Praveen Kumar Sadanand

Abstract

Aim: To compare subtenon’s block with peribulbar block with respect to complications encountered. Materials and Methods: A prospective, comparative time bound study was conducted including a total of 140 patients who were randomized into 2 groups; 70 patients each in PB Group (peribulbar block) and 70 in ST Group (subtenon’s block) who were selected for manual small incision cataract surgery. Any complications during administration of anaesthetic, limitation of ocular movements and onset of anaesthesia was assessed before starting the surgery and documented. Results: Most of the patients 92(65.7%) were between 50 to 60 years age. 58 patients in Peribulbar group experienced moderate pain at the time of block while only 18 patients experienced it in Subtenon’s group. Subconjunctival haemorrhage was seen limited to the site of anaesthetic administration in 52 patients in subtenon’s group. The onset of akinesia with subtenon’s block was (3min+/ 1.5min) compared to peribulbar block (7min+/2min). Conclusion: Subtenon’s anaesthesia is safe and effective in manual small incision cataract surgery. Keywords: Anaesthesia, Peribulbar, Subtenon’s.

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Abstract

Aim: To study the complications with pterygium excision and conjunctival limbal autograft with patient’s own blood used as adhesive for graft. Materials and Methods: A prospective, cross sectional, timebound study including 52 patients with primary pterygium. Pterygium autograft was pasted over recipient bed using patients own blood without using sutures or fibrin glue. A 0.5 mm oversize graft was held in place for 5 minutes using blood at the pterygium excised site as adhesive. Post operatively after 24 hours, the eye was assessed under slitlamp for graft adherence, symptoms or any other complications and were advised topical moxifloxacin, loteprednol and lubricating eye drops. Patients were followed up on 7th day, 1st month and 4th month. Results: Out of 52 patients there were 30 males and 22 females with highest incidence among 35 to 55 years age group (78.85%). Majority of patients had grade 2 (76.9%) pterygium and most of them were farmers by occupation while most common indications for surgery were visual problems (48.07%) and cosmetic (40.38%) reasons. Conjunctival autograft remained in place in 49 patients. In 3 patients there was mild graft dehiscence, 1 patient had pyogenic granuloma which needed resurgery. Conclusion: Graft related complications can be reduced by meticulous dissection, accurate orientation of graft and ensuring holding onto the graft placement area for at least 5 minutes for adherence. Keywords: Pterygium, Autograft, Complications.

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Abstract

Introduction: Microbial keratitis is a common, potentially vision-threatening ocular infection that may be caused by bacteria, fungi, or parasites. Successful treatment of corneal ulcer requires proper diagnosis and early institution of intensive therapy with appropriate antimicrobial agents. Aim: To determine specific pathogenic organism and clinical risk factors for infective Keratitis. Materials and Methods: Patient with clinical features of infective keratitis attending Ophthalmology OPD were included whose corneal scrapings were subjected to Gram staining, KOH Mount and culture sensitivity. Statistical analysis done by using appropriate statistical methods. Results: 40 cases were evaluated. 23 were males and 17 females. Age ranged from 21 to 70 years. History of trauma was present in 47.5% of patients, ocular surface disease was present in 10% while diabetes was present in 10% of patients. Based on culture reports, bacterial and fungal keratitis found in (65%) 26 patients. There was no organism isolated from rest of the 14 samples (sterile keratitis). Bacteria were isolated in 14 samples and in 12 samples fungal growth was isolated. The commonest bacterial isolate were Staphylococcus aureus followed by Pseudomonas, Coagulase negative staphylococcus and Klebsiella. Aspergillus species was isolated in 7 patients and fusarium species in 4 patients. Gram positive isolates were maximally sensitive to Ofloxacin, gram negative to Gentamicin. Conclusion: Staphylococcus aureus was the most common bacterium while Aspergillus was the most common fungus isolated. Trauma was the commonest risk factor for corneal ulcer. Keywords: Corneal ulcer, Staphylococcus, Aspergillus, Trauma, Culture.

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