Purpose: To find out the effect of oral contraceptive pills on tear film and intraocular pressure of women of reproductive age group. Study Design: Observational study. Place and Duration of Study: Khalid Eye clinic, Karachi, from February 2019 to January 2020. Methods: Eighty females between the 20 to 40 years of age were recruited for this study. They were divided into two groups of forty each. Group A included females using oral contraceptive pills for at least last nine months. Whereas, group B included control group of age matched females not using any contraceptive pills. The study dynamics was explained to all participants and informed consent was obtained. Tear film status was assessed on the basis of Tear film break up time (TBUT) on slit lamp examination and Schirmer strip test 2 (without anesthesia). Intraocular pressures were checked using Goldman Applanation tonometer. Studywas approvedfrom ethical review committee of the hospital. Results: Mean age was 29.3 ± 3.27 years. Tear film break up time was < 7 ± 1.5 sec in group A and > 10 ± 1.2 sec in group B. Schirmer strip test was ≤ 9 ± 1 mm of wetting in group A and ≥ 13 ± 1 mm of wetting in group B. Mean intraocular pressure was 17 ± 2 mmHg in group A whereas 13 ± 2 mmHg in group B. Grittiness, heaviness and foreign body sensation were more common in group A. Conclusion: Use of oral contraceptive pills has an adverse effect on the tear film status and intraocular pressures. Key Words: Oral contraceptive pills, Tear film, TBUT, Schirmer’s test, Intraocular pressure.
Purpose: To compare between the results of rectangular and triangular shaped scleral flaps in trabeculectomy for primary open angle glaucoma. Study design: Quasi experimental study Place and Duration of Study: Khalid eye clinic, Karachi, from July 2018 to June 2019. Methods: This study included 24 patients of either gender and age from 40 to 65 years. Patients with a diagnosis of primary open angle glaucoma refractory to medical treatment were included by convenient sampling technique. They were divided into two groups. Group A underwent trabeculectomy with rectangular shaped scleral flap whereas Group B underwent trabeculectomy with triangular shaped scleral flap. The main outcome measures were intraocular pressure reduction, anterior chamber depth and post-operative complications. All patients were followed up for a period of two months. Results: Mean age was 52.1± 6.72 years. Mean pre-operative intraocular pressure in group A was 24.4±2.13 mmHg and 23.5±1.64 mmHg in group B. Mean post-operative IOP was 11.6±1.51 mmHg in group A and 13.4±1.67 mmHg in group B with p-value of 0.11. Pre-operative anterior chamber depth (ACD) was grade 4 both groups. It remained same in all patients of group A but two patients of group B changed to grade 3 ACD. Two patients of group B developed hypotony on the first post-operative day. They did not require revision suturing and were managed conservatively. Conclusion: Both types of scleral flap are effective in reducing IOP but rectangular scleral flap reduced IOP more as compared to triangular scleral flap but the difference was not statistically significant. Keywords: Trabeculectomy, Intra ocular pressure, Open angle glaucoma.
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