This study was conducted to demonstrate refractory macular hole closure with human amniotic membrane graft and to evaluate type of closure Type I versus Type II.
Purpose: To compare the frequency of post-operative hypotony between 23G PPV and 25G PPV in advanced diabetic eye disease. Study Design: Quasi experimental study. Place and Duration of Study: Study was conducted at department of Ophthalmology, Lahore General Hospital, Lahore from 7th April 2016 to 6th October 2016. Methods: Total 100 cases of advanced diabetic eye disease with age ranging from 25 – 65 years and either gender were selected. Patients with nystagmus and claustrophobia, lamellar macular holes, epiretinal membrane and neovascular glaucoma were excluded. Patients were divided by lottery method into 2 groups. Data of the patient i.e. name, age, sex, patient’s registration number and address was recorded. Every patient had detailed preoperative work-up; including best corrected visual acuity by Snellen’s chart, intraocular pressure by applanation tonometer, indirect ophthalmoscopy and B-scan for retinal status. Group A underwent 23G PPV and group B underwent 25G PPV. Patients were followed after 24 hours of surgery to measure intraocular pressure to access hypotony. Results: Mean age of patients in group A was 50.16 ± 10.40 years and in group B was 50.26 ± 9.91 years. Out of 100 patients 57 (57.0%) were females and 43 (43.0%) were males, with female to male ratio of 1.1:1. Post-operative hypotony was seen in 24 (48.0%) patients with 23G PPV and 02 (4.0%) patients with 25G PPV (p-value = 0.0001). Conclusion: This study concluded that the frequency of post-operative hypotony in 23G Pars Plana Vitrectomy was higher as compared to 25G Pars Plana Vitrectomy in advanced diabetic eye disease. Key Words: Diabetic retinopathy, Pars Plana Vitrectomy, Hypotony.
Purpose: To find out the outcomes of suprachoroidal Triamcinolone injection in refractory diabetic macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Al-Ehsan Eye Hospital, Lahore from Jan 2020 to 31st Dec 2020. Methods: Sixty-five patients with refractory diabetic macular edema were included. Patients underwent complete ocular history and examination. To document baseline macular edema, SD-OCT was done. The recruited patients received 0.1ml of suprachoroidal Triamcinolone injection (40mg/ml) using a 30 gauge syringe. Follow up was performed at one week, one month and third month after injection. At each follow up, best corrected visual acuity, central macular thickness and retinal nerve fiber thickness were documented. Data was analysed using SPSS version 36.0. Comparison of BCVA, central macular thickness and retinal nerve fibre layer thickness (RNFL) before and after injection was analyzed by paired sample t-test with p value of ≤ 0.05 as significant. Results: Out of 65 patients, 29 (44.62%) were females. Mean age of patients was 54 ± 8.4 years (range 40 to 80 years). Central macular thickness after suprachoroidal Triamcinolone injection changed from 556.2 ± 10.9 to 313.6 ± 7.2 ųm. Change in visual acuity was 0.9 ± 0.01 to 0.6 ± 0.02. Pre-treatment and post-treatment visual acuities demonstrated a substantial change after undergoing treatment along with decrease in central macular thickness with p value ˂ 0.001. Conclusion: Suprachoroidal Triamcinolone injection results in anatomical as well as functional improvement in diabetic patients with refractory macular edema.
Aims: The objective of this survey was to evaluate how routinely and efficiently the skill of fundus drawing is practiced among retinal specialists. Fundus drawing is an invariably accepted evidence worldwide for documenting various retinal disorders. Methods: A self-administered online questionnaire was circulated among various ophthalmologists. Potential participants were vitreo retinal surgeons and those ophthalmologists who work in a vitreo retinal department within Asia, United Kingdom and USA. The respondents were asked to mark either “YES” or “NO” for the given questions through google survey form. Results: Responses were obtained from 68 ophthalmologists in total out of which 57(83.82%) were retinal surgeons and 11(16.18%) were not. 32 (46.38%) admitted drawing fundus diagrams in their routine practice whereas, significantly 37 (53.62%) were not practicing it routinely. 45(66.18%) confessed that they draw single colored fundus drawings of retinal patients and 23(33.82%) did not. Conclusion: Regrettably, a large number of ophthalmologists according to our survey seem to be unenlightened with the imperative requirement of a fundus diagram in order to document various retinal pathologies in vitreo retinal patients, despite the fact that this skill has been considered mandatory in routine clinical practice of ophthalmologists.
