Introduction: To evaluate the corneal astigmatism and contrast sensitivity before and after pterygium surgery and to study the relationship between amount of astigmatism and contrast sensitivity in various grades of pterygia. Material and Method: Sixty three eyes of 63 patients with primary pterygia were studied before and after surgery. The astigmatism induced by primary pterygium was measured by manual keratometer and contrast sensitivity by Pelli Robson chart. Preoperative and postoperative values were compared using paired t-test and ANOVA test. Result: Astigmatism decreased significantly following pterygium excision. The mean preoperative refractive cylinder decreased from 3.29±1.46 D to 1.49±0.82 D postoperatively. Surgical removal of pterygium caused a significant reduction in refractive astigmatism. The amount of astigmatism decreased significantly following pterygium excision in grade II , grade III and in grade IV. In grade I pterygium, decrease in the amount of astigmatism was not statistically significant (p=0.515). The contrast sensitivity increased significantly following pterygium excision. The mean preoperative contrast sensitivity increased from 1.49±0.21 to 1.70±0.20 postoperatively. Surgical removal of pterygium caused a significant improvement in contrast sensitivity. Conclusions: Surgical excision of pterygium improves contrast sensitivity, visual acuity and reduces astigmatism. Contrast sensitivity testing may provide additional objective methods for documenting impaired vision in patients with pterygium when Snellen visual acuity is minimally affected. Corneal astigmatism and contrast sensitivity values in patients with pterygia are useful indicators for the need of pterygium surgery or as indicators of surgical success.
Purpose: To calculate the intraocular lens power and to determine the relationship between ocular biometry and severity of diabetic retinopathy (DR) in patients with type II diabetes mellitus. Methods: The study group included 150 type II diabetic subjects with DR. The control group consisted of 150 type II diabetic subjects having no DR. Axial length (AL), corneal power, and anterior chamber depth were measured using LenStar. DR and diabetic macular edema were classified according to International DR Classification. Crystalline lens power was calculated using Barrett Universal II formula. AL to corneal radius ratio was calculated. Chi-square test was used for categorical variables. Results: In multivariate logistic models adjusting for age, sex, glycosylated hemoglobin, duration of diabetes, Mean age of patients in the study group was 62.45 ± 4.85 years, whereas in the control group, it was 63.37 ± 7.29 years. Of the eyes with DR, 117, 76, 69, and 38 had mild NPDR, moderate NPDR, severe NPDR, and PDR, respectively. The difference in the mean duration of diabetes mellitus and glycosylated hemoglobin in both study and control groups was found to be statistically significant. A progressive decrease in the mean AL and the anterior chamber depth was observed with increasing severity of DR, and difference was statistically significant. There was a progressive increase in intraocular lens power with increasing severity of DR, and difference was found to be statistically significant. Conclusion: In persons with diabetes mellitus, globe elongation plays quite an important role in protective effects against DR, with contribution from intraocular lens power and other refractive components.
Fibrin glue for securing conjunctivo-limbal autograft in pterygium excision is gaining popularity but suturing is still practiced widely. This study was carried out to compare the outcome of sutures with fibrin glue for conjunctivolimbal auto grafting in management of pterygium. A prospective study was carried out in sixty eyes of sixty patients with pterygium requiring surgical excision. Simple excision under local anaesthesia was performed followed by closure of bare sclera by conventional method of suturing conjunctivo-limbal autograft using interrupted sutures in 30 patients(group I)and glued conjunctival autograft in 30 patients (group II) and then bandaged for 24 hours in both the groups. Surgical time was recorded for both techniques. Postoperative discomfort was assessed in terms of pain, foreign body sensation and lacrimation in both groups. The patients were followed up for six months. During follow up, graft related complications and recurrence were noted. Mean surgical time for group I (34.70±7.96 minutes) was significantly more as compared to group II (25.83±6.23). Postoperative discomfort were seen in less number of patients and were of shorter duration in group II as compared to group I. Use of fibrin glue for securing conjunctivo limbal autograft after pterygium excision is simple, easy, safe, effective and less time consuming than sutured autograft. It also causes less postoperative discomfort and adverse events as compared with sutured conjunctivo limbal autograft technique. Hence fibrin glue can be good alternative to sutures for securing conjunctivo-limbal autograft in management of pterygium.
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