Introduction Scleral buckle surgery retains a special place in treatment of retinal detachment despite development of new and advanced vitreoretinal surgical techniques. The outcome of any retinal detachment surgery depends on correct selection of patient, type and nature of detachment, and the expertise. This study aims to evaluate various other parameters that determine the outcome of scleral buckle surgery. Method Records of 55 patients with primary rhegmatogenous retinal detachment treated with scleral buckling over a duration of 18 months that had a minimum of 3-month follow-up were retrospectively reviewed. Preoperative and postoperative characteristics were recorded. Parameters that were evaluated to determine the outcome were best-corrected visual acuity (BCVA), anatomical success, and complications. Results A total of 51 eyes of 50 patients that met the inclusion criteria were included. Mean age was 41 ± 19.9 years (range: 9 to 83). Primary anatomical success was achieved in 80.4%. Parameters significantly associated with the anatomical outcome of surgery were status of lens, preoperative visual acuity, and extent of retinal detachment. There was a significant improvement of visual acuity postoperatively. Conclusion Scleral buckle surgery is a highly effective surgery in uncomplicated retinal detachment cases, and single surgery success rates are better in cases with good preoperative visual acuity, partial detachment, and clear crystalline lens.
Introduction: Macular corneal dystrophy (MCD) is a rare autosomal recessive stromal dystrophy. The prevalence of inherited diseases varies in different communities. It is not commonly observed in Nepal. Case: A 14-year male presented with bilateral gradual and painless blurred vision with photophobia of three years duration. Cornea of both eyes showed focal grayish opacities in anterior and mid stroma with intervening stromal haze. There was no history of consanguinity in the family. Anterior segment ocular coherence tomography showed thinning of cornea and deposits in corneal stroma. Macular corneal dystrophy was the clinical diagnosis and the patient underwent deep anterior lamellar keratoplasty in the right eye. Histopathological examination and histochemical staining with Alcian Blue supported the diagnosis. Conclusion: Significant improvement in vision was observed in the operated eye. MCD may be present in communities without evidence of consanguinity. It can cause visual impairment at an early age. Timely intervention improves vision and quality of life.
Background: Penetrating keratoplasty is commonly performed surgery in patients suffering from corneal blindness and visual impairment, where full thickness diseased cornea is replaced with healthy cornea. This study aims to outline indications of Penetrating keratoplasty and visual outcomes following the procedure. Materials and Methods: This retrospective, hospital-based study included 48 eyes of 48 subjects fulfilling inclusion criteria and underwent Penetrating keratoplasty from January 2017-2020 at Bharatpur Eye Hospital. General ophthalmologic examination was done preoperatively and postoperatively. Indication of the surgery along with demographic outline and requisite investigations were performed. Results: Mean age of the subjects was 47±1.83 years (13-74 years) where most of them were in 61-70years (23%) age group. Male subjects were more (62.5%) compared to females. Triple procedure was performed in 6.25 percent of patients. The most common indication was infective keratitis (52%) followed by corneal opacity/ scarring, regrafts, keratoconus and bullous keratopathy. Penetrating keratoplasty was performed slightly more for therapeutic purpose (52%) than optical. Intraoperative complications were observed in 16.7% of patients, positive vitreous pressure being the sole cause. Ameliorated visual acuity was observed in 71% of patients with43.75% of patients having VA of ≥3/60 Conclusion: Infective keratitis was the predominant indication followed by corneal opacity/ scarring. Penetrating keratoplasty helps in maintaining integrity of the globe along with restoration of vision
Behcet’s disease is a multisystemic vasculitis of unknown etiopathogenesis characterized by recurrent acute inflammation. A 30-year male presented with progressive blurred vision in both eye for one month associated with photophobia, redness and ocular pain. On presentation best corrected visual acuity was 6/9 both eyes. Bilateral ocular examination of anterior segment demonstrated occasional cells. Treatment history of multiple joint pain along with oral aphthous ulcers. Erythematous papulopustular lesion over face, neck, trunk and genital ulcers were being treated. Irrespective of negative human leucocyte antigen B51 and pathergy, patient was diagnosed as Behcet’s disease on the basis of clinical criteria and started with topical steroid and cycloplegic. At one-month, ocular symptoms were relieved. Behcet’s disease is a rare, autoimmune disease, which lacks universal pathognomonic test and investigations, therefore diagnosis is primarily done with international criteria for Behcet’s disease. Multidisciplinary approach certainly helps in early diagnosis and eliminating morbidity.
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