Résumé
To evaluate the efficacy of peribulbar [sub-Tenon] versus retro bulbar local anesthesia in cataract surgery by comparing analgesia, akinesia and effect on intraocular pressure. Comparative Consecutive Interventional Case series. One hundred patients undergoing surgery for uncomplicated cataract at Munawwar Memorial Hospital Chakwal. Patients were selected on the basis of convenience sampling. Patients were divided in two equal groups of 50 each. One group received retrobulbar block and other group received sub-Tenon's block. Before starting the surgery complete systemic and ocular examination was done. Efficacy was compared in terms of analgesia, akinesia and effect on intraocular pressure. Out of total 100 patients, 60% were male and 40% were female with a ratio of 3:2. In retrobulbar anesthesia, 30 [65.2%] patients experienced pain free surgery as compared to sub-Tenon's local anesthesia where 49 [98%] patients experienced pain free surgery. Complete akinesia was achieved in 26 [56.52%] cases of retrobulbar anaesthesia group as compared to 5 [10%] cases in sub-Tenon's anaesthesia group. There was a significant elevation of intraocular pressure immediately after administrating the local anesthesia in retrobulbar group as compared to sub-Tenon's group. Conclusion: Sub-Tenon's anaesthesia is a safe and effective technique for patients undergoing day cataract surgery as compared to retrobulbar local anesthesia. It prevents sight and life threatening complications
Résumé
Cystoid macular edema [CME] is an important complication as a cause of reduced visual outcome after extracapsular cataract extraction with posterior chamber lense implant [ECCE/PCL]
Objectives: This paper reports the incidence of CME after ECCE with PCL implant, discusses it as a cause of decreased visual outcome and suggests measures for its prophylaxis
Design of study and setting: a prospective study of 6 month duration [from March 1998 to September 1998] on 52 patients was conducted at Ophthalmology department, Allied Hospital Punjab Medical College, Faisalabad
Results: the incidence of CME after ECCE with PCL implant as a cause of unfavorable visual outcome was found to be 1.92%. Four groups of patients were recognized in this study. The first group [30.78%] included patients with visual acuity of 6/6 to 6/9 posts operatively without correction. The second group consisted of patients [67.3%] with visual acuity of 6/6 to 6/9 with the best possible correction. The third group consisted of patients of visual acuity 6/12 or less with the best possible correction and with CME as a cause of reduced VA and only one patient [i.e. 1.92%] fell in this group. The fourth group included patients with VA less than 6/12 with best possible correction but with other explainable causes of visual loss other than CME. None of the patient fell in this group. The single patient falling in third group had visual acuity of 6/36 with the best correction. This patient on Fundoscopy and +90D bio microscopy revealed cystoid macular edema in macular area. Fundus fluorescein angiography [FFA] showed evidence of CME with leakage of fluoresceine around fovea, giving a typical flower pattern. Thus this patient had clinically significant and angiographic ally proven CME. He was further followed and was treated with increased steroid therapy as a case of persistent CME. The 51 patients [i.e. 98.08%] achieved a visual acuity of 6/9 to 6/6 at 12th postoperative week with or without correction