ABSTRACT
To compare the efficacy of subtenon with peribulbar local anesthesia without hyaluronidase in patients undergoing cataract surgery. A randomized controlled trial. Eye [B] Unit, Khyber Teaching Hospital, Peshawar, from October 2009 to October 2010. Patients undergoing cataract surgery were divided into two groups. Group A received subtenon anesthesia and group B received peribulbar anesthesia. Pain score, akinesia and intraocular pressure were compared in the two groups. Statistical Package for Social Sciences-14.0 was used for data analysis. There were 304 patients, 152 patients in each group. At the time of injection, there was less pain in group A as compared to group B [p < 0.001]. At the time of surgery and till 90 minutes after administration of anesthesia, there was no significant difference in pain between the 2 groups [p = 0.999 and 0.59 respectively]. Group A had better akinesia as compared to group B [p = 0.04]. There was a greater rise in mean intraocular pressure just after injection in group B as compared to group A [p < 0.001]; in both groups, the intraocular pressure declined to its base level 10 minutes after the injection [p = 0.52]. Subtenon anesthesia is less painful at the time of its administration, provides better akinesia and leads to smaller rise in intraocular pressure just after the injection than peribulbar anesthesia
ABSTRACT
Vogt Koyanagi Harada [VKH] disease is a chronic, bilateral, granulomatous panuveitis associated with central nervous system, auditory and integumentary manifestations. The study was conducted from January 2001 to December 2010 at the Department of Ophthalmology, Khyber Teaching Hospital, Peshawar. A total of 9 patients with diagnosis of Vogt Koyanagi Harada disease were included in the study. Extracted data included age, gender, duration of disease, initial and final visual acuities, treatment and complications. Initial visual acuity was ranging from 6/24 to perception of light. All the patients were treated with systemic and topical corticosteroids. In addition, one patient also received cytotoxic therapy. Final visual acuity was 6/18 or better in all cases [100%]. One patient developed bilateral cataract, glaucoma and sub-retinal fibrosis at the macula. The cataract and glaucoma were managed as per established protocols. The visual prognosis of Vogt Koyanagi Harada disease is generally favourable if the disease is identified early and adequately treated and the associated complications are addressed properly