RESUMO
Objective: The purpose of this study was to evaluate the safety and efficacy of transepithelial corneal collagen cross linking [TE-CXL] with modified riboflavin and accelerated UVA irradiance in thin corneas with pachymetry less than 400 microns at thinnest point, untreatable by epithelium off corneal collagen cross linking[CXL] in adult Pakistani population with progressive keratoconus
Methods: This quasi experimental study included twenty six eyes of 26 patients with progressive keratoconus who underwent accelerated transepithelial CXL in Armed forced institute of ophthalmology with 12 months follow up. Modified riboflavin, ParaCel [[riboflavin 0.25%, Benzalkonium chloride, EDTA, Trometamol, hydroxypropyl methylcellulose] and vibeX Xtra [riboflavin 0.25%] [Avedro, USA]] were applied to cornea in two stages. Uncorrected and Corrected Distant Visual Acuities [UDVA, CDVA], spherical equivalent [SE], astigmatism, pachymetry at thinnest point [Pachy thin], apex keratometry [Kmax], simulated and steep keratometry [Sim K, steep K] were measured at baseline and at 3, 6 and 12 months post operatively. The cornea was then exposed to accelerated UVA irradiance of 9mW/cm[2] for 10 min [total dose 30 mW/cm[2]]
Results: The mean age of the patient was 24.54 +/- 5.16 years. UDVA, CDVA, SE, astigmatism significantly improved at all postoperative test points [p=0.000, 0.004, 0.000, 0.004 respectively]. Kmax and pachy thin were significantly reduced over baseline at 1 year [p=0.000, 0.004 respectively]. Topographic indices Sim K and steep K did not show significant changes. No intra or post-operative complications were reported
Conclusion: Transepithelial accelerated CXL with modified riboflavin is a safe and effective procedure which halt disease progression in thin corneas with progressive keratoconus
RESUMO
Objective: To evaluate the effect of pan-retinal photocoagulation with Pattern Scan Laser [pascal] on best corrected visual acuity and central macular thickness in patients having proliferative diabetic retinopathy [PDR]
Methods: This study was conducted at AFIO, Rawalpindi, Pakistan from Oct 2014 to Jul 2015. Sixty seven eyes of 46 patients having proliferative diabetic retinopathy were included in the study. All patients underwent ophthalmic clinical examination including uncorrected distant visual acuity [UCVA], best corrected visual acuity [BCVA], fundus examination with slit lamp and optical coherence tomography to document the pretreatment central macular thickness [CMT]. Two sessions of PRP using Pattern Scan Laser were performed 04 weeks apart and OCT was repeated 04 weeks after the 2[nd] session. Central macular thickness and BCVA were documented
Results: Sixty seven eyes of 46 patients [29 females and 17 males] with mean age of 57.45 +/- 5.78 years underwent treatment with two sessions of laser PRP. Mean pretreatment BCVA was 0.67 +/- 0.43 and mean post-treatment BCVA was 0.57 +/- 0.3. Mean central macular thickness [CMT] as measured by OCT was 391.93 +/- 170.43 before treatment and 316.91 +/- 90.42 um after treatment. The magnitude of induced change in CMT after treatment was 75.01 +/- 90.75 and BCVA was 0.09 +/- 0.14
Conclusion: Laser PRP with Pattern scan laser alone in patients with combined presentation of PDR and DME is safe and effective