Long-term change in intraocular pressure after extracapsular cataract extraction with posterior chamber intraocular lens implantation versus phacoemulsification with posterior chamber intraocular lens implantation in Indians

The purpose of the study is to evaluate the long-term changes in intraocular pressure [IOP] after extracapsular cataract extraction [ECCE] with posterior chamber intraocular lens [PCIOL] implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation [ECCE group] and 31 patients were selected for phacoemulsification with PCIOL implantation [Phaco group]. IOP was measured pre-operatively and post-operatively, from the 1[st] month to the 12 [th] month. Statistical significance was indicated by P < 0.05. There was a mean fall in IOP of 2.70 mm Hg [19.74%] in the ECCE group and 2.74 mm Hg [20.57%] in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant [P < 0.01] at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups [P > 0.05, all post-operative visits]. After 4[th] monthpost-operatively, the IOP was mostly stable, but it was significantly lower than the pre-operative IOP. Significant IOP reduction may be expected after cataract surgery with either ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4[th] month

Transcanalicular endoscope combined laser assisted dacryocystorhinostomy

In this study, we have tried to assess the success rate and difficulties that we came across while performing the transcanalicular endoscope combined laser-assisted dacryocystorhinostomy [T-ECLAD]. A prospective study of 60 patients suffering from nasolacrimal duct obstruction confirmed by preoperative syringing was carried out at the Regional Institute of Ophthalmology. T-ECLAD is a new minimally invasive dacryocystorhinostomy procedure, which is performed by diode laser [980 nm diode laser with power of 10 watts] through lacrimal canaliculi with the help of a cannula and fiber optic cable. The interior of the nasal cavity was visualized with the help of the nasal endoscope on a monitor. Success of procedure was assessed by patency of the lacrimal drainage system on irrigation. We performed 56 successive T-ECLAD. The average procedure time was 10 min, and on an average 235 Joules of laser energy was needed. We observed a patent nasolacrimal duct on irrigation in 39 out of 56 treated eyes. 1 patient had partial, 5 patients had blocked irrigation, and 10 patients did not return for follow up. This yields a success rate of 69.6% [if we exclude patients who did not return for follow up] with an average follow-up period of 6 months. The 980-nm T-ECLAD is a new contribution to the field of lacrimal surgery. It is a minimally invasive and quick procedure.