ABSTRACT
Objective: To evaluate key corneal tomography parameters for screening refractive surgery patients in Pakistani population
Study Design: Cross-sectional, observation study
Place and Duration of Study: Armed Forces Institute of Ophthalmology AFIO, National University of Medical Sciences, Rawalpindi, Pakistan, from August 2013 to December 2016
Methodology: Myopic patients were evaluated by two separate observers on Allegro OculyzerII [Wavelight] for normal ocular examination. A total of 20 tomographic parameters, used for pre-refractive surgical evaluation, were included. Normality of data was evaluated using Kolmogorov-Smirnov test. Results for outliers were displayed as 2.5%, 5%, 95% and 97.5% percentiles
Results: The sample of 451 patients [895 eyes], comprised of 61% [n=277] females and 39% [n=174] males [39%]. The mean age was 26 +6.4 years [range of 18-62 years, M=F]. Normal mean anterior segment values included; flat simulated keratometry [K1] 42.9 +/-1.44 diopters [D], steep K2 43.9 +/-1.52 D, K mean 43.4 +/-1.43 D, K maximum 44.6 +/-1.56 D, astigmatism -0.96 +/-0.97 D, anterior chamber depth [ACD] 3.19 +/-0.28 mm, front elevation at the thinnest point 4.11 +/-2.44 um, and that at the back was 7.56 +/-4.52 um progression index [PI] maximum 1.14 +/-0.17, Ambrosio relational thickness maximum [ART max] 487.5 +/-89.0 and pachymetry at thinnest point 542.2 +/- 31.1 um
Conclusion: The study demonstrates key corneal tomography parameters, which can be useful for screening refractive surgery patients in Pakistani population
ABSTRACT
Objective: To determine the Efficacy of Corneal Crosslinkage [CXL], using Corneal Topography, in eyes with progressive Keratoconus
Methods: This randomized control trial was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from October 2013 to April 2014. A total of 60 eyes of 30 patients were included who presented with bilateral progressive Keratoconus. Each eye of the patient was randomized either to a treatment group [Group-A] or control untreated group [GroupB] of 30 eyes each. A written informed consent was obtained from each patient, following which corneal crosslinkage [CXL] with topical riboflavin eye drops was performed. Follow up visit was done at three months post operatively, Corneal topography was repeated and recorded
Results: The mean age of the patients was 23.13+/-7.62 years [range 13 to 39 years]. There were 26 males and 34 females patients. The mean simK value at the start of study was 50.94+/-4.84 diopters in Group-A and 49.73+/-5.24 diopters in Group-B. At three months follow-up, the mean simK value was significantly lower in Group-A [48.28+/-4.47] as compared to Group-B [51.11+/-4.85]. Keratoconus improved/ remained stable in 34 [56.7%] eyes while progressive disease was noted in 26 [43.3%] eyes. When compared between the groups, the frequency of efficacy was significantly higher in Group-A [86.7% vs. 26.7%; p=.000] as compared to Group-B
Conclusion: Corneal Crosslinking was found effective in causing regression or halting the progression of disease in patients with progressive Keratoconus at three months follow-up, however, the efficacy of corneal crosslinking was unaffected by patient's age and gender
ABSTRACT
To compare the mean root mean square [RMS] of total higher order aberrations [HOAs], coma and spherical aberrations in individuals with myopia, hypermetropia and myopic astigmatism. This prospective analytical study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from Jan 2014 to Dec 2014. Two hundred eyes of 121 patients with age ranging from 18-40 years were included in the study. Patients were divided into 4 group namely Low myopia, High myopia, Astigmatism and Hypermetropia on the basis of refractive error. Included were the patients who had refractive error more than +/- 0.5D and best corrected visual acuity [BCVA] of 0.00 or better. Patients who had history of surgery and / or eye disease were excluded from the study. Visual acuity [VA], Spherical equivalent [SE] of refractive error, RMS value of total HOAs, coma and spherical aberrations were evaluated. HOAs were measured with aberrometer [Wavelight analyzer version 1073] at 6 mm pupil size. Age of the patients ranged from 18 years to 40 years with mean age of 29.10 +/- 10.6 years. Seventy one [35.5%] were males and 129 [64.5%] were female. Mean RMS value of HOAs, coma and spherical aberrations was calculated in all four groups. RMS of total HOAs and spherical aberrations in hypermetropia was 0.96 +/- 0.96 and 0.30 +/- 0.42 respectively and it was higher than other three groups. In overall comparison the mean RMS of total HOAs and spherical aberrations was significantly increased in hypermetropia group and there was a statistically significant negative correlation of SE of hypermetropia with RMS of total HOAs and spherical aberration
ABSTRACT
