Background: Glaucomatous Optic Neuropathy (GON) is very common in the glaucoma patients, and impaired effect of glaucoma is measured by the Retinal Nerve Fiber Layer (RNFL) thickness.Objective: The study was conducted to find out the mean RNFL thickness, RNFL thickness in different quadrants, Intra-Ocular Pressure (IOP) changes, and visual field changes after filtration surgery in different ages and genders using Optical Coherence Tomography (OCT).Materials and Methods:The study was an interventional case-series conducted at the Glaucoma Clinic at the Regional Institute of Ophthalmology at Kolkata from March 2009 to August 2010. Fifty-one eyes of 43 open angle glaucoma patients had been selected for clinical and ophthalmologic evaluation. All the eyes of glaucoma patients who fulfilled the inclusion criteria were registered in the study population. The glaucoma filtration surgery was done in these patients. The RNFL thickness, IOP, visual field changes were measured before and after intervention of filtration surgery. Pre-operative OCT images of RNFL were obtained 0 to 120 days before surgery, and post-operative images were obtained from 60 to 120 days after surgery. Data collected in a standard data collection form included schedule.Results: Paired t-test was used. RNFL thickness was (pre-operative: 52.56 ± 17.40, post-operative: 58.48 ± 20.20, P < 0.0001) significantly increased after filtration surgery measured by OCT with significant reduction of IOP (r = - 0.38, P = 0.005) irrespective of age and gender.Conclusions: An increase in RNFL thickness was observed after glaucoma filtration surgery that correlated with IOP reduction.
A 63-year-old man with unremarkable previous ocular history presented with bilateral symmetrical corneal ulceration along with mucopurulent conjunctivitis and dry eye 10 days after the fourth dose of intravesical Bacille Calmette-Guerin (BCG) instillation for treatment of bladder carcinoma. Slit lamp examination revealed thinning of the cornea at the base of the ulcer in both eyes. Conjunctival swab and scraping from ulcer sent for Gram and acid fast bacilli stain and culture were negative. On the basis of history, clinical examination, and laboratory investigations, we diagnosed it as bilateral immune mediated sterile corneal ulceration along with mucopurulent conjunctivitis and dry eye. He was treated with topical antibiotics, cycloplegics, cyclosporine, lubricant gel, and bandage contact lens. There was progressive stromal melting, descemetocele formation, and perforation in the inferior part of cornea in both the eyes. He was treated with pulse steroid and paramedian tarsorraphy in both eyes. The patient was subsequently lost to follow-up. We report this case to highlight this rare complication of BCG therapy, in order to improve their management protocol in patients with similar clinical profile. We could not find a similar case after thorough PubMed search.
Posterior capsular opacification (PCO) is caused by proliferation of lens epithelial cells which causes fibrotic changes and wrinkling of the posterior capsule following extracapsular cataract extraction (ECCE). It results in decreased vision, glare, and other symptoms mimicking that of original cataract. PCO is treated by a non-invasive procedure, laser capsulotomy i.e. Neodymium yttrium aluminium garnet laser (Nd: YAG). Objective: To find out the visual outcome and complications following Nd:YAG laser capsulotomy. The prospective observational study was conducted in the Department of Ophthalmology, Calcutta National Medical College, Kolkata during March 2014 to August 2015. 60 eyes of 60 consecutive pseudophakic adult patients (age > 40 years) with posterior capsular opacity, who fulfilled the inclusion and exclusion criteria were selected in the study. The study had female preponderance (58.3%). Most of the patients (42%) were 61-70 years old. Most of the patients had visual acuity of 6/18 prelaser capsulotomy and 6/9 post laser capsulotomy. 73.37% pre laser capsulotomy patients had visual acuity (VA) of 6/36 or better .91.6% post laser capsulotomy patients had VA of 6/18 or better. The mean pre and post laser capsulotomy visual functional score were 54.45 ±36.44 and 94.16 ± 50.36 respectively. Nd: YAG laser capsulotomy is safe, effective and a rewarding non-invasive procedure for visual improvement in PCO patients.
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