ABSTRACT
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 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 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
ABSTRACT
To evaluate the results of combined trabeculotomy and augmented trabeculectomy as a primary procedure on intraocular pressure and corneal clarity in uncomplicated congenital glaucoma. A case series. L.R.B.T Free Base Eye Hospital, Karachi, from January 2007 to December 2010. Twenty eyes of 14 consecutive children with primary congenital glaucoma who had primary trabeculotomy and augmented trabeculectomy were observed from January 2007 to December 2010 at LRBT Free Base Eye Hospital, Karachi Main outcome measures were pre-operative and postoperative intraocular pressure, corneal clarity and complications. Out of 14 patients, 9 patients [64.2%] were male and 5 patients [35.7%] were female with age ranging between 5 months to 6 years. Mean duration of follow-up was 8.25 months. Seventeen eyes [85%] showed improvement in corneal clarity from baseline at their last follow-up. Mean intraocular pressure decreased from 32 +/- 2.5 mmHg pre-operatively to 13 +/- 2.5 mmHg postoperatively at the last follow-up [p < 0.001]. Complete success [intraocular pressure < 20 mmHg] was obtained in 16 [80%] out of 20 eyes. Complications encountered were vitreous loss per-operatively while performing iridectomy in 1 eye [5%], shallow anterior chamber on the first postoperative day in 1 eye [5%] and hyphema in 1 eye [5%]. Combined trabeculotomy and augmented trabeculectomy for primary congenital glaucoma resulted in improvement in reduction of intraocular pressure as well as improvement in corneal clarity. Hence, combined trabeculotomy and augmented trabeculectomy is a safe and effective procedure for primary congenital glaucoma
ABSTRACT
To determine the visual outcome of patients who underwent pars plana vitrectomy for dropped nucleus after phacoemulsification. Interventional case series. LRBT Free Base Eye Hospital, Karachi, from February 2008 to January 2011. Forty-eight eyes of forty eight patients having history of dropped nucleus [soft remnant, half nucleus or complete nucleus] underwent 20 gauge pars plana vitrectomy within 24 days of phacoemulsification. After complete vitrectomy nucleus was lifted with the help of perfluorocarbon and removed either through a limbal incision or by using phacofragmenter, whereas small lens remnants were removed with a vitreous cutter. Intraocular lens was implanted at the end of surgery. Postoperative visual acuity, and any complications were assessed. Patients were followed for a period of 12 months. Final visual acuity ranged from 6/9 to 6/18 in 34 eyes [70.83%], 6/24 to 6/36 in 8 eyes [16.66%] and 6/60 or less in 6 of 48 eyes [12.5%]. Complications included raised intraocular pressure in 6 eyes [12.5%] and retinal detachment in 2 eyes [4.1%], corneal oedema and decompensation in 3 eyes [6.25%] and cystoids macular oedema in 4 cases [8.33%] out of 48 cases. The loss of crystalline lens in the vitreous during phacoemulsification is a severe complication, but appropriate and timely management can restore good visual outcome and minimize complications