Objective:To compare effectiveness of pan-retinal photocoagulation alone versus panretinal photocoagulation combined with intravitreal bevacizumab on visual acuity and central macular thickness in patients presenting with proliferative diabetic retinopathy.Methods:This Randomized controlled trial was carried out at Armed Forces Institute of ophthalmology, Pakistan from Jan 2016 to Aug 2016. Seventy six eyes of 50 patients having proliferative diabetic retinopathy and diabetic macular edema were included in the study. All the patients were subjected to detailed clinical examination that included Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), slit lamp examination of anterior and posterior segments. Optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) were carried out and patients were divided in two groups (GP and GI). Three monthly sessions of Pan retinal photocoagulation (PRP) using Pattern Scan Laser (PASCAL) alone was performed in group GP while PRP along with three monthly intravitreal bevacizumab (IVB) was performed in group GI. BCVA and CMT was recorded 04 weeks after the third PRP session in both the groups.Results:Seventy six eyes of 50 patients (38 in each group) were treated with three sessions of PRP alone and PRP with IVB in Group GP and GI respectively. Mean age of the patient in group GP was 57.47± 6.08 years while that in group GI was 55.69 ±6.58. The magnitude of induced change in BCVA was 0.09 ± 0.15 in GP while 0.22 + 0.04 in GI groups while mean induced change in CMT after treatment was 77.44 ± 92.30 um and 117.50 ± 93.82 um in group GP and GI.Conclusion:Laser PRP combined with IVB has superior visual and anatomical outcome than PRP alone in patients with combined presentation of PDR and DME.

Objective:To compare the effects of Pars Plana Vitrectomy (PPV) and Scleral Buckling (SB) with reference to Central Corneal Thickness (CCT), Corneal Endothelial-Cell Density (CED), Anterior Chamber Depth (ACD) and Axial Length (AL) in repair of Rhegmatogenous Retinal Detachment (RRD).Methods:This comparative cross sectional analytical study was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from July 2013 to July 2015. A total of 69 eyes of 69 patients which underwent repair of RRD by either PPV or SB were analyzed to compare mean change in CCT, CED, ACD and AL between two groups.Results:Mean age of patients was 56.23±5.22 years. Mean pre-operative CCT, CED, ACD and AL in PPV group was 533.06±13.28µm, 2231.67±164.57Cells/mm2, 3.37±0.18mm and 23.66±0.76mm respectively. Mean post-operative CCT, CED, ACD and AL in PPV group was 534.81±11.83µm, 2037.19±167.83 Cells/mm2, 3.24±0.13mm and 23.88±0.80mm respectively. Change in CED, ACD and AL from pre-operative value after PPV was statistically significant (p<0.001). Mean pre-operative CCT, CED, ACD and AL in SB group was 530.73±12.59 µm, 2161.79±161.96 Cells/mm2, 3.343±0.14mm and 23.67±0.82mm respectively. Mean post-operative CCT, CED, ACD and AL in SB group was 532.76±7.74 µm, 2158.27±156.58 Cells/mm2, 3.24±0.10mmand 25.71±0.86mm respectively. Change in ACD and AL from pre-operative value after SB was statistically significant (p<0.001). Mean change of CED, ACD and AL between two groups was also statistically significant (p<0.001).Conclusion:Rhegmatogenous retinal detachment repair causes ocular changes, with significantly more decrease in corneal endothelial cell density after pars plana vitrectomy, and more increase in anterior chamber depth and axial length after scleral buckling.

Objective:To evaluate the effect of pan-retinal photocoagulation with Pattern Scan Laser (pascal)on best corrected visual acuity and central macular thickness in patients having proliferative diabetic retinopathy (PDR).Methods:This study was conducted at AFIO, Rawalpindi, Pakistan from Oct 2014 to Jul 2015. Sixty seven eyes of 46 patients having proliferative diabetic retinopathy were included in the study. All patients underwent ophthalmic clinical examination including uncorrected distant visual acuity (UCVA), best corrected visual acuity (BCVA), fundus examination with slit lamp and optical coherence tomography to document the pretreatment central macular thickness (CMT). Two sessions of PRP using Pattern Scan Laser were performed 04 weeks apart and OCT was repeated 04 weeks after the 2nd session. Central macular thickness and BCVA were documented.Results:Sixty seven eyes of 46 patients (29 females and 17 males) with mean age of 57.45 ± 5.78 years underwent treatment with two sessions of laser PRP. Mean pretreatment BCVA was 0.67 ± 0.43 and mean post-treatment BCVA was 0.57 ± 0.3. Mean central macular thickness (CMT)as measured by OCT was 391.93 ± 170.43 before treatment and 316.91 ± 90.42 um after treatment. The magnitude of induced change in CMT after treatment was 75.01 ± 90.75 and BCVA was 0.09 ± 0.14.Conclusion:Laser PRP with Pattern scan laser alone in patients with combined presentation of PDR and DME is safe and effective.

As different research and studies have been conducted for the sake of understanding the concept of employee satisfaction but still organizations are incapable to find those factors that affect mostly on Satisfaction level of Employee. The main purpose of this research is to sort out those factors with intensity that mostly effect employee Satisfaction. Particularly, we took workplace environment, employee empowerment and pay & promotion as the main variables to check their impact on employee satisfaction and further the impact of employee satisfaction on employee turnover. A questionnaire was developed for the purpose of collecting data to understand the level of employee satisfaction in different organizations. Convenient sampling was used to collect the data and 150 questionnaires were filled from the employees of different sectors. Statistically, the relationship of employee empowerment and workplace environment with employee satisfaction has significant results, but the relationship between pay and promotion and employee satisfaction was somewhat insignificant. Moreover, there was a significant effect of employee satisfaction on turnover intention of employees. This study will help the organizations to understand completely about the satisfaction level of employees and how they can motivate their employees to perform their job efficiently and effectively.

Objective: To compare the anatomical and functional success between conventional medical method and Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) laser embolysis in retinal artery occlusion. Methods: This randomized control trial was conducted at Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi from July 2018 to May 2020. A total of 14 eyes of 14 patients were received with fovea involving branch or hemiretinal artery occlusion within 24 hours of onset of symptoms. They were divided randomly in two groups. Initial treatment was given to all cases, and seven eyes received Nd:YAG laser treatment for embolysis. Both groups were analysed for anatomical success (reperfusion) and functional success (defined as improvement in visual acuity to better than 6/60 on Snellen’s visual acuity chart from baseline visual acuity). Results: In conventional group, anatomical success was achieved in 2 (28.6%) eyes, while significant visual improvement was seen in 3 (42.8%) eyes. In Nd:YAG laser embolysis group, anatomical success was achieved in 5 (71.4%) eyes, while significant visual improvement was seen in 6 (85.7%) eyes. All eyes which showed functional improvement underwent Nd:YAG laser embolysis within 6 hours of onset of symptoms. Conclusions: Nd:YAG laser embolysis is more effective in management of fovea threatening retinal artery occlusion, as compared to conventional medical treatment, if performed within six hours of onset of symptoms. doi: https://doi.org/10.12669/pjms.37.1.3196 How to cite this:Mehboob MA, Khan A, Mukhtar A. Efficacy of YAG Laser Embolysis in Retinal Artery Occlusion. Pak J Med Sci. 2021;37(1):71-75.  doi: https://doi.org/10.12669/pjms.37.1.3196 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.