Prasanna Jit Das

Abstract

Aims: To determine the clinico-pathological status of lacrimal abscess with special reference to bacteriological flora of lacrimal abscess in the region of Southern Assam. Materials and Methods: 50 patients of age group 15-65 years of either sex and age, presenting with lacrimal abscess from a period of January to December 2019 in Silchar Medical College and Hospital, Assam, were taken up for the study. Under aseptic and antiseptic conditions swabs were collected from lacrimal abscess and sent for microbiological analysis. Results: In this prospective study 50 patients of lacrimal abscess were enrolled during study period. Out of the 50 samples, 40 samples yielded a positive result and out of the 40 samples, majority of microorganisms isolated was Gram positive bacteria 60% (24) (Most frequently Staphylococcus aureus). Gram negative bacteria were encountered from 16 samples (most commonly E. coli). Conclusion: In our study we have found that the most common causative organism of lacrimal abscess was Staphylococcus aureus but in patients with previous history of mucopurulent discharge the Gram-negative bacteria were potential pathogens. The study of the bacteriology of the disease helps significantly in the choice of specific antimicrobial agents in particular demographic trend. Keywords: Dacryocystitis, Lacrimal abscess, Southern Assam.

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Abstract

Introduction: A pterygium is a triangular ‘wing-like’ growth consisting of conjunctival epithelium and hypertrophied subconjunctival connective tissue that occurs nasally and/or temporally in the palpebral fissure and encroaching over to the limbus and then to the cornea. Actual pathogenic mechanisms of this condition is unknown hence remains an enigma in ophthalmlogy. This degenerative thick and vascular conjunctival and sub- conjunctival tissue is triangular shape d most commonly found on the nasal side and also it progressively destroys the corneal bowman’s layer and superficial layer of the stroma. It is most commonly seen in the tropical country, implicating sunlight and UV radiation as a probable cause. Objective: To compare the post-operative outcome of primary pterygium excision followed by autologous limbal conjunctival grafting with application of sutures vs suture-less and glue-less. Materials and Methods: This study is a prospective comparative and interventional case study. 50 eyes with primary pterygium are selected. Patients were divided into two equal groups with 25 number of eyes in each group. a) Group- I = suturing of auto graft with (10-0) nylon sutures b) Group- II = fixing of auto graft without sutures i.e. Suture-less and without glue i.e. glue-less. Results: The average operative time for Group- I was 26.44 8.19 min and for Group- II was 20.52 5.13 min (p-value < 0> in 4 eyes i.e. 16% (p-value more in Group-I than Group-II from 1st Postoperative day. The duration of which lasted in Group- I for < 3> symptom free than the Group - I from the first postoperative day onwards. Post operatively in Group- 1 Graft oedema was seen in 5 eyes i.e.20% and in Group- II= 3 eyes i.e.12% which resolved within 2week. In Group -I = 2 patients i.e. 8% had graft lost and 1-patient i.e. 4% had recurrence which is statistically insignificant. Conclusion: Lots of surgical procedures has been tried for the treatment of primary pterygium this technique of fixing the auto-graft without sutures i.e. suture-less and without glue i.e. glue-less is rather an evolving one getting preference by the modern surgeons worldwide as it is less time consuming, more convenient in the sense of avoiding complication of sutures and glues thereafter the related problems of the sutures and glues, moreover it’s cost effectiveness is an advantage. Keywords: Primary pterygium, Pterygia, Conjunctival autograft, Suture- less, Glue- less.

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