ABSTRACT
Objectives: The objective of this research was to evaluate the outcomes of pars plana vitrectomy (PPV) without the use of an ocular tamponade in patients with tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy (PDR) presenting to Bahawal Victoria Hospital, Bahawalpur, Pakistan. Methods: This was an interventional study conducted at the Department of Ophthalmology, Bahawal Victoria (B.V.) Hospital, Bahawalpur, Pakistan, from July 2011 to July 2012. A total of 75 patients (84 eyes) with TRD secondary to PDR were treated by PPV without using an ocular tamponade. All patients included in the study had a TRD secondary to PDR but did not have or develop retinal breaks before or during the study period. The surgical procedure included a PPV combined with the removal of the tractional retinal membranes and the application of endolaser photocoagulation to the retina. The mean follow-up period was 12 months. Results: The study included 75 patients (84 eyes). Among these, 40 patients were females and 35 males. Successful retinal reattachment was observed in 78 of the operated eyes (92.8%). In these patients, the retina remained attached until the end of the 12 month follow-up period. Improvement in best corrected visual acuity (BCVA) was seen in 63 eyes (75%). The visual acuity remained unchanged in nine eyes (10.7%). Mean improvement in BCVA was 2.00 ± 1.24 at baseline to 1.24 ± 1.22 (P = 0.010) at the end of the follow-up period. Conclusion: In the absence of retinal breaks, a TRD secondary to PDR can be successfully treated and improved by PPV without the use of an ocular tamponade.
ABSTRACT
To evaluate the efficacy of proparacaine 0.5% as a topical anesthetic in pterygium surgery. Quasi-Experimental study. Eye Unitll, Bahawal Victoria Hospital, Bahawalpur, from December 2010 to April 2011. Thirty patients affected by primary pterygium undenwent pterygium excision under topical anesthesia using proparacaine 0.5% eye drops. Pterygium excision was performed along with dissection of the degenerative conjunctival tissue, scraping of the corneal surface with surgical blade N0.15, meticulous dissection of the underlying Tenon's capsule, preparation of a free conjunctival graft from the superotemporal sector of healthy conjunctiva, and positioning of this graft to the area of bare sclera using 6/0 vicryl suture. Computer software SPSS [version 10] was used to analyze the data. Results were considered statistically significant at p<0.05. lt was possible to perform all the procedure under topical anesthesia using 0.5% Proparacaine eye drops without a need of supplemental subconjunctival or peribulbar anesthesia. Pain reported by the patients, recorded by a Visual Analog Scale [VAS] with 0-4 grades, and was mild to moderate during the entire surgical procedure. Topical proparacaine 0.5% is a safe and effective anesthetic in pterygium surgery. The long lasting anesthesia with this agent permits performing the surgical procedure with low pain felt by the patients with a resultant low surgical invasivity anda short duration of surgery.
ABSTRACT
To determine the difference in mean corneal curvatures before and after pterygium excision, by using automated refraction and keratometry. This quasi-experimental study was conducted at Eye Unit-1, Bahawal Victoria Hospital, Bahawalpur, from March 2010 to August 2010. Thirty patients with primary pterygium were analyzed before and after pterygium surgery for corneal curvature changes. Automated refraction and Automated keratometry were used to calculate the cylindrical error and the corneal surface power respectively. The mean and standard deviation were calculated for the corneal curvatures and the refractive cylinder before and after the operation. Paired sample t-test was used to compare the corneal curvatures and refractive cylinder before and after pterygium excision. P-value<0.05 was considered significant. The preoperative cylindrical error decreased from 4.32+ 1.88 D to 2.11 +1.96D postoperatively. Similarly, before surgery, the keratometry readings were 43.71 + 1.12 D in horizontal meridian and 44.94+ 1.41 D in vertical meridian. One week after the pterygium surgery these values were 44.45+0.85 D in horizontal meridian and 45.23 + 0.78 D in vertical meridian. Pterygium excision brings a statistically significant change in corneal curvatures which leads to a decrease in cylindrical correction needed. This causes an improvement in subjective visual acuity in patients who have undergone pterygium surgery
Subject(s)
Humans , Male , Female , Cornea , Refraction, OcularABSTRACT
Mitomycin-c [MMC] and Conjunctival autograft [CAG] are two well known adjuvants used during pterygium excision to decrease the risk of pterygium recurrence. This study was conducted to compare the recurrence rate of pterygium following intraoperative use of mitomycin-c and Conjunctivalautograft. This randomized controlled trial was conducted at Eye Unit-l, Bahawal Victoria Hospital, Bahawalpur, from March 2010 to August 2010. One hundred and thirty patients participated in the study. They were randomized into two groups, one receiving intraoperative Mitomycin-c [n=65] and the other group underwent Conjunctivalautograft application [n=65]. Patients were followed monthly for six months, to see any signs of recurrence. Frequency of recurrences in two groups was calculated and compared by using Chi-square test. Results were considered significant at a p-value < 0.05. There were ten recurrences in Mitomycin-c group [15.3%] and only two recurrences in Conjunctivalautograft group [3%] over a six months follow up period. There was a statistically significant difference in the recurrence rate between the two groups [p < 0.05].This implies that the Conjunctivalautograft has a better outcome in terms of its success rate as compared to the Mitomycin-c adjuvant. In patients having visually significant pterygium, pterygium surgery with conjunctivalautograft application has a lower recurrence rate as compared to the Mitomycin-c adjuvant
Subject(s)
Humans , Female , Male , Conjunctiva/surgery , Recurrence , Mitomycin , Transplantation, Autologous , Randomized Controlled Trials as TopicABSTRACT
To find-out the determinants of malnutrition in children between six months to five years age in Bahawalpur. This was an observational descriptive cross - sectional study. At Paediatric Medicine out - patient department in Bahawal Victoria Hospital, Bahawalpur. From Feb. 2005 to March 2007. Eleven hundred children with malnutrition having ages six months to five years. Main outcome measures. Determinants of malnutrition in children under - 5 in Bahawalpur. This study consists of 1100 sick children between the ages six months to five years brought by their parents [mother] to the Pediatric Medicine out-patient department in Bahawal Victoria Hospital, Bahawalpur. Only the children with malnutrition [undernutrition] were included in the study population. Mothers of these children were interviewed and clinical examination of each child was carried-out to find-out the causes of malnutrition in them. According to Gome's classification, 39.45% of them had first degree malnutrition, 37.10%, second degree and 23.45%, third degree malnutrition. The major causes of malnutrition found in our study population included: Illiteracy; food-fads; poverty; lack of breast-feeding; improper weaning; diarrhea and respiratory diseases. All these factors were statistically significant