Efficacy of topical Bevacizumab in high-risk corneal transplant survival

Objective: To evaluate the effectiveness of topical Bevacizumab in preventing neovascularisation on high risk corneal grafts

Methodology: This study was a randomized, controlled, parallel group study, carried out from February 2008 to April 2012 [51 months] at Isra Postgraduate Institute of Ophthalmology and Yasin eye hospital, Karachi. Eyes with high risk corneal transplantation with corneal neovascularization were included in this interventional study/randomized clinical trial. Patients were randomly allocated to 2 groups. Group A and Group B. After penetrating keratoplasty, group A patients received topical bevacizumab [2.5%, 25 mg/ml] which was self-administered 4 times a day for 24 week while group B patients received only sham eye drops. Group B was the control group. Corneal neovascular invasion area i.e. the fraction of area on transplanted cornea in which vessels were present was measured using mathematical software program MatLab. Data analyses was done using SPSS version 19. Frequencies of age gender and groups were measured. Neovascular invasion area and change in visual acuity was compared between the 2 groups using paired t test. P value of less than 0.05 was considered significant

Results: Among the 2 groups mean Corneal neo vascular invasion area was minimum in group A [6.23%] while in group B it was [26.7%]. Maximum number of patients [26] attained visual acuity of 6/36 or better in the topical bevacizumab group compared to 17 sham group

Conclusion: When topical Bevacizumab is used, it reduces the recurrence of neovascularisation and thus helps increasing the frequency of graft survival in cases of high risk corneal transplants

Outcome of pars plana vitrectomy with silicon oil versus scleral buckling in primary retinal reattachment surgery

To evaluate the outcome of primary pars plana vitrectomy with silicon oil tamponade versus scleral buckling procedureas a treatment for rhegmatogenous retinal detachment. This prospective, comparative, interventional study was conducted from July 2008 to June 2009. Patients were selected and divided into two groups. Pars plana vitrectomy [group I] or scleral buckling [group II] was performed as primary procedure. Patients were followed for 06 months after surgery. Anatomical outcome in pars plana vitrectomy procedure was 96.2% as compared to scleral buckling procedure 87.0%. Functional outcome in pars planavitrectomy, best corrected visual acuity of 6/6 - 6/18 was attained in 34.6%, in sclera buckling procedure 65.2% at 06 months. Anatomical outcome in pars plana vitrectomy is better as compared to sclera buckling. Visual outcome and visual rehabilitation is earlier and better in scleral buckling as compared to pars plana vitrectomy

Visual outcome and complications of phacoemulsification catract surgery performed by residents at al ibrahim eye hospital, karachi

To describe visual outcome and the complications related to cataract surgery performed by phacoemulsification technique by fourth-year ophthalmology residents at Al-ibrahim eye hospital, Karachi, who are trained to perform phacoemulsification with prior experience with manual extracapsular extraction. Prospective, observational case series. We prospectively analyzed the incidence of complications and visual outcomes in the initial 575 phacoemulsifications [575 patients] performed by the 5 residents learning phacoemulsification in our training programe. All were experienced in standard [manual] extra capsular cataract extraction. Postoperative follow up of 6 weeks was available in 547 eyes. The 28 patients [28 eyes] lost to follow up did not have any intra-operative complications. Of 575 cataract surgeries, 559 eyes [97.2%] were performed using phacoemulsification technique. Posterior capsule disruption without vitreous loss occurred in 16 [2.8%], vitreous loss in 15 [2.6%] and IOL displaced into vitreous in 4 [0.7%] of 559 cases that underwent phacoemulsification technique. Other complications encountered in-Cluded localized corneal edema [23 eyes], iris damage interiorly [1 eye] and clinical cystoid macular edema [1 eyes]. A best corrected visual acuity of 6/ 12 or better was obtained in 521 eyes [95.2%] of the 547 eyes available for the six week follow up. In the eyes with vitreous loss, 10 out of 15 had visual acuity better than 6/12. The residents can perform phacoemulsification well with a very low complication rate, with prior training with extra capsular cataract extraction technique