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

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

Epithelial ingrowth after penetrating trauma

This is a case report about the anterior segment findings of epithelial ingrowth in a young female patient after penetrating trauma. The patient underwent multiple surgeries after penetrating trauma and epithelial ingrowth was noted on regular follow-up. Epithelial ingrowth was noted along the inner surface of corneal endothelium along with the presence of cysts. These findings suggest that epithelium penetrated through the site of perforation and grew along endothelium. Although epithelial ingrowth is a commonly reported complication of photorefractive surgery, it is rarely reported after trauma to eye. To authors' knowledge, this is the first reported case of epithelial ingrowth in Pakistan

Osteoporosis and its associated factors revisited: case control study

Background: Osteporosis is increasingly observed as a major public health concern as it leads to poor quality of life, pain and often disability for those effected. Especially in the developing countries, its prevalence in alarming in the face of poor awareness and management

Objective: To assess the risk factors for osteoporosis in females coming to a tertiary care hospital of Karachi

Methods: This was hospital based case control study conducted in a private tertiary healthcare facility of Karachi. It was carried out in 2012. 57 cases and 60 controls were selected through WHO Sample size calculator. Matching among cases and controls was based on gender, socioeconomic status and age group. Data was collected through questionnaire based personal interviews. Data entry and analysis was done using Epi Info. Association between categorical variables was found using chi square. Odds ratio was calculated for finding association between different risk factors and osteoporosis. The study was cleared through the Ethical review board

Results: One hundred and seventeen cases and controls were taken in this study with the age range of 45+ years [mean age 56.8 +/- 11.8]. Statistically significant difference was found in under 50 age group where cases were only n=8 [14%] as compared to controls n=25[42%]. Parsi ethnicity showed strong association with osteoporosis [OR 2.23]. Strong association was observed between smoking and osteoporosis with an Odds Ratio of 4.0. Strong association was observed with Rheumatoid arthritis [OR 2.8, CI at 95% 1.2-6.3] and Calcium deficiency [OR 2.2, CI at 95% 1.1-4.7]

Conclusion: The study revealed specific to Parsi ethnicity, family history, smoking, rheumatoid arthritis and Vitamin D deficiency were found to be potent risk factors. Therefore as reaffirmed from our study also, risk factors except from the non modifiable ones should be tackled well in advance through health education and interventions