Résumé
Background: The obstruction of the nasolacrimal duct leads to the blockage of lacrimal drainage. Congenital duct obstruction occurs in approximately 5% of normal newborn infants. There are many surgical techniques for its management
Objective: To study the efficacy of a new technique in the management of childhood nasolacrimal duct obstruction epiphora
Subjects and Method: Quasi experimental, interventional study, conducted from December 2001 to December 2008 at Eye department of Jinnah Postgraduate Medical Centre, Karachi and Eye Department Sheikh Zayed Medical College, Rahim Yar Khan. Fifty children between one to three years of age with epiphora due to nasolacrimal duct obstruction, in which at least previous one probing was done not less than three months back, were registered. Silicon intubation was done under general anaesthesia
Results: Forty [80%] cases were cured by the intubation in six months to one year follow up. Recurrent infection was noted in ten [20%] cases, which was managed medically. The severity of infection was much less than the one before intubation. All of the ten cases were planned for future dacryocystorhinostomy. Only a few treatable or insignificant complications were noted
Conclusion: This simple, easy and cost-effective technique of silicon intubation in nasolacrimal duct obstruction can be done in any operation theatre with general anaesthesia facilities
Résumé
Background: rhegmatogenous Retinal Detachment [RDD] is the most common type of Retinal Detachment, secondary to break in neurosensory layer of retina
Objective: to determine anatomical and functional improvement and complications, in patients with RDD, treated by scleral buckling procedure
Patients and Methods: this descriptive study was conducted in Department of Ophthalmology, Jinnah Post Graduate Medical Centre, Karachi, during July 2004 to December 2005. A total of 40 patients of RRD with proliferative vitreoretinopathy [PVR] grade A and B, underwent scleral buckling procedure [SBP]. The patients from 5 to 55 years of age and of either sex were included in this study. In addition, patients with diabetes mellitus, coronary vascular disease and other known risk factors for surgery were excluded from the study. All of the patients had uncomplicated RRD with duration of less than three months. Patients were followed up for up to three years for anatomical and functional improvement and complications
Results: a three year follow up showed anatomical reattachment after first surgery in 77.5% [31] of the cases and after second surgery in all of the cases. Visual improvement was observed in 75% [30] of the cases while 7.5% [3] cases had worsening of vison and 17.5% [7] cases showed no improvement in their vision. Per operative complication of iatrogenic break, choroidal hemorrhage was also noticed and draining of sub-retinal fluid [SRF] in a total of 7.5% [3] cases, RD in early post-operative period were encountered in 7.5% [3] cases, due to inadequate buckling, whereas in 15% [6] cases, RD developed in late-post operative period. In two of the cases, plumb was exposed. Out of these, one developed endophthalmitis. Causes of RD in early post-operative period was missed hole in two cases, which was dealt with successfully by application of additional plumb
Conclusion: observing the basic surgical principles and thorough pre and post-operative examination of the patients, scleral buckling procedure is a safe and effective technique for uncomplicated patients of RRD