Vishaka Naik

Abstract

Aims: To evaluate in intraoperative complications of MSICS performed by Junior Residents and to compare the incidences of major complications in the first six months of training versus last six months of training. Materials and Methods: It is a retrospective type of study. From March 2018 to February 2019 a total of 293 manual SICS were conducted by the Junior Residents in Department of Ophthalmology. Each of the patients underwent a detailed ophthalmological examination preoperatively and underwent MSICS under peribulbar anesthesia. Consents for surgeries were obtained from each patient. Following intraoperative complications were noted: tunnel related complications, capsulorrhexis related complications, Iridodialysis, posterior capsular rent, zonular dialysis, vitreous leak, surgical aphakia, Descemet membrane detachment, placement of ACIOL, Nucleus drop and IOL drop. The patient’s immediate postoperative vision was also noted. Statistical analysis used: SPSS version 15.0. Results: Tunnel related complications were found in 13.98% patients either as scleral button holing or premature entry. Posterior capsular rents and bag disinsertion were found in total of 11.94% patients owing to which 3.07% were left aphakic. 63.13% patients had visual acuity better than 6/12 by snellens chart on first postoperative day. Conclusions: Performance of adequate anterior capsulotomy, minimal handling of the cornea and avoidance of posterior capsular rent are some of the challenges faced by the residents while learning MSICS. Stepwise supervised training can help a resident doctor master these steps while keeping the complications at acceptably low levels. Key Messages: Stepwise supervised training of residents performing MSICS can minimize complications   Keywords: MSICS, Resident, Intraoperative complications.

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Abstract

Introduction: Mucopolysaccharidosis 1- Hurler’s disease (MPS) is a rare, life threatening, autosomal recessive, inborn error of lysosomal metabolism which is known to have ocular manifestations. Aim: To identify and document retinal findings in a case of mucopolysaccharidosis type 1. Subjects and Methods: A male child, 12 years old, born out of consanguinity, was referred to Ophthalmology OPD, Goa Medical College with decreased vision for evaluation. He underwent a detailed ophthalmological examination. Results: Fundus- showed  pseudopapillitis with retinal pigment epithelium changes, and hypopigmented lesions in the parafoveal region. OCT- revealed increased retinal thickness, with accumulation of GAGs in outer retinal layers; ILM-RPE central subfield thickness: 281µm. Conclusions: Patients with MPS require regular ophthalmological assessment to diagnose, monitor and treat ocular complications. Ophthalmological assessment becomes important because signs of raised intracranial pressure such as papilledema may be picked up. Regular ophthalmological assessments may help to provide a better quality of life in these children. Keywords: Fundus, Mucopolysaccharidosis, Retina.  

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