Meghana Reddy

Abstract

Purpose: To evaluate the influence of heparinized irrigation solution on postoperative inflammation on anterior chamber cellular reaction (ACR) after cataract surgery in diabetics. Materials and Methods: 120 patients of 164 patients selected for the study who completed 2 months follow up were included in this study. Patients with controlled blood sugar levels with cataract attending R.L. Jalappa Hospital OPD (Outpatient department) were selected. Consecutive patients were segregated into 2 groups. All patients underwent manual small incision cataract surgery (MSICS) under peribulbar anaesthesia performed by a single surgeon. Superior 6mm sclerocorneal tunnel was made and cataract was extracted and rigid PMMA (Polymethyl metha acrylate) lens was implanted in the bag. The remaining viscoelastic substance was replaced by balanced salt solution (BSS). In group 1, 5000 IU Low molecular weight heparin (LMWH) was added to balanced salt solution of 500 ml and hence the final concentration was 10 IU/ml of BSS. In group 2 heparin was not added to BSS. Post operative anterior chamber (AC)reaction were noted on first postoperative day, after 1 week, 1 month and 2 months. Intraoperative hyphaema, postoperative shallow AC and hyphaema were documented. The AC reaction was noted by (Standard Uvea Nomenclature) SUN classification system. It is a prospective randomized control trial. Statistical analysis was done by Chi-square test. Results: Anterior chamber reaction was statistically significant between the two groups at Day 1 and Day 7 postoperatively with p value being < 0> postoperative months with p value being statistically in significant. Postoperative complications such as Cystoid macular oedema (CME) was seen in 4 patients in group 2 and 1 patient in group 1. Pigments on IOL was seen in 14 pts and 3 pts of group 1 and 2 respectively. Conclusion: Addition of heparin to irrigating solution showed statistically significant lesser AC reaction in Group 1 than Group 2 at first and seventh postoperative day. There was no difference in the anterior chamber reaction in Group 1 and Group 2 at the end of postoperative 1 and 2 months. Keywords: Cataract, Heparin, Diabetes.

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Abstract

Aim: To study the ocular manifestations in cerebral venous thrombosis. Materials and Methods: We report a case of a 25-year- old married woman who presented to medical emergency with frank per rectal bleeding and later after two days complained of blurring of vision in both eyes and binocular diplopia. On probing the patient, she also gave history of on and off headache since 6 months. Results: MRI Brain with Venogram was suggestive of intracranial hypertension and non-occlusive thrombus in bilateral transverse and sigmoid sinuses. Conclusion: CVT should be kept in mind in any patient with acute onset of diplopia with papilledema or cranial nerve involvement. Acute blood loss with severe anaemia can precipitate CVT. Imaging modalities like MRI with venogram should be the investigation of choice in all cases of CVT. Keywords: Cerebral venous thrombosis, Diplopia, Papilloedema, Transverse sinus, Sigmoid sinus and intracranial hypertension.

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