ABSTRACT
Purpose: To compare the visual outcomes and complications between the eyes receiving retropupillary iris claw intraocular lens (IOL) and scleral-fixated IOL (SFIOL) for post-cataract aphakia. Methods: Medical records of consecutive patients who had iris claw IOL and SFIOL surgery from January 2010 to March 2015, with > 1 year of follow up were retrospectively analyzed. The surgical technique was based on individual surgeon preference. The best-corrected distance visual acuity (BCDVA), previous surgery, surgical technique, and complications were analyzed. Results: Retropupillary iris claw IOL was fixated in 48 eyes (46%) and SFIOL was performed in 56 eyes. Iris claw was performed more frequently at the time of primary cataract surgery (56%) compared to SFIOL (14%) (P < 0.001). At 1 month postoperative, BCDVA was significantly better in the SFIOL group [0.7 ± 0.5 logarithm of minimum angle of resolution (logMAR) in iris claw vs. 0.3 ± 0.2 logMAR in SFIOL, P < 0.001] but this difference did not persist at 1 year (0.4 ± 0.4 logMAR in iris claw vs. 0.3 ± 0.2 logMAR in SFIOL, P = 0.56). Eyes with iris claw IOL experienced significantly more postoperative iritis (17%), intraocular pressure spikes (10%), and ovalization of the pupil (16%). Conclusion: Retropupillary iris claw IOL fixation is as safe as SFIOL for visual rehabilitation of post-cataract aphakia. Visual rehabilitation following iris claw IOL might take longer than SFIOL. Ovalization of the pupil is the commonest adverse effect reported with this type of IOL design.
ABSTRACT
Background: Intertrochanteric and subtrochanteric fractures are leading cause of hospital admissions in elderly people. Aim: This study was done to analyze the surgical management of proximal third fractures of femur using Proximal Femoral Nail fixation. Materials and methods: 20 cases there were 15 male and 5 female patients of intertrochanteric and subtrochanteric fractures, which were treated with Proximal Femoral nail. Results: Mean age of 60.4 years. 50% of cases were admitted due to slip and fall and with slight predominance of right side. Out of 20 cases, 10 were trochanteric and 10 were subtrochanteric. In Trochanteric class 60% were Boyd and Griffin type 2, in Subtrochanteric class 40% were Seinsheimer type 3a and 20% were 2b. Mean duration of hospital stay is 19.33 days and mean time of full weight bearing is 12.6 weeks. Out of 20 cases 2 cases expired before first follow up and 1 case lost for follow up. Out of 17 remaining cases 9 were Trochanteric and 8 were Subtrochanteric. Good to excellent results are seen in 100% cases of trochanteric fractures and 87.5% cases of subtrochanteric fractures. Conclusion: We consider that PFN is an excellent implant for the treatment of proximal third fractures of femur.