Intraoperative and early postoperative complications of manual sutureless cataract extraction

To determine the intraoperative and early postoperative complications of manual sutureless cataract extraction. Case series. Redo Eye Hospital, Rawalpindi, Pakistan, from January 2009 to December 2010. Three hundred patients of cataract through purposive non-probability sampling were selected. The patients underwent manual sutureless cataract surgery [MSCS] by single experienced surgeon and intraoperative complications were documented. The surgical technique was modified to deal with any intraoperative complications accordingly. Patients were examined on the first postoperative day and on the first postoperative week for any postoperative complications. The data was entered in Statistical Package for Social Sciences [SPSS] version 13.0 and the results were calculated in frequencies. Among the 300 cases, 81.3% surgeries went uneventful whereas 18.6% had some complication. The common intraoperative complications were superior button-hole formation in 5%; posterior capsular rent in 5% and premature entry with iris prolapse in 3% cases. Postoperatively, the commonly encountered complications were striate keratopathy in 9.6% and hyphema 9%. At first week follow-up, 4% had striate keratopathy and 0.6% had hyphema. Striate keratopathy resolved with topical medication on subsequent follow-up. A total of 9 cases [3%] underwent second surgery: 2 cases for lens matter wash, 2 cases for hyphema and 5 cases needed suturing of wound for shallow anterior chamber due to wound leak. Superior button-hole formation, posterior capsular rent and premature entry were the common intraoperative complications of MSCS whereas the common early postoperative complications were striate keratopathy and hyphema.

Frequency of clinically visible diabetic retinopathy among indoor diabetic patients in a teaching hospital of Rawalpindi

To determine the frequency of diabetic retinopathy among indoor diabetic patients. To document the effect of duration, type, control of diabetes, gender and concurrent hypertension on severity of retinopathy in our local population. Detailed ophthalmic evaluation of indoor diabetic patients in Pakistan Railways Hospital Rawalpindi was performed. History of duration, type of diabetes, control, treatment and hypertension was recorded. Thorough ophthalmic examination was performed including fundus evaluation with maximum mydriasis using direct and indirect ophthalmoscopy and superfield lens fundus assessment under high magnification. Out of 4725 patients admitted, 789 were diabetics. 171 diabetics presented to ophthalmology department. Non-proliferative diabetic retinopathy [NPDR] was seen in 25.14% and proliferative diabetic retinopathy [PDR] in 11.11% of cases. Advanced diabetic eye disease was seen in 3.8% of patients [included in PDR cases]. Retinopathy was more frequent in cases with longer duration, type 1 diabetes, poor control, male gender and concurrent hypertension [with poor diabetic control]. Hypertension in the presence of good diabetic control did not adversely affect the retinopathy. On comparing the presence and severity of retinopathy between 10 years duration of diabetes, a statistically significant difference was found [p 0.0005]. Comparing the same between type 1 and type 2 diabetes, the difference was statistically significant [p 0.006] while comparison between good and poor control of diabetes yielded a difference that was statistically significant [p 0.0495]. Gender comparison revealed male preponderance but the difference was not statistically significant [p 0.739]. Among the diabetic admissions seen, 36.25% of patients had the changes of diabetic retinopathy. Significantly greater frequency of retinopathy was seen in cases with longer duration, type 1 and poor control of diabetes. Hypertension in the presence of poorly controlled diabetes affected the retinopathy adversely. Developing countries require aggressive screening and control strategies for diabetes to prevent microvascular complications

Comparison of photorefractive keratectomy results in two myopia groups

To compare the visual results and complications after photorefractive keratectomy [PRK] in mild to moderate and severe myopia groups. A private setting in Model Town, Lahore, from February 2004 to June 2005. Two hundred patients [400 eyes] underwent PRK on Summit Apex Plus excimer laser. Complete preoperative eye examination was done including BCVA [best-corrected visual acuity]. Three months postoperatively, the UCVA [uncorrected visual acuity] and complications in each eye were recorded. The eyes were divided into group I [<=-6.00D] and group II [>-6.0D] myopia retrospectively. Out of 400 eyes 324 [81%] belonged to group I and 76 [19%] to group II. In group I, prelaser BCVA was 6/6 in 87% and 6/9 in 7.7%. In group II, 61.8% of eyes had 6/6 BCVA and 15.8% had 6/9 vision. In group I, post laser UCVA was 6/6 in 79% and 6/9 in 12% while in group II it was 44.7% and 25% respectively. Some of the eyes had a prelaser BCVA of<6/6 but postlaser UCVA was equivalent to prelaser BCVA. This was designated as comparable vision. In group I, a total of 275 eyes out of 324 had a post laser UCVA of 6/6 or comparable vision [to the pre laser BCVA], while in group II 52 eyes out of a total of 76 had a post laser UCVA of 6/6 or comparable vision [statistically significant. In group I 10.8% of eyes lost 2 or more lines of UCVA postoperatively while in group II it was 21.1% [p<0 .021]. Post laser complications were seen in 86 out of 324 eyes in group I and 36 out of 76 eyes in group II [p<0.0001]. Moderate haze and scarring was each seen in 3.9% of the eyes in group II, and none in group I. The occurrences of under correction, overcorrection and complaints of poor contrast, glare were seen more in group II than in group I .d effective with minimal complications in myopia of less than minus 6.0 D when compared to that of more than minus 6.0 D myopia and the differences were statistically significant