Rimsha Thaseen

Abstract

Introduction: Due to variation in etiology and presentation, it is difficult to predict the outcomes of phacoemulsification in patients suffering from uveitis. The present study evaluated outcomes of surgery at a tertiary care teaching hospital. Materials and Methods: 64 eyes of 64 patients with uveitis were retrospectively studied for vision related outcome and complication rate after phacoemulsification surgery. However, after exclusion, 46 eyes were analysed. Results: The mean age of patients with uveitis enrolled was 46.7±2.3 (range, 28-56 years). The mean duration of follow-up was 12.6±3.4 (range, 8-16 months). Improvement in vision was significantly better in males (P=0.05). Uveitis was silent for 6.3±2.6 months prior to performing surgery. Tuberculosis was the most commonly identified etiological factor followed by Fuch’s iridocyclitis and Vogt’s Koyanagi Harada disease, respectively. The frequent complications of surgery were recurrent uveitis, cystoid macular edema and after-cataract. Factors influencing vision were location of uveitis, intake of preoperative steroids and posterior segment pathology. At final follow-up, the vision was 0.24±0.07 Log MAR units. Conclusion: Thorough control of inflammation prior to performing surgery is the key to good visual outcome in uveitis. Phacoemulsification with posterior chamber IOL implantation provided good vision when the inflammation is confined to the anterior segment of the eye. Visual prognosis compromise in diseases involving the central fundus. Keywords: Cataract, Cystoid macular oedema, Intraocular lens implantation, Posterior capsule opacification, Uveitis, Vision.

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Abstract

Introduction: Due to lack of correlation between symptoms and signs in dry eye disease, changes in tear film parameters and ocular surface health have shown wide variance across different studies worldwide. The present study evaluated the efficacy Schirmer, tear film break-up time (TBUT) and conjunctival impression cytology (CIC) in type 2 diabetics with retinopathy. Materials and Methods: The scoring of Schirmer test, TBUT, and CIC was compared in 75 eyes of diabetics with retinopathy and 75 eyes of age and sex matched healthy controls. The diagnostic accuracy of these test for dry eye diagnosis was estimated using receiver operating curve (ROC) analysis. Results: Dry eye indices showed a significant reduction (PTBUT (AUC=0.948) >Schirmer (AUC= 0.864), respectively. Conclusion: Tear film characteristics and ocular surface health in patients with type 2 diabetes mellitus with retinopathy include decreased tear production as well as tear film stability with worse Nelson grade (squamous metaplasia), respectively. Second, the accuracy of CIC to evaluate dry eye in patients with diabetes was higher as compared to TBUT and Schirmer. All diabetic patients should be examined for tear film and ocular surface changes irrespective of the stage of retinopathy. Keywords: Conjunctival impression cytology, Dry eye, Receiver operating curve, Schirmer Test, Tear film break-up time, Type 2 retinopathy.

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