Pterygium is a triangular encroachment of bulbar conjunctiva on to the cornea known for high recurrence rate. Various adjunctive measures were used to reduce the recurrence rate. Nowadays thoughutureless and glue-free conjunctival autograft has been encouraged for treating primary pterygium yet sutured conjunctival autograft is also extensively performed. To assess and compare graft stability, complication profiles and patient comfort in sutureless glue-free and sutured conjunctivo limbal autograft in pterygium surgery and to assess postoperative improvement in parameters associated with visual defects due to pterygium.Sutured conjunctival autograft were done in 25 patients (group A), and sutureless and glue-free conjunctival autograft was done in 25 patients (group B). Postoperative discomfort was assessed for 90 days during which graft related complications and recurrence if any were noted. Pre and postoperative parameters associated with visual defects due to pterygium were also compared. Total number of patients who developed postoperative complications was 22(88%) in Group A and 15(60%) patients in Group B. Number of patients with postoperative discomfort was significantly less in group B after 1 week and almost nil on 30 day. In Group A one patient graft unstability and in Group B two patients showed graft unstability.Sutureless glue free auto conjunctivo limbal stem cell transplantation showed significantly better patients comfort and decreases suture related complications.
To evaluate the efficacy and cost-effectiveness of preoperative loteprednol versus flurbiprofen, when combined with moxifloxacin in maintaining intraoperative mydriasis and reducing postoperative complications. Materials and Methods: 200 cataract patients were divided into 2 groups. Group 1 receiving preoperative Flurbiprofen(0.03%) with moxifloxacin(0.5%) and Group 2 receiving Loteprednol(0.5%) with moxifloxacin(0.5%), three times a day 24 hrs prior to cataract surgery,followed by postoperative loteprednol(0.5%) and moxifloxacin(0.5%) in both groups. Intraoperative mydriasis and post operative complications were analysed. Patients were followed up on day 1, 1 week, 3 weeks and 7 weeks. Parameters evaluated included inflammation, pain, corneal edema, anterior chamber reaction (including cells and flare), intraocular pressure, CME. Results: Intraoperative mydriasis obtained in both the groups was comparable with no significant difference. Postoperative visual outcome was also comparable but postoperative inflammation was slightly more in Group 1 (p <0.05). Pain was more in group 1 on first postoperative day which was not statistically significant but this difference did not persist during further follow ups. 3 patients in group 1 and 2 patients in Group 2 developed CME on the last follow up which was not statistically significant. The rest of the parameters were comparable in the 2 groups with a much better compliance in group 2. Conclusion: This hospital based study in western Rajasthan revealed Loteprednol to be equally potent as flurbiprofen in maintaining intraoperative mydriasis along with significant reduction of postoperative complications while maintaining cost effectiveness and compliance as a single eye drop was used before and after surgery, with no steroid related complications.
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