Upper Eyelid Reconstruction Surgeries; Comparison Of Outcomes Between Reverse Tenzel Flap Versus Cutler Beard Flap Procedure.

BACKGROUND: Objective of this study was to compare Reverse Tenzel flap and Cutler Beard flap for upper eyelid defects. METHODS: This interventional study was carried out at occuloplasty department of LRBT (Layton Rahamatullah Benevoloent Trust), Karachi. Patients diagnosed with upper eye lid defect between 50 and 75 years were included after ethical approval from institutional ethical review committee and briefing patients about study dynamics. The patients were randomly divided in two groups, group A in whom reverse tanzel flap was done, while in group B Cutler beard procedure was done. Main outcome measure was eyelid contour, complete lid closure and surgical procedure time. SPSS version 25.0 was used for data analysis. RESULTS: Reverse Tenzel flap mean age 64.00±6.17 years, mean duration of surgery 33±5.78 minutes, and mean healing time 2.2±0.41 weeks. Cutler Beard flap mean age 59.60±6.26 years, mean duration of surgery 32±5.78 minutes, and mean healing time 5.7±0.8 in 3 weeks. 60% of patients were female. 30 (50%) patients each underwent Reverse Tenzel flap and Cutler Beard flap. In Reverse Tenzel flap, no complications were observed. In Cutler Beard flap, 06 (20%) patients reported mild entropion, 04 (13.3%) retraction of flap and 02 (6.7%) were found to have mild incomplete lid closure. CONCLUSIONS: Reverse Tenzel flap was superior to Cutler Beard flap as it reported no complications, being single stage surgery with early healing. Cutler-Beard flap reported mild entropion and retraction of flaps which required second surgery and delayed healing.

Pars plana vitrectomy in vitreous hemorrhage with or without Intravitreal Bevacizumab a comparative overview.

OBJECTIVE: To compare the success in patients having vitreous hemorrhage undergoing pars plana vitrectomy with or without preoperative intravitreal injection of Bevacizumab. METHODS: This Randomized controlled trial was conducted at Department of Ophthalmology, Jinnah Postgraduate Medical Centre. Karachi. Duration of study was six months from January 2010 to June 2010. In this study 56 patients of advanced diabetic eye disease were divided into two groups. Patients in Group-A underwent three ports pars plana vitrectomy with preoperative intravitreal injection of Bevacizumab (Avastin) 1.25mg/0.05ml, 3.5mm from the limbus seven days before surgery and in Group-B patients underwent vitrectomy without preoperative intravitreal Bevacizumab (Avastin). Intraoperative bleeding was monitored in both groups and was graded as no bleeding, mild bleeding and severe bleeding. The results were statistically analyzed through computer software SPSS 17. RESULTS: Twenty eight patients in Group-A who were given an injection of intravitreal Bevacizumab (Avastin) before surgery, intraoperative bleeding monitored was, no bleeding in 17 cases (60.7%), mild was observed in 6 cases (21.4%) and severe bleeding requiring diathermy to stop was observed in only 5 cases (17.9%). 28 patients in Group-B that underwent surgery without Avastin no bleeding was observed in only 2 cases (7.1%), mild in 6 cases (21.4%) and severe in 20 cases (71.4%). CONCLUSIONS: Intravitreal injection of Bevacizumab (Avastin) was effective before vitrectomy in the surgical management of Advanced Diabetic Eye disease.