Kumaresh Chandra Sarkar

Abstract

Background: Posterior capsular opacification (PCO) is caused by proliferation of lens epithelial cells which causes fibrotic changes and wrinkling of the posterior capsule following extracapsular cataract extraction (ECCE). It results in decreased vision, glare, and other symptoms mimicking that of original cataract. PCO is treated by a non-invasive procedure, laser capsulotomy i.e. Neodymium yttrium aluminium garnet laser (Nd: YAG). Objective: To find out the visual outcome and complications following Nd:YAG laser capsulotomy. Materials and Methods: The prospective observational study was conducted in the Department of Ophthalmology, Calcutta National Medical College, Kolkata during March 2014 to August 2015. 60 eyes of 60 consecutive pseudophakic adult patients (age > 40 years) with posterior capsular opacity, who fulfilled the inclusion and exclusion criteria were selected in the study. Results: The study had female preponderance (58.3%). Most of the patients (42%) were 61-70 years old. Most of the patients had visual acuity of 6/18 prelaser capsulotomy and 6/9 post laser capsulotomy. 73.37% pre laser capsulotomy patients had visual acuity (VA) of 6/36 or better .91.6% post laser capsulotomy patients had VA of 6/18 or better. The mean pre and post laser capsulotomy visual functional score were 54.45 ± 36.44 and 94.16 ± 50.36 respectively. Conclusion: Nd: YAG laser capsulotomy is safe, effective and a rewarding non-invasive procedure for visual improvement in PCO patients. Keywords: Posterior capsular opacification (PCO), Nd: YAG laser capsulotomy, Visual acuity.

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Abstract

Introduction: Pterygium is a slow growing, wing shaped, elastoticsubconjunctival degeneration within the palpebral fissure involving the cornea. As it encroaches the limbus, it proliferates as vascularised granulation tissue destroying the superficial stroma and Bowman’s membrane and is characterized by tissue remodelling, cellular proliferation, neovascularisation and inflammation. Objective: To compare between fibrin glue and polyglactin sutures in limbal based conjunctival autograft technique in primary pterygium surgery in terms of duration of surgery and early and late post-operative complications. Materials and Methods: It was a prospective comparative, randomized controlled trial which was conducted at North Bengal Medical College, Darjeeling, from July 2016 to June 2017. Patients with progressive pterygium diagnosed after proper clinical examinations and admitted for excision with conjunctival autograft attached with fibrin glue or for excision with conjunctival autograft sutured with 8-0 polyglactin. Data were collected and analysed. Results: 52 patients were randomly and equally divided into two groups, group A (fibrin glue) and group B (sutured with polyglactin) according to the type of surgery. In both the groups, there was female preponderance and the average age of the patients were 45.15 (5.576) and 40.65 (8.299) years respectively. Regarding the post-operative complications such as graft oedema (p= 0.002, c2 =10.035, df = 1), graft granuloma (p =.037, c2 = 4.333, df = 1) and recurrence (p = 0.638, c2 = 0.221, df = 1), the group A had less incidence than group B. The reduction of complications was statistically significant in group A in terms of graft oedema and graft granuloma but not in recurrence. Keywords: Conjunctivo-limbal autograft, Fibrin glue, Progressive pterygium.  

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Abstract

Introduction: Glaucoma is a chronic progressive optic neuropathy characterized by retinal ganglion cell death and associated visual field loss irrespective of intraocular pressure changes. The exact pathophysiological mechanism is not fully understood. The vascular hypothesis of OAG states that a low blood pressure (BP) relative to IOP can lead to low mean ocular perfusion pressure (MOPP), thus impairing perfusion of the Optic Nerve Head (ONH) with resultant glaucomatous cupping and visual field loss. Objective: To find out any relationship between systemic hypertension, intraocular tension (IOP) and mean ocular perfusion pressure (MOPP) in primary open angle glaucoma (POAG), normal tension glaucoma and normal population. Materials and Methods: It was a cross-sectional observational study. A total 125 patients attended in eye OPD at Calcutta National Medical College & Hospital, Kolkata, in one year having primary open angle glaucoma including normal tension glaucoma. Patients were distributed into three groups according to the technique of management. Applanation Tonometry and fundoscopic evaluation (+ 90 D lens) were done for all cases. Single recording of BP was taken. Gonioscopy, Humphrey's central visual fields and pachymetry were done. Data analyzed using standard statistical technique and a probability value (‘p’ value) of < 0.05 was considered as statistically significant. Results: The average age of the study population was 54.38 ±8.92 years and ranging from 41 to 75 years. The study was male preponderant. The relationship between mean arterial pressure, intraocular pressure and mean ocular perfusion pressure was statistically significant in all subgroups. Conclusion: There was a moderately strong correlation between MAP and MOPP whereas between MAP and IOP was weakly positive. The relationship between IOP and MOPP was inversely correlated. Keywords: Ocular perfusion pressure, Open-angle glaucoma, Systemic hypertension.

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