Comparison of preoperative and intraoperative mitomycin C in prevention of pterygium recurrence and postoperative complications

To compare the frequency of recurrence and corneoscleral complications with pre-operative and intraoperative mitomycin C when used with excision of primary pterygium by bare sclera technique. Quasi experimental study. Armed Forces Institute of Ophthalmology Rawalpindi. Ten months [October 2006 to July 2007]. A total of 70 cases with primary pterygium were selected and divided equally into group A and B. in cases of group A, 0.1cc of 0.15 mg/ ml of MMC was injected sub-conjunctivally and pterygium excision with bare sclera technique, a sponge soaked in 0.04% MMC was applied over the bare sclera for three minutes intraoperatively. The patients were followed up to see recurrence and corneoscleral complications for three months. A total of 70 cases, 35 in each group were analyzed statistically. Mean age of group A was 40.83 +/- 12.655 years whereas that of group B was 44.57 +/- 13.718 years. Group A had 28 [80%] males and 7 [20%] females. Group B had 23 [65.7%] males and 12 [34.3%] females. Number of patients who presented with recurrence in group A was 1 [2.9%] and group B were 4 [11.4%]. In group A no patient presented with corneoscleral complications during the study whereas in group B these complications were seen in 7 [20%]. Chi-square test revealed no significant difference in recurrence [P=0.356] whereas it showed significant difference in corneoscleral complications between the groups [P=0.011]. Preoperative MMC is as effective as intraoperative MMC in preventing recurrence but it is much safer than intraoperative MMC causing less corneoscleral complications

Interferon associated retinopathy

Interferon is an immunomodulating cytokine which is used to treat different diseases. Nowadays it is being commonly used for the treatment of chronic hepatitis C. Few patients develop ocular complications secondary to the use of Interferon. We report here a case in which a young soldier with no other risk factors developed retinopathy changes after five months of interferon alpha 2b therapy which included cotton wool spots at the posterior pole and dot-blot haemorrhages in both fundi. These changes gradually started resolving after cessation of treatment and completely disappeared after six months

Posterior capsule tear in phacoemulsification of posterior polar cataracts and uncomplicated cataracts

The aim of our study was to document the difference in the incidence of posterior capsule tear in phacosurgery of the posterior polar cataract and uncomplicated cataract and to report the visual outcomes of these cases. A quasi-experimental study. CMH Rawalpindi, from Mar 2004 to Mar 2007. The medical records of all patients who had Phacoemulsification surgery during the study period were retrospectively analyzed. Only patients with posterior polar cataracts and uncomplicated cataracts were included. The data of eyes, which developed posterior capsule tear, were further analyzed. Hydrodissection was not done in the eyes with posterior polar cataracts instead gentle hydrodileneation and viscodissection was done. The incidence of posterior capsule tear and the visual outcome were recorded in the two groups. Out of the 2110 eyes of 1750 patients included in the study, 1735 patients [99.16%] had uncomplicated cataracts [2089 eyes/ 99.001%] and 15 patients [0.86%] posterior polar cataract [21 eyes/ 0.99%]. Posterior capsule rupture occurred in 33 eyes [1.56%] of all study patients. It was significantly high in patients with posterior polar cataract 7 cases [PP group] out of 21 eyes [33.33%] than in eyes with uncomplicated cataract 26 [UC group] out of 2089 eyes [1.24%] [P value <0.001]. The corrected visual acuity significantly improved inpatients of both groups; 6/12 or better in 21 eyes [80.76%] of 26 eyes in UC group and 5 eyes [71.4%] of 7 eyes in PP group postoperatively. Posterior capsule rupture occurred more frequently in posterior polar cataract than uncomplicated cataract. If managed by experienced surgeon, the visual outcome is good in both the groups

Frequency of ocular manifestations of chronic graft versus host disease

With the advancement of techniques for haematopoietic cell transplantation, the number of transplant survivors is increasing rapidly and so are the chances of chronic graft versus host disease [cGVHD]. The ocular manifestations of this disease have not been explored in our local population. This study was conducted to determine the frequency of ocular complications in cases of cGVHD following successful bone marrow transplantation. Twelve diagnosed cases of cGVHD were evaluated from June 2008 to March 2009 and there ocular manifestations were noted especially the ocular surface disorders, using double staining method with fluorescein and rose-bengal. Nine patients [75%] were having dry eyes, 7 [58.3%] with mebomian glands dysfunction, 4 [33%] with acute conjunctivitis, 2 [16.7%] with bilateral lacrimal canalicular occlusion, and 1 [8.3%] each of bilateral posterior subcapsular cataract, unilateral sterile corneal epithelial defect, anterior uveitis, retinal haemorrhages and disc oedema. The higher frequency of dry eyes along with other ocular manifestations in patients of cGVHD suggests the need of close ophthalmic monitoring in all such cases