Aim: To explore the impact on students (in terms of engagement, improvement in achieving the learning outcomes, motivation and metacognition of prior knowledge) if facilitator behaves as simulated patient in PBL. Methods: The research was carried out at the University College of Medicine and Dentistry in Lahore, Pakistan. The method employed was purposeful heterogeneous sampling. Through an online session of focus group discussion using Zoom software, qualitative data was collected from 30 students and 6 facilitators. The data was transcribed, and the codes were manually coded by highlighting them. Themes were then created Result: Over all, the attitude of students towards simulated PBL was positive and respondents were satisfied. Five emerging themes that supports the efficacy of simulated PBL and active role of facilitators were as follows: PBL is efficacious pedagogy, professional development, life-long learner, impact of role modelling and role of simulation in PBL. Conclusion: The study concludes that PBL is an effective pedagogy, the role of facilitators’ impacts positively on students by enhancing their professional development like communication skills, empathy and confidence. Simulation and role modelling by the facilitator inculcate the confidence and competence and make them lifelong learner. Key words: Engagement, Facilitator, Problem based learning, Qualitative, Simulation
Objective: The purpose of this review article is to highlight the efficacy of Vancomycin and Ceftazidime formulated in different solutions for ocular use in the management of microbiological Ocular infections varies. Methodology: To locate and assess all relevant literature, we employed systematic review as a search approach, utilizing punctilious and unambiguous methodologies. We initiated by stipulating key terms and selecting appropriate databases for your literature search. To find replicable and reportable publications from high-quality peer-reviewed journals, we used Google Scholar, PubMed, and Research Gate. Results: Ceftazidime precipitated at 37 degree Celsius, but not at room temperature, however it did not show any effect on the pH of the medium. In both the media of Normal Saline and Balanced Salt Solution, it precipitated on its own or when coupled with vancomycin. Ceftazidime was initially prepared in Balanced Salt Solution rather than Normal Saline, which resulted in further precipitation. Ceftazidime prepared in Normal Saline precipitated to 54% after 168 hours in the dialysis chambers, compared to 88% in Balanced Salt Solution. Ceftazidime synthesized in Normal Saline declined from an initial concentration of 137.5 to 73.4 µg/ml after 48 hours, while ceftazidime prepared in Balanced Salt Solution decreased to 6.3µg/ml. Vancomycin precipitation was inappreciable. Conclusion: Vancomycin did not precipitate in Normal Saline or Balanced Salt Solution, according to this systemic study. Regardless of the presence of vancomycin, ceftazidime precipitated, and it precipitated more expeditiously if it was produced in Balanced Salt Solution rather than Normal Saline.
Background: Cataract surgery has become one of the most common surgeries in the world with one in every four surgeries performed being a cataract extraction and the numbers are expected to increase by 16 percent in the USA alone by 2024 as compared to the current statistics. The aim of the study is to analyze the visual outcomes of intraocular lens implants for various visual ranges. Methods: This non-comparative interventional study was conducted at the Ophthalmology department of Al Ehsan Eye Hospital from Jan to Dec 2021. It included patients who underwent uneventful phacoemulsification with an intraocular lens implant and analysis of the visual outcomes for uncorrected distance (UDVA), uncorrected intermediate distance (UIVA), and uncorrected near distance (UNVA). Results: Independent sample t-test was applied to observe the mean values of recorded far vision on the 1stday, 1 week, and 1 month after the trifocal intraocular lens implantation. It showed a significant difference with a p-value of 0.00 on 1st day, 1 week, and 1 month after was 0.3±0.1, 0.17±0.09, and 0.14±0.08 respectively. Mean improvement in near vision after 1 month was N6 with S.D 1.03 and in intermediate vision was N8±1.4 respectively. Conclusion: Trifocal Intraocular lens implantation offers an improved vision for near, intermediate, and distant visual ranges without the need for correction.
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