[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.
Full-text · Article · Jun 2012 · BMC Ophthalmology
[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.
Full-text · Article · Oct 2011 · Online Journal of Health and Allied Sciences