To determine mean change induced in root mean square value of higher order aberrations in myopic patients undergoing wavefront optimized laser assisted in situ keratomileusis. This quasi experimental study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from Jan 2014 to Dec 2014. Sixty eyes of 35 myopic patients were included in the study. All patients underwent wavefront optimized [WFO] laser assisted in situ keratomileusis [LASIK] using femtosecond laser [FM 200Wavelight technologies] and excimer laser [Ew SOOWavelight technologies]. Higher order aberrations [HOAs] were measured with aberrometer [Wavelight allegro analyzer version 1073] during preoperative assessment and one month after surgery. All 35 patients ranged from 20 to 32 years with a mean age of 24 +/- 3.41 years. Refractive error ranged from -1.00 to -9.50 DS with a mean spherical equivalent [SE] of -3.73 +/- 1.95 before surgery and - 0.36 +/- 1.50DS one month after LASIK. Uncorrected visual acuity [UCVA] was improved to 0.00 or better in all 60 eyes. An increase of 1.56 fold was observed in RMS of total HOAs. Among the HOAs, a statistically significant positive correlation was observed between spherical aberrations [4[th] order aberration] and preoperative spherical equivalent. In spite of excellent improvement in refractive error, significant amount of higher order aberrations were induced after WFO LASIK
ABSTRACT
To compare the effect of rapid and conventional methods of corneal collagen cross linking [CXL] on visual acuity [VA] and corneal parameters in Keratoconus. Randomized control trial. Armed Forces Institute of Ophthalmology, Feb 2012 to Apr 2013. Thirty patients, fifteen in each group, were randomized by non probability consecutive sampling to rapid or conventional CXL group. Pre and post operative [6 months] best corrected visual acuity [BCVA], anterior and posterior keratometric [K] values and pachymetry were recorded. Intra and inter group comparison of all these parameters were statistically analyzed. All thrty patients showed either stabilization or improvement in BCVA. Both groups showed comparable results in terms of improvement BCVA [p = 0.682], reduction in the corneal thickness at thinnest point [p = 0.062], anterior flat and steep K [p = 0.633, p = 0.443 respectively] and posterior flat and steep K values [p = 0.130, p = 0.068] at six months duration. Conventional and rapid methods of CXL are comparable in terms of their effect on VA and corneal parameters
Subject(s)
Humans , Male , Female , Cornea , Collagen , Visual AcuityABSTRACT
Valsalva retinopathy is a rare condition characterized by preretinal haemorrhage in patients with H/O increased intrathoracic pressure caused by forceful exhalation against a closed glottis. We are presenting a case of a young male adult who developed bilateral valsalva retinopathy following strenuous exercise
Examination of his fundus revealed a round, circumscribed bright-red mound of blood over both maculae
The extent of the lesion in left eye was lesser than the right eye. He was managed conservatively and showed remarkable visual recovery with return of vision to normal in both eyes after 12 weeks
ABSTRACT
A middle aged lady was surgically treated repeatedly elsewhere for growth on right upper lid before presentation to this department. On examination she was found to have nodulo-ulcerative non-tender growth, about 40 x 20 mm in size involving the lateral three-fourth of the lid. There was associated mild conjunctivitis and palpable pre-auricular lymph node. Lid growth was excised followed by lid reconstruction. Pre-auricular lymph node was also removed. Histopathology report of the tissue revealed it to be the palpebral sebaceous carcinoma, while lymph node showed reactive hyperplasia
Subject(s)
Humans , Female , Eyelid Neoplasms , Eyelids/surgery , Conjunctivitis , Lymph Nodes/pathology , Sebaceous Gland NeoplasmsABSTRACT
To compare the effectiveness of dexamethasone and diclofenac sodium eye drops in the resolution of inflammation following phacoemulsification surgery with posterior chamber intraocular lens implants. Quasi-experimental study. Ophthalmology Department, PNS Shifa Hospital, Karachi, from June 2006 to March 2007. One hundred subjects were operated and postoperatively divided into two groups, designated as 'dexamethasone' and 'diclofenac' groups. They were assessed for visual acuity and followed for 5 weeks for the signs of inflammation, which included cells and flare in the anterior chamber and striate keratopathy. Proportions were compared by Fisher's exact test and the chi-square test. Topically applied diclofenac sodium suppressed postoperative inflammation effectively but its anti-inflammatory effects were of lesser magnitude as compared to that of topically applied dexamethasone drops [p < 0.005]. Dexamethasone eye drops were found to have more potent anti-inflammatory activity in moderate to severe cases than diclofenac sodium eye drops in postoperative cases