Objective: Analysis of safety and efficacy of Self engineered polymethylmethacrylate (Acry C) implants in Non-Penetrating Glaucoma surgery (NPGS) as compared to NPGS without implants for control and maintenance of Intraocular pressure in Primary Open Angle Glaucoma (POAG) patients. Design: A Hospital based Randomized study Participants: 70 eyes of 70 POAG patients, divided in 2 groups based on whether implants were used in NPGS Materials: NPGS was done in 35 patients with poly-methyl methacrylate implants made from haptics of intraocular lenses and without the implant in the remaining 35. All patients were followed up after 1 week, 1 month, 3 months, 6 months and 12 months. Post-operative success was defined as IOP <21 mm Hg at 1 month in absence of additional anti glaucoma medication or other treatment. Results: A significant reduction in intraocular pressure was observed post-surgery in both groups, changing from a preoperative mean of 31.09±7.37 mm of Hg and 29.26 ±7.10 mm of Hg to a postoperative mean of 15 ±3.06 mm of Hg and 14.85 ±4.22 mm of Hg respectively (P<0.001) at 12 months. It was observed that intraocular pressure was significantly controlled in both groups and that between two groups the difference was insignificant. It was however seen that Failure rates were higher with NPGS without implant as compared to with implant (p<0.05). For both procedures, the only significant complication was failure of surgery. Conclusion: NPGS with Acry -C implants is a safe, noninvasive and cost effective (less than one U.S. dollar) procedure for control of Intraocular pressure in POAG patients and results in lower failure rates as compared to NPGS without implants and should therefore be preferred as the first line surgical treatment in Primary Open Angle Glaucoma.
The study aims at analysis of visual outcomes in clear corneal cataract surgery as per WHO guidelines at eye camps. The need to maximise visual outcome after cataract surgery is obvious and routine monitoring of visual outcome can be a mechanism to achieve this. Clear Corneal Manual Small Incision Cataract Surgery was the procedure performed in this study and the outcomes recorded and analysed. MATERIALSThis camp-based prospective study included 483 eyes of 483 patients with senile cataract without comorbid ocular or systemic conditions, who gave consent. Manual SICS with Clear Corneal Incision was performed by experienced ophthalmic Surgeon. Patients were followed up on 1, 7, 15 days and 1, 3, 6, 12 months evaluated for results. RESULTSManual small incision cataract surgery with clear corneal tunnel was the technique. From 483 patients, 458 came for follow-up postoperatively. From 458 cases, good visual outcome seen in 396 (86.43%) patients, which fairly meets the guidelines by WHO. Study indicates that intraoperative complications (8.25%) are the major cause affecting the final visual outcome. Intraoperative complications occurred in 44 (9.8%) patients, which is below maximum limit of 10% as per guidelines given by WHO. Posterior Capsule Rent occurred in 16 (3.64%) patients is common intraoperative complication followed by vitreous loss 13 (3.32%). Rate of both complications is below the maximum limit of 5% as per guidelines given by WHO. Similarly, post-operative complications including Surgically Induced Astigmatism. Cystoid Macular Oedema, Retinal Detachment and Endophthalmitis were below 5%. CONCLUSIONVisual outcome of clear corneal cataract surgery at the eye camps meet the guidelines of WHO. Intraoperative complications are important causes of low visual outcome in our study. This study advocates improvement in visual outcome lies in reducing incidence of intraoperative and postoperative complications and management of them with good quality of instruments and modern techniques. Routine monitoring of visual outcome of cataract surgery at every hospital will go in a long way to improve both quantity and quality of surgery and thus reduce the substantial amount of burden of blindness on our country.
OBJECTIVESPurpose analysis of safety and efficacy of Non-Penetrating Glaucoma Surgery (NPGS) for control and maintenance of intraocular pressure as compared to penetrating glaucoma surgery in Primary Open Angle Glaucoma (POAG) patients. DESIGNA hospital based randomized study. Participants 70, eyes of 70 POAG patients, 35 of which underwent NPGS and the remaining underwent Trabeculectomy surgery. MATERIALSNPGS and trabeculectomy was performed by standard surgical procedures after recording routine preoperative data. Patients were divided into 2 groups depending on the procedure they underwent. All patients were followed up after 1 week, 1 month, 3 months, 6 months and 12 months. Post-operative success was defined as IOP <21 mmHg at 1 month in absence of additional antiglaucoma medication or other treatment. RESULTSA significant reduction in intraocular pressure was observed post-surgery in both groups, changing from a preoperative mean of 31.09±7.37 mmHg and 29.26±7.10 mmHg to a postoperative mean of 15±3.06 mmHg and 14.85±4.22 mmHg respectively (P<0.001) at 12 months for trabeculectomy patients. It was seen that there was approximately constant reduction in all ranges of IOP, while for NPGS patient's best control in IOP was seen between at preoperative IOP between 21 to 30 mmHg. There was a significant difference in complications between two groups and the NPGS group had significantly less number of complications than the trabeculectomy group (p<0.05). However, the trabeculectomy group had a significantly lesser failure rate as compared to the NPGS group (p<0.05). CONCLUSIONTrabeculectomy though more effective for higher preoperative IOP, range is associated with greater risk of complications and hence for IOP range between 21 to 30 mmHg, NPGS would be the surgery of choice due to its equivalent efficacy and much greater safety standards.
The ocular manifestations of HIV/AIDS may lead to visual impairment or blindness. The need of hour is an understating of ocular sequelae of HIV infection leading to an early diagnosis of AIDS so that we can start early and effective treatment as per conditions.1. To study the prevalence of ocular manifestations in HIV patients; 2. To study relation of CD4 T Cell count with ocular diseases. The study concluded that HIV/AIDS is a significant cause of ocular disease. Almost around 39% patients having HIV/AIDS have eye disease. HIV Retinopathy is most common in posterior segment and lens involvement is most common in anterior segment manifestations. Usually, early presentation of ocular manifestations in HIV/AIDS patients is asymptomatic or with very less symptoms, which leads to delay in diagnosis and treatment.
Background: Cataract in diabetic patients is a major cause of visual impairment in the world. The aim of cataract surgery in diabetics with raised serum glucose levels is to achieve good postoperative vision and reduced complications. Purpose: The purpose of this study is to observe the intraoperative and postoperative complications and postoperative visual acuity after cataract surgery with intraocular lens implantation in diabetic patients with raised preoperative random blood sugar levels. Materials and method: A single surgeon carried out manual small incision cataract surgery followed by implantation of a posterior chamber intraocular lens. Patients were followed up at day 1, 6 weeks, 6 months and 1 year after surgery. At every visit Best Corrected Visual Acuity, measurement of intraocular pressure, anterior segment examination by slit lamp and dilated fundus examination was done. Result: Maximum number of patients was having excellent visual acuity (85.3%) at 6 weeks follow up and in accordance to WHO recommendations. The most common postoperative complications were early postoperative fibrinous exudates (28.2%), cystoid macular edema (23%), posterior capsular opacification (20.5%). Conclusion: In this study, we observed that over one year period, diabetic patients with raised serum glucose levels who underwent cataract surgery did not show any vision threatening complications. There was no influence of preoperative serum glucose levels on final visual outcome.
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