Prevention of pterygium recurrence by using intra-operative 5-fluorouracil

This study was aimed to determine the role of intraoperative application of 5-Fluorouracil in the prevention of ptergyium recurrence. A prospective clinical trial. The study was conducted at Eye Department, Military Hospital, Rawalpindi from February 2000 to August 2001. A total number of one hundred and fifty patients were selected for the study and they were divided into two groups on a random basis. Control Group included 75 patients who underwent conventional pterygium excision. 5-Fluorouracil Group included 75 patients who received a single application of 5-Fluorouracil [25 milligram per milliliter] for five minutes immediately after pterygium excision. Follow up was conducted in case of both the groups for at least six months During follow up period, recurrence of pterygia was seen in thirty one patients [41.33%] in the control group while recurrence was seen in 25 patients [33.33%] in the 5-FU group. This shows a slight decrease in recurrence rate [P<0.05] but it significantly delayed the onset of recurrence [P<0.05]. It can be concluded that a single intraoperative application of 25 milligram per milliliter of 5-Fluorouracil can be considered as an adjunct treatment in pterygium surgery to prevent its recurrence

Sliding conjunctival flap in the surgical management of pterygium: a better approach

To note the frequency of recurrence of pterygium after surgical management using "Sliding Conjunctival Flap Technique" and "Bare Sclera Technique" thereby finding out a better technique where least recurrence occurs. Prospective interventional study. Study was carried out between February 2003 and February 2005 at Department of Ophthalmology, Military Hospital Rawalpindi initially and completed at Eye Department CMH Khuzdar, Balochistan. Surgical intervention was carried out on ninety patients with virgin pterygium; who had no other ocular pathology. Patients were selected from routine OPD using non randomized convenience sampling and were divided into two groups; Group A and Group B. Group A included 42 patients and were managed using "bare sclera technique, while Group B comprised of 48 patients and were managed using "sliding conjunctival flap technique". Patients were followed up for 1 year post-surgically at regular intervals. All patients were prescribed a standard treatment and results were documented. It was found that at the end of 1 year, 9 [21.42%] patients in Group A developed recurrence and only 3 [6.25%] patients in Group B developed recurrence. The results were found to be statistically significant [P-value <0.05]. Patients operated upon using sliding conjunctival flap technique had less frequency of recurrence of pterygium than those operated upon using bare sclera technique

Intralesional corticosteroid injection vs surgical treatment of chalazia in pigmented patients

To compare the outcome of intralesional corticosteroid injection and surgical treatment of chalazia. An interventional comparative study. PNS Shifa, Naval Hospital, Karachi from 1st September 2002 to 31st August 2003. During a 9-month recruitment period all patients attending PNS Shifa, Naval Hospital, Karachi, for treatment of chalazia were inducted in the study. A 141 patients with chalazia completed the study. Patients received either incision-curettage [surgical treatment/ ST group] or intralesional corticosteroid injection treatment [steroid injection/ SI group]. The same procedure was repeated in unsuccessful cases only once. Z-test of proportion was used as appropriate statistical test of significance at p <0.05 for the comparison of the results between the two groups. The success was achieved in 59 out of 75 patients [79%] in ST group and 41 of 66 patients [62%] in SI group at first visit after two weeks [p-value <0.01]. The success in ST group improved to 89% [67 out of 75 patients] after second operation and to 80% [53 out of 66 patients] in SI group after second injection of the steroid given at second week [p-value < 0.14]. Intralesional steroid injection is an effective and safe alternative procedure for the treatment of chalazia. The results are comparable to surgical treatment especially after second injection. It is not associated with any serious complications although skin depigmentation is relatively common in coloured population

Pseudoexfoliation syndrome and secondary catract

Pseudoexfoliation syndrome is a relatively common degenerative disorder, wherein a grey-white, fibrillogranular material is deposited in and around the anterior segment of the eye especially on the anterior lens surface, iris border and cornea. This can cause inflammation in the eye causing complicated cataract and secondary glaucoma We conducted this study to find out the frequency of complicated cataracts in such cases. Two hundred and seventy five cases with pseudoexfoliation syndrome presenting in the Dept of Ophthalmology, Military Hospital, Rawalpindi were taken up in the study and their detailed anterior chamber examination was done with special emphasis on the presence of cataract after maximal pupillary dilatation. Eighty cases [29.09%] showed the presence of cataract in their involved eyes. The occurrence of cataract in a significant number of cases suggests careful preoperative attention to zonular integrity if lens extraction is contemplated

New concepts in the management of EALE' s disease

Eales' disease is a leading cause of visual loss and invalidement out of service in young healthy soldiers. A prospective study of 637 patients of Eales' disease was conducted from January 1998 to December 2001 in Department of Ophthalmology, Military Hospital, Rawalpindi. 423 [66.40%] patients were treated in out patient department and 214 [33.60%] were hospitalised for a duration of about 3 1/2 months [105 days]. All patients received three-week course of systemic steroids, 557 [87.44%] received laser photocoagulation therapy and 46 [7.22%] were treated with vitrectomy and endolaser photocoagulation. 78 [12.25%] patients were placed in permanent medical category 'CEE' and 89 [13.98%] were invalided out of service due to permanent visual loss. Maximum number of patients with long-term bed occupation in eye ward are suffering from Eales' disease