Purpose: To evaluate the visual outcome and long-term complications of intraocular lens implantation along with primary posterior capsulectomy & anterior vitrectomy in children with bilateral developmental cataract.</p> <p>Methods: This retrospective study was carried out on the 48 eyes of 24 children who had undergone cataract surgery under general anesthesia. Age range was 2 to 8 years. All patients underwent primary posterior capsulectomy, primary in-bag intraocular lens (IOL) implantation, irrigation-aspiration of lens debris, and anterior vitrectomy. At intervals of one week, one month, three months, and six months, every case was evaluated. After 6 months best corrected visual acuity was recorded and intraocular pressure, anterior chamber angle, optic disc, and peripheral retina were evaluated.</p> <p>Results: Postoperative best corrected visual acuity were 6/6 in 10.4% eyes, 6/9-6/18 in 56.3% and <6/18 in 33% eyes. Intra ocular pressures were found within normal limit (12 ± 2.09 mm of Hg) in all cases. Anterior chamber angle was normal in 44 eyes (91.7%). Peripheral retina and vitreous were normal in all cases. No significant Optic disc changes were noticed. The most common cause of decreased vision was amblyopia (79.2%) in the fellow eye due to delayed surgery.</p> <p>Conclusion: Amblyopia is the main cause of decreased visual recovery in children after cataract surgery. Surgical intervention in proper time results in good visual outcome
Aim: To describe the temporary management of corneal perforation by using dried sclera patch graft prior keratoplasty when donor tissue not available. Case report: Two cases of corneal perforation (>2mm) of various causes presented with severely decreased vision and shallow anterior chamber and soft eye ball. Both needed immediate therapeutic keratoplasty to save the globe and restore the vision. Due to unavailability of donor cornea, both patients were surgically managed with dried scleral patch graft temporarily to save the globe. Both patients underwent therapeutic keratoplasty one moth and one and half months respectively. Both patients gained better vision (6/18 and 6/24 respectively), quiet anterior chamber and no secondary glucoma after 6 month of keratoplasty. Conclusion: Dried sclera patch graft is a good option for temporary management of corneal perforation of various causes until a donor cornea is available. These patch grafts prevent ocular hypotony, posterior synechiea and secondary glucoma.
Retinoblastoma is the most common primary intraocular tumor in children with an incidence of 1: 16,000 to 18,000 live birth. Every year worldwide newly detected cases are about 8000 and in India about 1400. It represents 11% of cancer that develop in the first year of life. Current revolutionary management strategy has increased the survival rate of retinoblastoma above 95% in developed country and it is the highest among all pediatric cancer. But still it is a deadly cancer worldwide. Survival from retinoblastoma based on income >90% vs 40% (in high to low income countries). Occurrence of metastases is higher in low-income countries (32% vs 12% in middle-income). Forty three (43%) of global burden lives in 6 countries of Asia (India, China, Indonesia, Pakistan, Bangladesh & Philippines). Mortality rate varies in different continents. An estimated worldwide death rate is more than 40% and most of them from Asia and Africa. Bangladesh is one of the developing countries of the South- East Asia region and retinoblastoma constitutes 83% of all pediatric cancer bellow 4 years of age. For proper management of retinoblastoma with an international standard, establishment of retinoblastoma center consisting of Ocular oncologist, Clinical oncologist, Radiation oncologist, Pediatrician, Oculoplastic surgeon, Retina specialist, Pediatric ophthalmologist, and Ocularist is needed. Management include proper diagnosis, treatment of the disease, genetic counseling, regular follow up, rehabilitation of survivor and screening of sibling. Chittagong Eye Infirmary & Training Complex which is a tertiary center and one of the referral centers of the Bangladesh is treating retinoblastoma since its inception. Due to demand of time the hospital has been reorganized the various facilities to serve retinoblastoma patients with a team approach from 2017. From January 2017 to March 2022 total 304 patients were diagnosed. Among them 132 received VEC (Vincrisrine, Etoposide, Carbplatin) chemotherapy from this center and 79 underwent enucleation with long optic nerve. The hospitals also screen sibling, provide visual and psycho-social rehabilitation of the RB survivors and run awareness program in community level.
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