ABSTRACT
Objective: To compare the safety and efficacy of topical anesthesia versus peribulbar anesthesia for 23-gauge pars plana vitrectomy
Study Design: Randomized controlled trial
Place and Duration of Study: Ophthalmology Department, Lahore General Hospital, Ameer-ud-Din Medical College, Postgraduate Medical Institute, Lahore from April 2013 to March 2016
Methodology: A total of 110 patients were equally divided [n=55] in group A [topical anesthesia] and group B [peribulbar anesthesia]. In group A, pledget soaked with 0.5% proparacaine hydrochloride were placed in the superior and inferior fornices three minutes before surgery, and removed just before surgery. For group B patients, 3 ml of 0.5% bupivacaine was used for peribulbar anesthesia three minutes before surgery. Surgical time was noted from the placement of pledget in fornix till the eye pad placed in group A, and from the time of peribulbar anesthesia in group B till the eye pad placed at the end of surgery. All data was recorded in Excel sheet and p-values were calculated using online OpenEpi
Results: The mean age of the patient was 56.28 +/-13.76 years. Male patients were 78 [70.9%] and female patients were 32 [29.1%]. Mean duration of surgery was 30.32 +/-7.07 minutes and mean pain score was 2.30 +/-0.98. There was a significant difference with respect to mean duration of surgery in patients who were given topical anesthesia [32.52 +/-6.92 minutes] versus those given peribulbar anesthesia [28.12 +/-6.57 minutes, p<0.001]. Mean pain score in topical anesthesia group [3.11 +/-0.89] was significantly higher as compared to peribulbar anesthesia group [2.67 +/-0.91, p=0.011]
Conclusion: Topical anesthesia is as effective as peribulbar anesthesia in terms of patient comfort and duration of surgery for 23-G pars plana vitrectomy in patients with vitreous hemorrhage
ABSTRACT
To evaluate visual outcome of patients diagnosed with Harada Disease. A prospective observational study A total of 4 patients presenting with exudative retinal detachment were included in this case series. Study was conducted in Department of Ophthalmology Lahore General Hospital, Lahore. Detailed ocular exam including visual acuity, slit lamp examination and dilated fundus examination was done. Fundus photos and Optical Coherence Tomography pre and post treatment was done in almost all patients. Patient A, 37/F, presented with VA CF OD and CF in OS and B/L exudative retinal detachment. After 4 weeks of treatment B/L retina was flat and BCVA was improved to 6/6 in Right eye and 6/9 in Left eye. Patient B, 35/F, presented with VA CF in both eyes and exudative retinal detachment. After 4 weeks of treatment B/L retina was flat and BCVA of both eyes was 6/6P.Patient C, 38/F, presented with BCVA 6/60 in both eyes and exudative retinal detachment. After 8 weeks of treatment B/L retina was flat and BCVA was 6/6 in both eyes. Patient D 20/F presented with VA CF in both eyes and B/L exudative retinal detachment. At 2nd follow-up visit [Post treatment 14 days] B.C.V.A. was 6/6P OD and 6/9 in OS. Patient is still under treatment and follow-ups. The visual prognosis is good for patients with Harada disease and the disease may manifest itself with minimum neurological features
ABSTRACT
A 57 years female presented with complaints of pain in the left hypochondrium and fever for 4 weeks. A single firm preoperative diagnosis could not be made in this lady. At exploration, spleen was enlarged with a lobulated mass at the hilum. Splenectomy was done and patient made an uneventful recovery. The histopathological report of resected specimen of spleen was inflammatory pseudotumour of spleen. The clinical, radiological and pathological features of previously reported cases are reviewed in this case report