RESUMO
To compare the results of intra-operative use of epinephrine with or without pre-operative topical flurbiprofen in the maintenance of intra-operative mydriasis Study Design: Comparative Consecutive Interventional Case Series. A total of 105 patients, that underwent uncomplicated extra capsular cataract extraction with posterior chamber IOL implantation, were enrolled in the study. All the patients received intra operative epinephrine in the irrigating solution while 52 of the patients also received pre-operative topical flurbiprofen 0.03% drops every 15min for a total of four doses along with other dilating drops beginning one hour before surgery. Pupillary diameters in both groups of patients were measured with calipers and rulei; just before entering into the anterior chamber and immediately after lens matter aspiration. There was no statistically significant difference between the two treatment groups in base line pupillary dilation. However the group receiving topical flurbiprofen 0,03% along with intra-operative epinephrine showed better maintenance of mydriasis, so much so that some of the pupils got even further dilated, by the end of the surgery. Flurbiprofen 0.03% has an additive effect with epinephrine; the group treated with flurbiprofen and epinephrine had a smaller proportion of cases where pupil size decreased than the group treated with epinephrine alone
RESUMO
To determine the role of B-scan ultrasonography [USG] in pre operative assessment of eyes with age-related mature cataract by documenting the frequency and nature of posterior segment intraocular pathologies detected by it. A hospital based descriptive observational study Two hundred nine [209] eyes with age related mature cataract of the patients presenting at the outpatient department of Al-Shifa Trust Eye Hospital, Rawalpindi from May to August 2003 A detailed ocular and medical history was taken keeping in view the inclusion and exclusion criteria. Eyes of these patients were divided into four groups on the basis of their age. All patients underwent a comprehensive ocular evaluation including visual acuity assessment, slit-lamp examination, pupil reactions and applanation tonometry. B-Scan USG of these patients was performed at both high [58-61 db] and low [42-44db] instrument sensitivity settings. By compiling data obtained by these various scanning approaches, a three dimensional concept of the lesion was developed and its topography adequately documented. SPSS software [Ver.10.0] was used for statistical analysis of results. It was observed that out of 209 eyes considered for simple mature cataract, USG revealed that 29 [13.87%] of them also had some other ultrasonically detectable posterior segment pathologies. 10 [4.78%] eyes out of 209 had vitreous haemorrhage [VH], 9 eyes [4.30%] had PVD, 3 eyes [1.43%] had asteroid hyalosis, 4 eyes [1.91%] had membranes in anterior and mid-vitreous, 2 eyes [0.96%] had chorioretinal layer thickening while one eye [0.48%] had optic disc edema. Pre operative B-Scan ultrasonography of cataract patients, when posterior segment examination is not possible by conventional methods, helps in diagnosis of additional posterior segment pathologies. Knowledge of these hidden posterior segment pathologies will then help the surgeon in explaining prognosis and expected outcome of surgery to patients. Surgeons can modify their plan of surgery and can also take measures to combat various predictable complications. In addition many legal and technical problems can also be avoided