusion: Most of the diabetic retinopathy cases were below the age of 60-years, and majority of DR cases presented with type 1 diabetic retinopathy

Periocular tuberculosis

Tuberculosis has reemerged as a serious public health problem in recent years. The periorcular manifestations of tuberculosis are uncommon and diverse. We present two cases of periocular tuberculosis. One patient had a history of painless non-healing ulcer in the right periorbital region inferiorly and temporal fossa. Initially, it was on inferior side and, later on same type of lesion occurred in temporal fossa. Both the lesions developed communication in the form of sinus. Other patient was referred with the suspicion of chronic dacryocystitis with history of watering and painless swelling since 9 months and not responding to systemic antibiotics. Both cases had no known history of systemic tuberculosis, only the periorbital findings were presenting manifestations of systemic tuberculosis. In both cases anti-tuberculosis regimen was advised. In conclusion, ocular tuberculosis can have variable clinical manifestations and occasionally appears as a dacryocystitis or non-healing ulcer in periorbital region. A high degree of clinical suspicion is important in cases not responding to antibiotics