Indian Journal of Public Health Research & Development

Kunal Sharma ¹, P.K. Manjhi ², M.L. Pandey ³, Neha ⁴, Vineet Gupta ⁵, Roopam Chauhan ⁶, Kritika Singla ⁶

Affiliations
1 Post-graduate Resident, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
2 Professor & Head, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
3 Professor, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
4 P.G. Resident, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
5 Assistant Professor, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
6 Senior Resident, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN

Abstract

Background: Suturing of conjunctival graft is a traditional technique for pterygium excision surgery. Owing to its many disadvantages & complications many newer techniques like autologous fibrin glue have been introduced & accepted as an alternative method of graft adhesion. Methodology: The present study was conducted at the Department of Ophthalmology, MMIMSR, Mullana (Maharishi Markandeshwar Deemed to be University) in the time period extending between December 2017 and January 2019. 100 eyes of patients of either sex with primary pterygium were selected and divided into 2 groups of 50 each in Group 1- patient underwent conjunctival auto graft with 10-0 ethilon sutures while in Group 2 suture less conjunctival auto graft was done with patient’s own blood fibrin. Results: Parameters such as mean operating time, presenting complaints like pain, watering, burning and foreign body sensation, complications & recurrence were compared between the two groups on postoperative Day 1, Day 7, 2 weeks, 1 month, 2 month, 3 month & 6th month. Statistical significant difference (p<0.01) was found between the suture and sutureless surgery for pterygium in relation to post-operative discomfort grading. There was a significant difference (t = 22.149, p = 0.001) in the duration of surgery for GROUP I surgery. Conclusion: Conjunctival auto graft with autologous serum is a safe and fast method. It is equally effective as conventional sutured autograft technique. Post operative discomfort is significantly less in this method. It also prevents suture related complications.

Keywords

Pterygium, sutures, sutureless, duration of surgery postoperative discomfort, complications, recurrence.

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M.L. Pandey ¹, Neha Sharma ²

Affiliations
1 Professor, Department of Ophthalmology, M.M. Institute of Medical Science and Research, Maharshi Markandeshwar (Deemed to be University), Ambala, Haryana, IN
2 Resident Doctor, Department of Ophthalmology, M.M. Institute of Medical Science and Research, Maharshi Markandeshwar (Deemed to be University), Ambala, Haryana, IN

Abstract

Introduction: Glaucoma is the group of acute and chronic multifactorial condition where lowering IOP is the mainstay of the treatment in the patients, but despite of all effort progression of disease is inevitable. The prevalence of primary open angle glaucoma (POAG) in India is 1.62% and increasing with age, where 98.5% were not even aware of the disease. In our study, we assessed the outcome of trabeculectomy using retinal nerve fiber layer (RNFL) thickness measurements and clinical parameters. Material and Method: Twenty seven patients of primary open angle glaucoma undergoing trabeculectomy were included. Ophthalmological examinations including best corrected visual acuity, pupils and anterior segment evaluation, intraocular pressure, fundus and optic disc examination, perimetry and optic coherence tomography were performed preoperatively and 1 week, 1 month and 3 months postoperatively in each and every subject. Results: With mean age of 57.9 years, total of 18 male and 9 female patients were recruited. IOP was decreased by 43.85% from baseline but best corrected visual acuity was increased marginally after 3 months postoperatively. Optic nerve head parameters were improved significantly. Visual Field analysis showed that mean sensitivity and mean deviation were improved from 8.73±4.5493 and 19.044±4.6111 preoperatively to 9.859±5.5606 and 17.926±5.4928 dB postoperatively, respectively. Conclusion: Our data suggested that in early POAG, trabeculectomy provides good IOP control and clinical outcome with little complication rate under experienced hands.

Keywords

Optic nerve head parameters, Primary open angle glaucoma, Retinal nerve fiber layer thickness, Trabeculectomy.

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Kunal Sharma ¹, Neha ¹, M.L. Pandey ², Vineet Gupta ³, Pankaj Saini ¹

Affiliations
1 Resident, Department of Ophthalmology, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN
2 Professor, M.M. Institute of Medical Science and Research, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN
3 Assistant Professor, Department of Ophthalmology, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN

Abstract

Purpose: Axenfeld-Rieger syndrome is an ocular anterior segment dysgenesis, autosomal dominantly inherited, commonly associated with glaucoma and systemic anomalies. This study presents various clinical manifestations of Axenfeld-Rieger syndrome within one family. Material and Method: Three members of the family: patient 1--father (54 years old), patient 2--son (12 years old) and patient 3--daughter (8 years old), underwent complete ophthalmic examination, including standard glaucoma diagnostics. It was impossible to perform complete eye examination in one case (patient 1) because of severity of ocular changes. Results: All family members described had iris abnormalities (hypoplastic iris stroma) and advanced glaucoma, however severity of symptoms were different in each case. The most advanced disease was recognized in patient 1. Other findings included: posterior embryotoxon (patients 2 and 3), iridocorneal angle abnormalities (patients 2 and 3), stretch holes and extraocular features (patient 2): dental anomalies (microdontia and hypodontia), maxillary hypoplasia and periumbilical skin fold. All of these symptoms supported the diagnosis of Axenfeld-Rieger syndrome. In addition, we also diagnosed high myopia & strabismus (patient 2) and corneal scar in (patient 1). Conclusion: Reported cases of Axenfeld-Rieger syndrome demonstrate phenotypic variability of the disease among family members, which is characteristic for this disorder and can cause diagnostic problem.

Keywords

Axenfirldreiger syndrome, Glaucoma, Corectopia, Iris Stretch holes, Maxillary hypoplasia, dental abnormalitiies.

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