Comparison of corneal endothelial cell density in patients of pseudoexfoliation syndrome with normal population

Objective: To compare the corneal endothelial cell density in patients of Pseudoexfoliation syndrome [PXS] with normal healthy controls. Study Design: Cross sectional comparative. Place and Duration of Study: This study was carried out at Armed Forces Institute of Ophthalmology, Rawalpindi from Mar 2016 to Jan 2017

Patients and Methods: Patients of PXS and healthy subjects of both genders between ages of 40 and 50 years, with best corrected visual acuity of 6/6 on snellen visual acuity chart were included in the study. All the participants including controls and PXS patients were subjected to ophthalmic clinical examination including corrected distance visual acuity, slit lamp examination by the single trainee researcher to exclude bias. Participants in both groups were evaluated for corneal endothelial cell density [ECD] by using non-contact, TOPCON SP 3000P Specular microscope. Sampling bias was eliminated by analyzing 100 cells in the center of each specular microscope photograph and mean of three readings was analyzed

Results: Both the groups were similar with respect to gender and age. In our study sample there were 29 [58%] males in PXS group and 24 [48%] males in control group with no statistical significant [p-value > 0.05] difference between gender distributions of both groups. The mean age of the PXS group was 46.34 +/- 2.932 years, and in control group was 45.54 +/- 2.887 years [p-value >0.05]. The mean value of ECD was found to be 2021.548 +/- 528.142 cells/mm2 in PXS patients and the mean value of ECD in healthy subjects was noted to be 2772.692 +/- 383.395 cells/mm2, showing significantly lower ECD in PXS cases. Similarly, significantly higher number of cases 22 [44%] had CED <2000 in PXS as compared to normal healthy subjects

Conclusion: Corneal endothelial cell density decreases in patients of pseudoexfoliation syndrome and this must be considered while planning any intraocular surgery including cataract extraction

Comparison of plasma homocysteine [HCY] levels in normal population and patients of pseudoexfoliation syndrome

Objective: To compare mean plasma homocysteine [HCY] levels [measured in umol/L] of normal population with patients having pseudoexfoliation syndrome [PXS]. Study Design: Cross sectional comparative study. Place and Duration of Study: This study was carried out at Armed Forces Institute of Ophthalmology, Rawalpindi, from May 2016 to Apr 2017

Patients and Methods: In this study 60 patients of PXS and 60 healthy subjects of both genders between ages of 40 and 50 years, with best corrected visual acuity of 6/6 on snellen visual acuity chart were included. All the participants were subjected to ophthalmic clinical examination including corrected distance visual acuity and slit lamp examination. Participants in both groups were evaluated for plasma homocysteine levels, by collection into a heparinized tube and later transferred in ice blocks. The samples were centrifuged at 4000 rpm for 5 minutes and stored at -20°C until the biochemical assay. HCY levels were determined by high performance liquid chromatography [HPLC]

Results: Total 120 participants of both groups were similar with respect to gender and age [p-value>0.05]. There were 36 [60%] males and 24 [40%] females in PXS group and in control group there were 29 [48.3%] males and 31 [51.7%] females. The mean age of PXS group was 44.68 +/- 3.234 years and for healthy control group it was 45.0 +/- 3.13 years. The comparison of homocysteine level between healthy controls and PXS patients showed a highly significant [p-value<0.01] difference between both groups. The mean homocysteine level was [32.14 +/- 14.33] in PXS group as compared to healthy controls [14.41 +/- 4.51]. The comparison of proportions of homocysteinemia showed that the rate of homocysteinemia was significantly [p-value<0.05] greater among patients of PXS. There were 24 [40%] participants in healthy control group who had homocysteinemia in comparison with 58 [96.67%] patients who had homocysteinemia among PXS group

Conclusion: Plasma HCY levels were raised in patients of pseudoexfoliation syndrome as compared to normal population, hence these patients may be considered for further systemic investigations by a medical specialist

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