RESUMO
Objective: To find out outcomes of pterygium excision with sutureless, glue free conjunctival auto graft
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Ophthalmology Department Unit-I, Dow University of Health Sciences, Civil Hospital Karachi from June 2011 to May 2015
Materials and Methods: Either gender patients above 25 years of age enrolled for primary pterygium excisionfollowed by limbal to limbal orientation of conjunctival auto graft without suture or adhesive glue. Recurrent pterygia, pseudo pterygia, ocular surface disorders, vascularized cornea, dry eye and patients already on topical anti metabolites were not included. Follow up was scheduled on 1[st] day, 1[st] week, 1[st], 3[rd], and finally 6[th] months. Chi square test was applied to check significance of recurrence with age, gender, occupation and graft size or graft application time
Results: Out of 382 participants, 303 [79.3%] were males. Majority of patients [77.7%] were young between 25 to 45 years of age. Mean time required for graft application was 16.89 +/- 2.58 [std] minutes. Recurrence of pterygium was found in 32 [8.4%] cases. No significant relationship of recurrence of pterygium was found with other variables like gender, age, occupation, graft size or graft application time
Conclusion: Natural healing tendency of vascularized conjunctiva allow graft to adhere underlying scleral bed while well aligned autograft margins and limbal to limbal orientation do not allow overgrowth of fibrovascular conjunctival tissue thereby prevent recurrence of pterygium
RESUMO
Objective: To evaluate visual outcome after arteriovenous sheathotomy for the treatment of branch retinal vein occlusion [BRVO]
Design: A descriptive case review
Setting: Civil Hospital and Dow University of Health Sciences, Karachi, Sindh - Pakistan
Methods: A pars plana vitrectomy and dissection of the involved AV crossing site were performed consecutively in 20 eyes of 20 patients with BRVO and vision loss. The overlying retinal artery was dissected free from the retinal surface, and separation of the artery and vein at the crossing site was attempted
Results: In 19 of 20 eyes, the retinal artery was dissected around the crossing site. After a mean follow-up of 10.5 months, VIA improved by at least two lines or more in 16 eyes [80%], remained unchanged in two eyes [10%], and worsened by at least two lines in two eyes [10%]. Mean change [ +/- SE] in logMAR acuity was -0.28 +/- 0.11; two or three lines of improvement [P=0.016] at 1 to 2 months' follow-up and -0.44 +/- 0.14; three or four lines of improvement [P = 0.008] at the final follow-up. Cataract formation or progression occurred in 88% cases
Conclusion: A surgically important adhesion between the retinal artery and vein at proximal AV crossings was encountered in all eyes undergoing AV sheathotomy. Cataract formation was a frequent complication. Visual improvement may occur after vitrectomy and AV sheathotomy without separation of the retinal vessels
RESUMO
To evaluate the anatomic and functional outcome of vitreoretinal surgery in eyes with pathologic myopia and macular hole and to determine if surgery improves visual acuity.Twenty-four consecutive highly myopic eyes with full-thickness macular hole without posterior retinal detachment, were treated by vitrectomy. Posterior hyaloid dissection, removal of epiretinal and internal limiting membranes [IIM] if thickened, instillation of platelet concentrate, and flushing with 25% sulfur hexafluoride were performed. Patients' refractive error ranged between -8.0 and -17.5 diopters, and axial length ranged form 27.1 to 31.4 mm Two epimacular membranes and 10 macular ILM were removed. Ten patients also underwent phacoemulstification and intraocular lens implantation at the same procedure. Mean preoperative best-corrected visual acuity was 20/200. Successful and anatomic macular hole closure occurred 6 months postoperatively in 100% of eyes after one [21 eyes, 87.5%] or two surgeries [3 eyes, 12.5%]. Visual acuity improved three or more lines in 83.3% of patients. Mean postoperative visual acuity was 20/70. No retinal detachment was observed during the follow-up period, which ranged from 12 to 45 months. Our results suggest that vitreoretinal surgery may effectively manage myopic macular holes, thus improving anatomic and visual outcomes. By closing the hole, vitreoretinal surgery may decrease the risk of posterior retinal detachment in highly myopic eyes
RESUMO
Ocular trauma [OT] is a common but preventable disease. A total of 102 eyes with OT involving 98 admitted patients were analyzed in a retrospective study spanning over a period from Jan. 2001 to Jan. 2004 in Ophthalmology Unit II of Civil Hospital, Karachi. The aims of the study were to identify etiological factors, to assess the visual outcome and to explore possible methods of reduction of OT in our setting. Out of the 98 patients, 92 [93.88%] were males and the commonest age group involved was 11-30 years with 64 [65.30%] cases. OT most frequently [72.44%] occurred in out-door cases, mostly from sharp objects [68.36%], followed by blunt objects [26.53%] and intra-ocular foreign bodies [3.06%]. Primary enucleation was done in four cases, and the patients were followed-up for a mean period of 20 months. Phthisis bulbi occurred in two patients, but none developed sympathetic ophthalmitis, siderosis bulbi or post-operative infections. Predictors of better visual outcome i.e. visual acuity [VA] 6/12 or better were initial VA of hand movement, wound location anterior to the plane of insertion of recti, wound length of 10mm or less, and sharp injuries. Even blunt trauma when tackled urgently and methodically gives excellent final visual outcome. Major causes of decreased VA were astigmatism, central corneal scar and central retinal injury. This study has identified that OT requiring hospital admission remains a serious problem. Prevention, as the optimum management of trauma, should however remain a priority in order to reduce morbidity and costs