Visual outcome of cataract surgery in a field hospital of sub- Saharan Africa

The aim of the study was to document the visual outcome of cataract surgery in the difficult setting of the field hospital and compare it with international standards. A quasi-experimental study. Level II hospital United Nation mission, Sudan. Feb 2006 to Nov 2006. All the patients undergoing cataract surgery in our hospital were included in the study. The patients had complete general physical, systemic and ophthalmic examination before surgery. Most of the patients underwent phacoemulsification, or extra-capsular cataract extraction [ECCE] with posterior capsular intraocular lens [IOL] implantation. The patients were followed up after 1 day, 7 days, 6 weeks, and 3 months of surgery. The preoperative and postoperative visual acuity was compared. A total of 163 eyes in 145 patients were operated by one experienced Phaco surgeon and only those who completed 6 weeks follow up were included in the study [141 eyes in 136 patients]. The average age of the patients at operation was 57 years [age ranged from 10-78 years]. There were 88 [64.71%] females and 48 [35.29%] males. Most of the patients had senile cataracts. The majority of the patients had marked improvement in the vision at six weeks follow up. Preoperatively 112 of eyes [79.43%] had poor vision [best corrected acuity <3/60] compared to only 2 [1.41%] eyes postoperatively. A corrected vision of 6/18 or better was achieved in 124 [87.94%] eyes. An uncorrected vision of 6/18 or better was obtained in 102 eyes [72.34%] at their last follow up visit. Six patients [4.2%] had a poor visual outcome [best corrected vision less than 6/60]. Cataract extraction with IOL implantation gives good visual results even in the field hospital settings provided it is performed by experienced surgeon with good team support

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