Pankaj Soni

Abstract

Objective: To compare the efficacy and analyse between autologous blood clot limbal conjunctival autograft (CAG) with amniotic membrane grafting (AMG) on pterygium excision surgery. Materials and Methods: This study included 62 patients (18-70 years) with primary pterygium attending OPD in Dept. of Ophthalmology in our tertiary care hospital. It is a 1 year observational study(February 2018 to January 2019) with 6 months period of observation in post-operative patients of CAG and AMG groups in primary pterygium excision surgery and the results have been compared in the study. Results: The mean age group being 42 ± 7 years of total 62 patients with 54 male patients and 8 female patients with no drop out throughout the study. 38 patients were randomly selected for CAG group rest 24 patients were selected into AMG group. In 6 months of post-operative observation 2 (3.23%) patients in CAG group and 6 (9.68%) patients in AMG group had recurrence of pterygium while 1 patient had symblepharon in the intermediate period of observation in CAG group. Conclusion: The recurrence of pterygium (?1mm) was more in amniotic membrane graft patient compared to autologous blood clot tenon free conjunctival autograft. Autologous blood clot conjunctival graft required more surgical skills, proper techniques and took more surgical time as compared amniotic membrane grafting, but BCAG more economical compared to AMG. Both CAG & AMG appears to be safe for excision of pterygium with fewer recurrence of pterygium. Keywords: Pterygium, Recurrence, Autologous blood clot conjunctival autograft, Amniotic membrane graft.

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Abstract

Aim: To evaluates the efficacy of both amniotic membrane transplantation and mucous membrane graft with conformer in each group in fornix reconstruction in mild to moderate contracted socket. Materials and Methods: This study included 20 patients (10-60years) with mild-moderated contracted socket, attending OPD, Department of Ophthalmology in tertiary care hospital. Study Design: observational study for one year patients were randomly grouped as Group A include 10 patients who underwent fornix reconstruction with AMG with conformer and rest 10 patients in Group B who underwent MMG with conformer, these patients were followed up on post-operative 3rd month, 6th month and 9th to assess the pre-operative and post-operative central inferior fornix depth. Results: 20 patients of contracted socket were included in this study and randomly 10 patients each were categorized into Group A and Group B.GROUP A: AMG with conformer- The mean pre-operative and post-operative central inferior fornix measured was 3.19 ± 0.28 mm and 7.09 ± 0.15mm respectively. Complete success in post-operative 9th month was in 8 cases (80%) while 2 cases (20%) had partial success. GROUP B: MMG with conformer- The mean pre-operative and post-operative central inferior fornix measured was 3.04 ± 0.24 mm and 6.94 ± 0.18mm respectively. Complete success in post-operative 9th month was in 7 cases (70%) while 3 cases (30%) had partial success .There were no graft rejections. p-value 0.0001 in each group which was statistically very significant. Conclusion: AMG and MMG with a conformer is a simple and safe method for fornix reconstruction in mild to moderate contracted socket. Keywords: Amniotic membrane graft, Fornix reconstruction, Mucous membrane graft, Prosthesis, Symblepharon.

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Abstract

Aim: To assess pre-existing astigmatism and to evaluate the effect of limbal relaxing incision on pre-existing astigmatism post-operatively in patients undergoing SICS cataract surgery. Materials and Methods: The study was conducted in the Department of Ophthalmology at Nehru Hospital attached to B.R.D. Medical College, Gorakhpur from period of July 2016 to June 2017. Study Design: This study is a comparative observational study. All the surgeries were performed by one surgeon. Study Group: patients meeting the inclusion criteria i.e. 1-3 D astigmatism as per keratometric readings. Results: A total of 90 patients were included in the study. Mean age 58.19 ± 7 years(range 30-70yrs). Mean pre-operative astigmatism of 1.44 ± 0.39D was found in these patients. Data analyzed demonstrated statistically significant reduction in the mean post-operative day 30 astigmatism in the LRI group to 0.54 ± 0.34 D (range: 0 to 2.5)  from 1.31 ± 0.38 D (range: 1 to 3 D) preoperatively as compared to control group to 1.19 ± 0.56 D (range: 0 to 2.5) from 1.57 ± 0.37 D (range: 1 to 3 D) preoperatively, p-value 0.0001. There were no intraoperative complications or postoperative subjective complaints in our patients. Conclusion: Limbal relaxing incisions performed during SICS cataract surgery appear to be effective as well as safe procedure to reduce pre-existing corneal astigmatism. Keywords: LRI, SICS, Cataract, Astigmatism.

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