RESUMEN
To establish the usefulness of grading system based on the size and extent of corneal involvement in predicting recurrence in patients undergoing primary pterygium excision with intraoperative use of adjunctive topical Mitomycin-C [MMC]. A case series. Section of Ophthalmology, the Aga Khan University Hospital, Karachi, from 2005 till 2010. One hundred and twenty male patients [120 eyes] underwent surgical removal of pterygium using bare sclera method with MMC in concentration of 0.2 mg/ml [0.02%] with exposure time of 3 minutes. Classification of subjects was done according to the grading of pterygium. Patients were followed at 3 months interval for a minimum period of 1 year to record any recurrence. The pterygium recurrence rate was 6.7% at a follow-up of 1 year. There was no significant association of pterygium recurrence with younger age [p = 0.14]. A higher level of corneal involvement by the pterygium at presentation correlated significantly with the recurrence [p = 0.01]. These results suggest that a higher grade of pterygium at presentation in patients leads to increased rate of recurrence after surgical excision. Hence, early excision of pterygium is recommended to decrease its recurrence rate
RESUMEN
To determine the frequency and management of intraocular pressure [IOP] elevation following intravitreal triamcinolone acetonide [IVTA]. Case series. Isra Postgraduate Institute of Ophthalmology/Al-Ibrahim Eye Hospital, Karachi, from May 2007 to May 2008. In this study, 198 eyes of 150 patients requiring IVTA injection, were included. Pre-injection assessment comprised of detailed history, general and ocular examination including anterior and posterior segment examination with IOP measurements with Goldmann tonometer. After informed consent, IVTA 4 mg/0.1 ml was injected through pars plana and IOP was measured at 1 week, 1 month, 3 months and 6 months and if raised, treated accordingly. Out of 150 patients, 82 were male [54.7%] and 68 were female [45.3%] [M: F = 1.2: 1]. Mean age was 50.61 +/- 10.59 years. Raised IOP value after IVTA, higher than 21 mmHg was observed at one week in 28 eyes [14.1%], at 1 month in 48 eyes [24.2%], at 3 months in 76 eyes [38.4%] and at 6 months in 25 eyes [12.6%]. Raised IOP was controlled by topical beta blockers alone or in combination with carbonic anhydrase inhibitors in 58 eyes [76.3%]. Elevation of IOP after IVTA injection occurred in 76 eyes [38.3%]. It may take an extended period of time to manifest raised IOP. In majority of the patients, raised IOP was managed with topical medications