[Show abstract][Hide abstract] ABSTRACT: Background
The aim of the study is to compare the outcome of phacoemulsification in patients with and without pseudoexfoliation syndrome in Kashmir.
200 patients were prospectively evaluated and divided into 2 groups. Group 1 comprised 100 cases with pseudoexfoliation and Group 2 (control) 100 cases without pseudoexfoliation. Phacoemulsification with posterior chamber intraocular lens implantation was performed by 3 surgeons. Intraoperative and postoperative observations were made in both the groups at regular intervals upto 6 months. A chi square test was used for statistical analysis.
Patients with pseudoexfoliation were significantly older (P = 0.000), had harder cataract(P = 0.030) and smaller mean pupil diameter(P = 0.000) than the control group. Intraoperative complications were comparable between the 2 groups except the occurrence of zonular dehiscence which was seen in 7% patients of Group 1 compared to 0% in Group 2. Higher postoperative inflammatory response was seen in Group 1(P = 0.000). Decrease in intraocular pressure (IOP) at all postoperative measurements was more in Group 1(P = 0.000). The visual acuity was better in the control group in the early postoperative period (P = 0.029), however the final visual acuity at 6 months was comparable between the 2 groups.
Phacoemulsification in presence of pseudoexfoliation necessitates appropriate surgical technique to avoid intraoperative complications. Pseudoexfoliation is associated with higher inflammatory response, significant postoperative IOP drop and satisfactory visual outcome.
[Show abstract][Hide abstract] ABSTRACT: The Prevalence of exfiolative glaucoma has shown extensive variation all over world ranging from 0 to 50%.
To know the prevalence of exfoliative glaucoma in Kashmir.
A hospital based cross-sectional study was conducted from January 2006 to January 2007 on 300 patients with documented raised intra ocular pressure (IOP), glaucomatous changes in the fundus and open angle of anterior chamber.
The study included 236 males and 64 females. Out of 300 patients, 115 had exfiolative glaucoma and among those left eye was involved in 47 patients, right eye in 31 and 37 had bilateral involvement. The patients above 60 years of age were found to have this condition more frequently as compared to those below 60 years of age. Occupation of patients had a strong association with this condition, as the disorder was seen more commonly in patients engaged in outdoor activites. The patients with exfiolative glaucoma were found to be having less Visual acuity; a higher IOP at presentation and a more severe and early optic nerve head involvement as compared to those with open angle glaucoma.
The study reveals that prevalence of exfoliative glaucoma as seen in our OPD based cross sectional study was found to be 38.3%. This prevalence was high as compared to prevalence studies conducted in southern parts of the country and low as compared to the studies conducted in the Scandinavian countries. The difference in the prevalence of the condition was probably inpart related to the differences in the climatic conditions, ethnic origin and in part related to genetic factors of the studied population.
[Show abstract][Hide abstract] ABSTRACT: Acute myeloid leukemia (AML) may rarely involve the orbit as a solid tumor termed granulocytic sarcoma. This re-port describes the case of a child who presented with rapidly progressive unilateral proptosis and was diagnosed as rhab-domyosarcoma. However subsequent examination of the peri-pheral blood film revealed AML. Thus proptosis may present as the initial manifestation of AML. Introduction: The orbit, especially in children can be involved in a number of diseases either ophthalmic or non-ophthalmic. The common le-sions include orbital cellulitis, dermoid cysts, rhabdomyosar-coma and hemangioma. 1 However certain rare causes also exist, like granulocytic sarcoma. Thus the differential diagnosis should be kept in mind and a thorough clinical examination and appropriate investigations should be carried out to facilitate early treatment. Case Report: Eight years old child presented with proptosis of right eye with ocular pain and redness over a span of 15 days. Vision in right eye was 20/200 (later decreased to 20/400). Proptosis of 6 mm was noted with downward and lateral dis-placement of globe [Fig 1]. Extra ocular movements were re-stricted superiorly and inferiorly. Conjuctiva was congested and chemosed, cornea showed exposure keratitis, minimal hypopy-on, pupil reacted sluggishly to light, intraocular pressure was 22 mmHg, fundus examination revealed normal disc with dilated tortuous vessels. Left eye was normal. A provisional diagnosis of rhabdomyosarcoma was made due to the acute onset of proptosis and young age, rhabdomyosar-coma being the commoner primary orbital malignancy in chil-dren. CT Scan revealed 3 x 3 cm well defined mass in superior aspect of right orbit with contrast enhancement, superior rectus was not seen separately. No bone destruction, no intracranial extension was seen [Fig 2]. Radiologists suggested heman-gioma. Subsequently peripheral blood film (PBF) was ordered which showed lymphopenia and thrombocytopenia, hypochromic macrocytes with anisocytosis, polymorphs 30%. lymphocytes 25%, >blasts 45% [Fig 3]. Figure 1: Photograph showing unilateral proptosis.