RESUMO
Objective: To assess the visual outcome and complications of Combined Pars Plana Lensectomy- Vitrectomy in hereditary ectopia lentis
Study Design: Prospective observational study
Settings: Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi; from Jan' 2004 to Dec' 2007
Subjects and Methods: Forty eyes of 23 patients diagnosed as having hereditary ectopia lentis were included in the study. All the cases were worked up according to the standard protocol and were operated upon. The surgical procedure adopted was pars plana lensectomy with core vitrectomy. Endolaser photocoagulation was performed in selected cases
Results: Forty [40] eyes of 23 patients with ectopia lentis of hereditary type were included in the study. Seventeen patients had bilateral and 6 patients had unilateral ectopia lentis. There were 8 male and 15 female patients. Age range was 5 - 29 years. Preoperative visual acuity was 6/12 - 6/18 in 4 [10%] eyes; 6/24 - 6/60 in 28 [70%] eyes and < 6/60 in 8 [20%] eyes. Postoperative corrected visual acuity was 6/6 - 6/9 in 28 [70%] eyes; 6/12 - 6/18 in 4 [10%] eyes; 6/24 - 6/60 in 6 [15%] eyes and less than 6/60 in 2 [5%] eyes. Intra-operative complications were accidental iris injury in 1 eye and dropped lens fragment into the vitreous cavity in 1 eye. Post-operative complications were transient ocular hypertension in 2 eyes and persistant postoperative uveitis and vitritis in 1 eye
Conclusion: Pars plana approach for management of ectopia lentis is a safe and effective method of treatment
RESUMO
To evaluate the indications and complication rate in fifty consecutive patients in whom percutaneous endoscopic gastrostomy [PEG] was attempted. A descriptive study. Fifty consecutive adults referred to our unit for consideration for primary percutaneous endoscopic gastrostomy feeding between November 1999 and October 2001 at The Aga Khan University Hospital, Karachi and Isra University Hospital, Hyderabad were evaluated prospectively. PEG insertions were successful in all fifty patients [29 Males, 21 Females]. The indications for PEG were neurogenic [80%], recurrent aspiration, not the gastric contents [8%], head and neck tumors [6%], esophageal tumor [4%] and dermatomyositis [2%]. Ninety six percent of the patients had the procedure as inpatients while 4% were outpatients when the procedure was performed. Eighty percent of the patients had at least one follow-up after the tube insertion. Major complications were peritonitis [2%] and aspiration of gastric contents [4%]. Minor complications were PEG site infection [16%], accidental tube removal [10%], PEG migration [6%] and PEG blockage [4%]. One patient died due to peritonitis. Oral feed was resumed in 12% of the patients and the tube was removed subsequently. PEG is a feasible and safe procedure in our set up. It provides adequate feeding support and has low mortality rate even in patients, debilitated secondary to their underlying disease