Comparison of mean corneal endothelial cell loss after trabeculectomy with and without mitomycin C

Objective: To compare mean endothelial cell loss in patients of primary open angle glaucoma undergoing trabeculectomy with and without mitomycin C. Study Design: Randomised control study. Place and Duration of Study: Institute of Ophthalmology, Mayo Hospital, Lahore, from May 2016 to April 2017

Methodology: Patients with primary open angle glaucoma, not controlled with medication, were selected from the outpatient department. Patients with secondary glaucomas and concomitant ocular disease were excluded. Selected patients were divided into two groups of 30 each. Group A patients underwent trabeculectomy with adjunctive mitomycin C while group B patients underwent trabeculectomy alone. Pre- and post-trabeculectomy endothelial cell counts were recorded with the help of specular microsope and entered on proforma

Results: Median cell loss was 283 [66.50] when trabeculectomy was done with the use of adjunctive mitomycin C in group A while median endothelial cell loss was 72.50 [19.25] when the trabeculectomy was done without the use of adjunctive mitomycin C in group B

Conclusion: Use of mitomycin C causes more endothelial cell loss during trabeculectomy as compared to when done without it

Retinal nerve fiber layer thickness changes after phacoemulsification with intraocular lens implantation

Objective: to determine the changes in the retinal nerve fiber layer as measured on optical coherence tomography [OCT] after phacoemulsification with intraocular lens implantation

Study Design: quasi-experimental study

Place and Duration of Study: department of Ophthalmology, Lahore General Hospital, Lahore, from March 2017 to April 2018

Methodology: all patients [n=64] diagnosed with cataract and requiring surgery were included in study. Patients having any coexisting ocular pathology hindering the OCT measurement, i.e. corneal opacity, vitreous hemorrhage, retinal detachment etc. were excluded from study. Retinal nerve fiber layer thickness was measured in four quadrants. Signal strength on OCT was also documented. Preoperatively, visual acuity was measured, OCT performed, and the findings were recorded on a designed proforma. Postoperatively, the patients followed up after one month for visual acuity and OCT measurement

Results: retinal nerve fiber layer thickness was increased postoperatively as measured on OCT as did the signal strength. The increase was statistically significant [p <0.001]

Conclusion: removal of cataract by surgery enhances the OCT measurement of retinal nerve fiber layer, resulting in increased thickness