Comparative Study of Surgical Treatment of Chalazion.

A chalazion is chronic lipogranulomatous inflammatory lesion caused by blockage of meibomian gland orifices & stagnation of sebaceous secretion. Common practices in treatment of chalazion are intralesional steroid injection, incision & curettage and excision of chalazion. Recurrence rate is high for incision & curettage in case of large chalazion. The aim of the study is to established that excision large chalazion give better result than incision & curettage. The study was carried out at Diabetic Association Medical College & Hospital, Faridpur and General Hospital, Fadidpur. A total 100 cases were selected for study. Technique of operation were incision & curettage through conjunctival surface and excision of chalazion through skin surface. In 50 % cases we performed incision & curettage both in small (size <5mm) and large (size >5mm) chalazion. In 50 % cases of large chalazion we performed excision of chalazion. The follow up period was 3 months to 6 months. In group -A with incision & curettage through conjunctival surface, in case of small chalazion 27 out of 30 patients were cured (90%). In case of large chalazion 14 out of 20 patients were cured (70%). In group B with excision of chalazion through skin surface, in case of large chalazion 49 out of 50 patients were cured (98%). So higher success rate after excision of large chalazion through skin surface.

Amblyopia of Refractive Origin: a Clinical Evaluation.

Amblyopia is defined as unilateral or bilateral decrease in visual acuity without any organic ocular lesion. It generally develops during the first decade of life when the visual system is vulnerable to deprivation. Unilateral amblyopia is more common than bilateral and the amblyopic eye is called lazy eye. This study was carried out in Faridpur Medical College & Hospital (FMCH) and Diabetic Association Medical College & Hospital (DAMCH) Faridpur, in the department of Ophthalmology from January - 2010 to December 2012 with a view to establish that anisometropic (Refractive) amblyopia is more in patients with astigmatism with the rule of both hypermetropic & myopic types also astigmatism against the rule in hypermetropic patients but simple myopia is not associated with amblyopia. Clinically diagnosed 110 patients of amblyopia of refractive origin were selected. Age of the patients was 6 to 15 years with male & female ratio 1.2:1. There was no pathology in the eyes except refractive error. Refraction done all the cases and found the following results: 26 cases (23.63%) of simple myopic astigmatism with the rule, 19 cases (17.27%) of compound myopic astigmatism with the rule, 10 cases (9.09%) of simple hypermetropia, 38 cases (34.54%) of simple hypermertopic astigmatism with the rule and 17 cases (15.45%) of compound hypermetropic astigmatism againt the rule. No case of simple myopia was associated with amblyopia. Amblyopia was more in patients with astigmatism with the rule of both hypermetropic and myopic types and also astigmatism against the rule in hypermetropic patients but simple myopia was not associated with amblyopia.

Advantage of Crescent Knife in Making Excision of Pterygium.

A pterygium is a triangular sheet of fibrovascular tissue which invades the cornea. In the management of pterygium surgical excision is needed. Common practices in pterygium surgery are simple excision, excision with post operative b- radiation or tropical thio-TEPA solution(1:2000) or mitomycin-C solution(0.4%), excision with peroperative use of mitomycin-C or conjunctival autograft or amneotic membrane graft or lamellar keratoplasty of the affected part of the cornea. Recurrence is high in pterygium surgery probably due to facing difficulty for easy and complete separation of fibrovascular growth. So this is a search for new technique where easy smooth and complete separation pterygial tissue can be done with minimum surgical trauma and a good cosmetic look. This study was carried out at Faridpur Medical College Hospital (FMCH) from January 2010 to December 2011. A total 50 cases were selected for study. Technique of operation in all the cases were excision of pterygium with conjunctival autograft. In 50% cases, the head of the pterygium removed from the cornea with crescent knife and in 50% cases the head of the pterygium removed with tooks knife. The follow up period was 12 to 24 months. In the group- A, recurrence occurred in two eyes i.e 8% and succeed in 23 eyes i.e 92%. In the group-B, recurrence occurred in 6 eyes i.e 24% and succeed in 19 eyes i.e. 76%. So, higher success rate and low recurrence rate with good cosmetic look and minimum surgical trauma for those where crescent knife were used.

Prevalence of Pre-Existing Corneal Astigmatism in Age Related Cataract Patient.

Cataract surgery is no more a blind rehabilitation surgery, it absolutely gives normal vision. In the era of modern cataract surgery patients expectations are also high about visual outcome. This prospective study was carried out to investigate the magnitude and pattern of pre-existing corneal astigmatism in age related cataract patient at Faridpur Medical College Hospital, Faridpur and Agha Yusuf Adhunik Hospital, Kustia, from July 2009 to June 2012. We examined 850 eyes of 730 patients who underwent cataract surgery. The mean age at the time of surgery was 61.9±8.1 (40 to 70) years. Corneal astigmatism was measured by Auto Refracto Keratometer at least two times for each patient. Astigmatism was calculated from diopteric difference of vertical reading from horizontal reading. With the rule (WTR) astigmatism was considered when steep meridian at 900± 200. Against the rule (ATR) astigmatism was considered when steep meridian at 1800±200. Astigmatism is in other direction is defined as oblique. On keratometry, when vertical reading (k1) was found greater than horizontal (k2) was considered WTR astigmatism and the reverse reading for ATR astigmatism. The percentage of corneal astigmatism was 1D or less was 69.6%, more than 1D and less than 1.5D, 27.6% and more than 1.5D and less then 2D 2.8%. Prevalence of ATR astigmatism was more than WTR astigmatism and prevalence of ATR astigmatism increases significantly with age. Approximately two third of pre-operative patient had 1D or less astigmatism and one third had more than 1D corneal astigmatism.