ABSTRACT
To assess the visual outcome and complications of 25-gauge micro incision vitrectomy surgery [MIVS] in diabetic vitreous haemorrhage. This Quasi Experimental study was conducted at LRBT, Tertiary eye care hospital Karachi, from February 2012 to January 2013. Sixty eyes of sixty patients with uncontrolled type II diabetes mellitus [[DM] were included. There were 43 [71.7%] males and 17 [28.3%] females. Age range was 40 - 60 years. All randomly selected patients underwent 25-gauge sutureless micro incision vitrectomy surgery for diabetic vitreous haemorrhage. Main outcomes measured were best corrected visual acuity [BCVA] assessed with logMAR and post-operative complications. Follow ups were at one day, one week, one month, three months and six months post-operatively. Best corrected visual acuity [BCVA] gradually improved in majority of subjects in each subsequent follow up visit. Preoperative visual acuity was 1.023 +/- 0.226 logMAR, which was improved after final follow up to 0.457 +/- 0.256 and P-value was < 0.001. Five patients developed recurrent vitreous haemorrhage during study period, one patient developed cataract [1.7%], one [1.7%] had ocular hypotony defined as intraocular pressure < 5 mmHg and one [1.7%] developed endophthalmitis. 25-gauge micro incision vitrectomy surgery [MIVS] is an effective sutureless parsplana vitrectomy surgery which has good visual outcome in diabetic vitreous haemorrhage with minimum manageable complications
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