Introduction: Trabeculectomy controls the intraocular pressure (IOP) and decreases the progress of open-angle glaucoma; the outcome of such procedure has not been ascertained in Libya. Objective: We report the short-term outcome of trabeculectomy in terms of IOP in primary open-angle glaucoma (POAG). Settings and Design: The medical records of the trabeculectomy patients previously diagnosed with POAG were reviewed retrospectively. Patients and Methods: Case characteristics were extracted including preoperative IOP and the IOP outcome 6 months postoperatively using Goldmann applanation tonometry. Data were presented as frequencies and mean ± standard deviation. Wilcoxon signed-ranks test was used to analyze the changes in the measurement of IOP after trabeculectomy. Results: Fifty-seven cases had trabeculectomy with a mean age of 51.6 ± 12.2 years. There was a statistically difference (P < 0.0001) in the IOP measurement pre and 6 months post trabeculectomy. 39 patients (68.4%) achieved an IOP of ≤21 mmHg 6 months after surgery without medications. IOP decreased from 33.2 ± 6.5 mmHg before surgery to 18.8 ± 5.8 mmHg after surgery. All the cases with preoperative IOP of 21–30 mmHg had a posttrabeculectomy IOP ≤ 21 mmHg (P < 0.0001). The rate of complications was low; seven eyes (12.3%) developed early postoperative complications that resolved within 2 weeks. Conclusions: This is the first report on trabeculectomy surgery in Libya. The results are encouraging with a low complication rate. This warrants further evaluationsof long term outcomes.
Purpose to-Report the largest outbreak of infectious endophthalmitis after intravitreal injection (IVI) of bevacizumab (BCZ) from a single-use vial to 14 Libyan patients. Design-A retrospective non-comparative case series.Methods-Medical records and microbiology results of 13 out of 14 endophthalmitis patients who were injected with BCZ on two consecutive days September 3 and September 4, 2019, were reviewed.Results -Fourteen patients were injected by four physicians on 2 consecutive days with BCZ, prepared by a well-trained operation theatre (OT) nurse at the major operation theatre in Alkeish polyclinic under aseptic technique. All of them presented the next day with signs and symptoms of endophthalmitis, (13 out of 14 patients) were treated by intravitreal antibiotic injections as an emergency measure and they underwent PPV within 5-7 days. Microbiology results revealed that Acinetobacter baumannii was the organism responsible for the infection. After one month of the incident; One patient (7.5%) recovered vision of 6/24, four patients (31%) had a vision of 6/60, but eight patients (61.5%) did not recover their vision and had a vision of count-fingers and less. Conclusion-The unavailability of a single-use ampule of BCZ and its compounding from a larger volume vial is a risk that mandates following the standard guidelines for IVI for the prevention of complications.
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