ABSTRACT
Objective: To evaluate the efficacy and complications of 20 gauge vitrectomy via corneal approach for the management of congenital cataract
Method: We performed anterior capsular vitreorhexis, lens matter aspiration [LMA], primary posterior vitrectorhexis and anterior vitrectomy via corneal approach using 20 gauge vitrectomy system in children younger than two years of age with congenital cataract between January 2014 to December 2014. The intra and postoperative complications were observed
Results: Twenty nine eyes of 21 children were included in this study. Congenital cataract surgery using 20 gauge vitrectomy system via corneal approach did not reveal any intra operative complication. Post operatively all children were able to freely open their operated eyes. Conjunctival congestion at the incision site in four eyes and mild anterior chamber reaction in 8 eyes were seen on 1[st] day which resolved at one week follow up. Other major post operative complications such as inflammatory membrane, irregular pupil, posterior/anterior syneache and opacification of visual axis were not seen during follow up period
Conclusion: The 20-gauge vitrectomy system via corneal approach is easy to perform, is less time consuming, safe and effective for the management of congenital cataract in younger children
ABSTRACT
Objective: To evaluate the mean changes in Central Corneal Thickness [CCT] and Endothelial Cell Count [ECC] in eyes after pediatric cataract surgery with foldable intraocular lens using scleral tunnel incision micro-surgical technique
Study Design: Qausi experimental study
Place and Duration of Study: Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi, from May 2011 to March 2012
Methodology: Fifty-two eyes of 37 children with pediatric cataract were included in the study. Extracapsular Cataract Extraction [ECE] with foldable Intra Ocular Lens [IOL] implantation using sclera tunnel incision was performed in all children. Endothelial Cell Count [ECC] and Central Corneal Thickness [CCT] were recorded before surgery and 1 month, 3 months and 6 months after surgery and the effect of currently practiced surgical technique on ECC and CCT was Evaluated
Results: The mean age at the time of surgery was 8.8 +/- 2.7 years [range: 4 to 15 years]. The postoperative ECC and CCT were significantly different from the pre-operative values. Mean pre-operative ECC was 3175.3 +/- 218.4 cell/mm[2] and in first postoperative month the mean ECC was 3113.4 +/- 210.8 cell/mm[2] [p<0.0001]. In the 3rd and 6th month postoperative means ECC were 3052 +/- 202.5 cell/mm[2] [p<0.0001] and 3015 +/- 190.6 cell/mm[2] [p<0.0001], respectively. The mean cell loss at first postoperative month was 1.95% and at 3rd and 6th postoperative month were 3.9% and 5.05%, respectively. Mean pre-operative CCT was 514 +/- 49.9 [micro]m and first postoperative mean CCT after 1 month was 524.1 +/- 25 [micro]m [p = 0.084]. After the 3rd and 6th months postoperative, mean CCT were 527.3 +/- 24.6 [micro]m, and 530 +/- 24.5 [micro]m, respectively. Third and 6thmonths postoperative means were significantly higher than baseline CCT, p = 0.024 and 0.007, respectively
Conclusion: Endothelial cell loss with closed chamber micro-surgical technique using scleral tunnel incision is within acceptable limits and within the range of normal ECC in children
ABSTRACT
Congenital myasthenia gravis is caused by genetic mutations affecting neuromuscular transmission, characterized by muscle weakness usually starting in childhood. A two and a half years old male child presented with bilateral ptosis and hoarseness of voice. The symptoms progressed giving the clinical impression of congenital myasthenia gravis. A series of tests were done including Ice Pack Test, acetylcholine receptor antibody test, trial of steroids and finally neostigmine test which confirmed the diagnosis. This case illustrates the challenges in diagnosing congenital myasthenia gravis and highlights the potential benefits of neostigmine test in its diagnosis
ABSTRACT
Hemifacial spasm in infants is a rare condition. An 8 months old female patient was noticed to have contraction of right side of the face by her mother. Her anterior segment and fundus examination were within normal limits. No neurological signs were present apart from the hemi facial spasm that occurred multiple times daily. She was advised follow up, to monitor the disease and assess need for any imaging studies