Visual outcome of cataract surgery in a tertiary care teaching hospital.

Objectives: To review the visual outcomes after cataract surgery in a tertiary care teaching hospital, Isra University Hyderabad. Methods: This retrospective clinical study was carried out for six months at Isra University Hyderabad from December 2020-May 2021. Total patients included were 982. The data comprised of patients who underwent cataract surgery from Sept 2018 - Aug 2020. Individuals over 40 years were included and who returned for out-patient appointments. Visual acuity before and six weeks after cataract surgery were noted and categorized according to World Health Organization criteria (i-e Good, Moderate and Poor).. Data analysis was done with the help of SPSS version 22.0. Results: Out of 982 patients who underwent Phacoemulsification at Isra University Hospital, the operated eyes were 483 right and 499 left respectively. Meanwhile, 966 had good visual acuity six weeks after the surgery, while 16 had moderate visual acuity noted after six weeks. Conclusion: Clinical audit of cataract surgeries by measuring visual acuity postoperatively is an excellent approach in improving the outcomes and maintaining the good care facilities at a tertiary care hospital.

Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy.

OBJECTIVE: To compare efficacy of intravitreal bevacizumab augmented with Panretinal photocoagulation versus Panretinal photocoagulation alone in high risk proliferative diabetic retinopathy. METHODS: This is Randomized clinical control trial study conducted at ISRA University Hospital, Hyderabad from July 2018 to December 2018. A total of 76 eyes were randomized into two groups, 38 eyes undergone PRP plus intravitreal bevacizumab, while 38 eyes had PRP alone. Status of neovessels was assessed before and after treatment with the help of fundus fluorescein angiography. Neovessels at disc (NVD's) and neovessels elsewhere (NVE's) were assessed with the disc surface diameter. RESULTS: Seventy-six eyes were enrolled in this randomized clinical trial into two groups consecutively, that all completed the six months follow-up. In the PRP group mean BCVA (logMAR) worsened significantly from mean 0.30±0.07 to mean 0.40±0.04 at a 30th day and mean 0.40±0.04 at day 90. While BCVA become improved from 0.30±0.05 to 0.1±0.03 at week four and 0.1±0.02 at week 12 in PRP-Plus group. There was significant change in regression of NVES in PRP only group at week 4 is 2.25±0.75 (p=0.00004) and at 12 weeks 2.00±0.50 (p=0.00002), while in PRP + intravitreal bevacizumab group at 4th week was 1±0.5 (p =0.0001) and at 12th week was 0.75±0.25 (p=0.0001). CONCLUSION: Intravitreal Bevacizumab augmented with PRP is more effective in early regression of neovessels in high risk PDR patients.

Vitrectomy With Epiretinal Membrane Peeling Alone Verses Combined With Internal Limiting Membrane Peeling For Idiopathic Epiretinal Membrane.

BACKGROUND: The objective of this study was to determine and compare the structural and functional outcome in eyes who underwent Pars Plana Vitrectomy (PPV) with Epiretinal Membrane (ERM) peeling alone verses combined Epiretinal membrane with Internal Limiting Membrane (ILM) peeling for Idiopathic Epiretinal Membrane along with the rate of recurrence. METHODS: It was an interventional randomized study, conducted at Al-Ibrahaim Eye Hospital, Malir, Karachi, for two-year period from 1st August 2016 to 1st August 2018. A total of forty-four eyes of 44 patients were divided into two groups equally. Group A contains 22 eyes of 22 patients who underwent PPV with ERM peeling alone. Group B also contains 22 eyes of 22 patients who underwent PPV with ERM and ILM peeling. The follow up period was 1 year. The patients having best corrected visual acuity (BCVA) less than 6/18 or symptom of metamorphopsia were included in our study. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were recorded at 3, 6 and 12-month follow up. RESULTS: In group A, the mean preoperative BCVA was 0.148 Log MAR (6/36 Snellen chart). The mean postoperative BCVA at 3, 6, and 12 months was 0.32 (6/18), 0.49 (6/12 P), and 0.50 (6/12), respectively. In group B, the mean preoperative best corrected visual acuity was 0.161 Log MAR (6/36 P Snellen chart). The mean postoperative BCVA at 3, 6, and 12 months was 0.36 (6/18 P), 0.51 (6/12), and 0.51 (6/12) respectively. The mean preoperative Central Macular Thickness (CMT) was 398.9 µm in group A and 384.7 µm in group B. The mean CMT in group A was 271.4, 236.7, and 229.8 µm at 3, 6, and 12 months, respectively. In group B, the mean CMT was 272.1, 233.8, and 220.4 µm at 3, 6, and 12 months, respectively. No significant difference was found in the visual outcome and central macular thickness between the two groups. CONCLUSIONS: Pars plana vitrectomy along with ERM peeling alone or combined with ILM peeling is a safe procedure. Both methods were effective functionally and structurally in the treatment of idiopathic ERM, however, no significant difference and no recurrence of ERM was observed in either group.