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Purpose: External dacryocystorhinostomy (DCR) surgeries are cost-effective with excellent success rates. The present study was designed to compare the safety and efficacy of conventional external DCR versus external DCR using Pawar silicone implant in chronic dacryocystitis. Methods: This is a prospective, comparative, interventional case series over a period of 18 months with patients managed by external DCR surgery with and without Pawar implant. Institutional review board approval was obtained before the study. The success of the surgery was objectively measured by sac patency on syringing at the last follow up. Results: A total of 65 patients with chronic dacryocystitis were included in the study. The mean age of patients in the series was 41.43 years (median, 41 years; range, 12 years-60 years). All patients presented with epiphora (100%) and underwent external DCR and were chosen for conventional surgery (n = 33, 51%, group 1) or Pawar silicone implant surgery (n = 32, 49%, group 2) on a random basis. The mean duration of the surgery from the time of skin incision to skin closure for group 1 was 27.7 minutes (median, 26 minutes; range, 21-30 minutes) while in group 2, it was 75.5 minutes (median, 75 minutes; range, 60-88 minutes), which was statistically significant (P < 0.01). The success rate of the procedure done in group 1 was 90% which increased to 97% after the management of failed cases as compared to the success rate in group 2 of 91% and 94%, before and after the management of failed cases, respectively. Conclusion: External DCR using Pawar implant is a safe surgery which is faster than conventional external DCR with almost equal success rates between both the procedures.
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Purpose: To analyze applications for blindness certificates to find causes of visual impairment (VI), handicap, and blindness in a tertiary hospital of Bihar. Methods: Applications for blindness certificates were analyzed over a two-year period. The main cause of blindness, visual handicap, and VI in these applications was ascertained by age group and etiology. VI disability percentages and definitions proposed by Governmen of India (category 0� 20�0%) were used to categorize and give percentage to all applicants. Results were compared with data from studies on blindness certificates and population based studies. Results: In total, 203 applicants were reviewed. Mean age was 23.5 � 7.9 years. Overall, most common cause of visual handicap (40�0% impairment) and blindness (75�0% impairment) was macular pathology (P <.05), while most common cause of overall VI (20�0% impairment) was amblyopia. In age group 0� years, most common causes of blindness/visual handicap were congenital globe and hereditary retinal or optic nerve disorders (P = 0.016). In age group 16� years, macular pathology was the most common cause of visual handicap [P = 0.007], while amblyopia was the most common cause of VI [P = 0.00]. Between 31 and 45 years of age group, corneal scar in one eye was the most common cause of VI, while macular scar in both eyes was the most common cause of visual handicap. Glaucoma and diabetic retinopathy were the most common causes of blindness/visual handicap between 46 and 65 years and above 65 years of age, respectively. Data about causes of VI such as amblyopia, complicated cataract surgery, and one eyed blindness could not be ascertained by analyzing blindness certificate alone. Conclusion: Data from applications for blindness certificates provide valuable information regarding different causes of VI that might otherwise not be eligible for blindness certification and provide an insight into the overall trends in disease profile and service delivery.
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Background: Evaluation of changing axial length in eyes after paediatric cataract surgery. Aim – To assess the change in axial length of eye after paediatric cataract surgery which will help us to determine the amount of under-correction required in IOL power with increase in age. Methods: 32 patients were divided in three age groups; 0-2 years, 2-5 years and 5-10 years. Post cataract surgery, in all the patients axial length measurement, intraocular pressure recording and cycloplegic refraction was done at 6month, 1 year and after 2year of surgery. An unpaired T-test was performed to check the significance of study. Results: The change in axial length in first group(0-2 years) was higher at the end of 2 years (1.82mm) than second (1.74mm) and the third group (0.85mm). The mean axial growth of aphakic eye was higher (1.65mm) than the pseudophakic eyes of the same age group. Maximum growth rate (40-56% of the total growth) was observed in the first 6months of surgery in all the three groups. Myopic eyes in group 2 had higher mean axial growth (2.28) than the non-myopic eyes (1.28) of the same study group. Myopic eyes in the other group also had higher growth rate. Conclusion: Paediatric eye is a growing system with an eminent myopic shift which necessitates the required adjustment in IOL power to achieve emmetropia at adult age. As the rate of growth in axial length is maximum between 0-2 years of age, the required reduction in IOL power is more in this group to achieve the final status of emmetropia.
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Werner syndrome (WS) is a rare progressive disorder. It is characterized by the appearance of unusually accelerated aging (progeria) including bilateral senile cataract. Here, we report a successful management of hypermature cataract in WS.
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Purpose: To study the safety and efficacy of biologic fibrin glue (FG) in comparison with infinity suture in SICS with compromised scleral flap. Methods: A retrospective comparative study of patients who were treated with FG (Group A) with 10�nylon (Group B) as sealing agent for intraoperative compromised tunnels in SICS. Parameters noted were postoperative inflammation, wound integrity, anterior chamber (AC) depth, intraocular pressure (IOP), and surgically induced astigmatism (SIA) at postoperative day 1, 4 weeks, 6 weeks, and 6 months, respectively. Epi Info 7 software and SIA calculator, Version 2.1 were used to analyze the result. Results: We reviewed the two groups of 18 patients each and noted that there was no statistically significant difference in postoperative inflammation (P > 0.05), AC depth (P > 0.05), and IOP (P > 0.05) between both groups at each postoperative visit. One patient in Group A showed postoperative shallow AC and subconjunctival bleb. Exposed sutures causing foreign body sensation had to be removed in five patients in Group B. At the end of 6-month postoperative period, no statistically significant difference was found in SIA (P = 0.92) between the two groups. Conclusion: Biologic FG can be safely used in securing the compromised scleral incisions in SICS. It also avoids suture-related complications.