ABSTRACT
Objective: To evaluate the effect of preoperative intravitreal bevacizumab injection on the incidence of postoperative haemorrhage and visual prognosis, in patients undergoing 25-gauge micro incision vitrectomy surgery [MIVS] for diabetic vitreous haemorrhage
Methods:One hundred and twenty two eyes of 122 patients of diabetic retinopathy of both genders and aged over 18 years, who presented with non-resolving vitreous haemorrhage were enrolled for this study. All patients received an intravitreal injection of 1.25 mg/0.05 mL bevacizumab [Avastin] which was followed one week later by 25-gauge sutureless micro incision vitrectomy surgery. Main outcomes measured were best corrected visual acuity [BCVA] assessed with logMAR and post-operative vitreous haemorrhage. Follow ups were up to six months post-operatively. IBM SPSS 21 was used for data analysis
Result: A total of 122 patients were included; 78 [63.9%] males and 44 [36.1%] females. Mean age at the time of surgery was 51.4 +/- 13.66 years. The mean preoperative BCVA was 1.64 +/- 0.427 logMAR which improved to 0.57 +/- 0.253 logMAR at 12 months post-operatively [p-value < 0.001]. Recurrent vitreous haemorrhage was seen in four patients [3.28%]. one1 week before 25-gauge vitrectomy helps to reduce the incidence of early post-vitrectomy haemorrhage in diabetic patients
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
ABSTRACT
To determine the results of 23-gauge sutureless vitreo-retinal surgery for superior/supero-temporal rhegmatogenous retinal detachment [RRD]. Study Design: Quasi experimental study. LRBT, Free Base Eye Hospital, Karachi, from January 2010 to December 2011. Adult patients who underwent 23-gauge sutureless vitreo-retinal surgery along with use of Perfluoropropane [C[3]F[8]] gas as internal tamponading agent for fresh [upto 3 weeks] superior/supero-temporal RRD was reviewed. Major outcome measures were anatomical success, best corrected visual acuity [BCVA] with Log Mar and complications during and after surgery. Postoperative follow-up was done on 1st day and at 1st, 4th, 8th and finally at 12th week. Sixty eyes of 60 patients, age between 30 - 60 years including 37 [61.67%] males and 23 [38.33%] females having superior or superatemporal RRD underwent 23-guage sutureless vitreo-retinal surgery with the use of perfluoropropane [C[3] F[8]] gas as internal temponade at the end of procedure. Anatomical success rate was 81.66% [49 out of 60 eyes]] with first surgery and raised to 90% [54 cases] with second surgery. Log Mar BCVA significantly improved from mean baseline 0.93 to 0.49 with mean difference of 0.43 [p < 0.001], 95% confidence interval. Postoperative complications were sub-conjunctival haemorrhage in 11 eyes [18.33%], wound leak in 7 eyes [11.66%], anterior chamber became shallow in 6 eyes [10%], cataract developed in 5 eyes [8.33%], re-retinal detachment in 4 eyes [6.66%], ocular hypotony and sterile inflammatory reaction in 3 eyes [5%] each, while iatrogenic breaks developed in 2 eyes [3.33%]. The 23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment achieved high anatomical success and significant visual improvement. Sub-conjunctival haemorrhage was the most frequent procedural complication
ABSTRACT
To determine the changes in visual acuity in patients undergoing Trans-Scleral Sutured Posterior Chamber Intra-Ocular Lens [TSSPCIOL] implantation at a tertiary care hospital in Karachi, Pakistan. Case series. LRBT Tertiary Eye Hospital, Karachi, from January 2006 to December 2010. Records of all patients undergoing implantation of TSSPCIOL were reviewed. Patients with diagnosed glaucoma, diabetic retinopathy, macular degeneration, history of recurrent uveitis, corneal haze or central corneal scars were excluded. For the final analysis, 70 eyes out of a total of 75 were selected. Main outcomes of interest were pre and postoperative visual acuities and surgical complications. SPSS 21 was used for data analysis. Pre-operatively, the average Best Spectacle-Corrected Visual Acuity [BSCVA] was 6/36 on the Snellen chart. This improved to 6/12 postoperatively. The mean improvement seen was 2.4 lines on the Snellen chart [p < 0.05]. Complications include transient intraocular pressure elevation in 25 eyes [36%], IOL tilt in 4 eyes [7.1%], Cystoid Macular Edema [CME] in 4 eyes [5.7%], vitreous haemorrhage in 2 eyes [2.9%], hyphema in 2 eyes [2.9%], uveitis in 1 eye [1.4%], and retinal detachment 1 eye [1.4%]. No IOL subluxation, suture erosion, iris capture, choroidal effusion or endophthalmitis was encountered and no re-operations were needed. TSSPCIOLs are a good management option for patients with aphakia in whom PC IOLs cannot be placed
Subject(s)
Humans , Male , Female , Visual Acuity/physiology , Lenses, Intraocular , Sclera , Posterior Capsule of the Lens , EyeABSTRACT
To evaluate the efficacy, visual outcome and complication following Nd:Yag laser hyaloidtomy for subhyaloid hemorrhage. This interventional case series was managed at LRBT, Free Base Eye Hospital Karachi from January 2010 to December 2010. It included 30 eyes of 30 patients with subhyaloid hemorrhage due to different causes which underwent Nd: Yag laser sublyaloidotomy. Out of thirty patients, eighteen [60%] were male and twelve [40%] were females. Mean age was 32.57 years. Males pre-dominated the study. Pre laser visual acuity was between counting finger at one meter in 22 patients [73.33%] and between counting finger one meter to hand movement in 8 patients [26.66%]. Vision improved to 6/6 in 10 patients [33%], 6/9 - 6/12 in 17 patients [56.66%] and between 6/24 - 6/60 in 3 patients [9.99%] at the end of follow up. Complications were persistent vitreous hemorrhage in one [3.33%] patient, failed drainage in one [3.33%] patient and metamorphopsia in one [3.33%] patient. Nd: Yag laser hyloidotomy is an excellent technique for management of Subhyaloid hemorrhage with early visual recovery provided there is no macular pathology
ABSTRACT
To evaluate the outcome and complications of removal of silicone oil after pars plana vitrectomy. Case series. Layton Rahmatullah Benevolent Trust [L.R.B.T], Free Base Eye Hospital, Karachi, from February 2008 to January 2011. Ninety five eyes of 95 patients with a history of undergoing three-port pars plana vitrectomy were included in this study that subsequently underwent removal of silicone oil. Silicone oil was removed after ophthalmoscopically determining retina attachment or when the duration of silicone oil tamponade was atleast of 6 months. Patients were followed for a period of 12 months. Retinal re-detachment was seen in 19 [20%] out of 95 eyes, vitreous haemorrhage in 2 [2.1%] out of 95 eyes, corneal decompensation in 6 [6.3%] out of 95 eyes, hypotony in 7 [7.3%] out of 95 eyes, phthisis bulbi in 2 [2.1%] out of 95 eyes and lens opacification in 9 [9.4%] out of 95 eyes. In this study, silicone oil removal resulted in various complications among which retinal re-detachment was the most frequent