This study was conducted to demonstrate refractory macular hole closure with human amniotic membrane graft and to evaluate type of closure Type I versus Type II.

Purpose:  To compare the frequency of post-operative hypotony between 23G PPV and 25G PPV in advanced diabetic eye disease. Study Design:  Quasi experimental study. Place and Duration of Study:  Study was conducted at department of Ophthalmology, Lahore General Hospital, Lahore from 7th April 2016 to 6th October 2016. Methods:  Total 100 cases of advanced diabetic eye disease with age ranging from 25 – 65 years and either gender were selected. Patients with nystagmus and claustrophobia, lamellar macular holes, epiretinal membrane and neovascular glaucoma were excluded. Patients were divided by lottery method into 2 groups. Data of the patient i.e. name, age, sex, patient’s registration number and address was recorded. Every patient had detailed preoperative work-up; including best corrected visual acuity by Snellen’s chart, intraocular pressure by applanation tonometer, indirect ophthalmoscopy and B-scan for retinal status. Group A underwent 23G PPV and group B underwent 25G PPV. Patients were followed after 24 hours of surgery to measure intraocular pressure to access hypotony. Results:  Mean age of patients in group A was 50.16 ± 10.40 years and in group B was 50.26 ± 9.91 years. Out of 100 patients 57 (57.0%) were females and 43 (43.0%) were males, with female to male ratio of 1.1:1. Post-operative hypotony was seen in 24 (48.0%) patients with 23G PPV and 02 (4.0%) patients with 25G PPV (p-value = 0.0001). Conclusion:  This study concluded that the frequency of post-operative hypotony in 23G Pars Plana Vitrectomy was higher as compared to 25G Pars Plana Vitrectomy in advanced diabetic eye disease. Key Words:  Diabetic retinopathy, Pars Plana Vitrectomy, Hypotony.

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Purpose:  To find out the outcomes of suprachoroidal Triamcinolone injection in refractory diabetic macular edema. Study Design:  Quasi experimental study. Place and Duration of Study:  Al-Ehsan Eye Hospital, Lahore from Jan 2020 to 31st Dec 2020. Methods:  Sixty-five patients with refractory diabetic macular edema were included. Patients underwent complete ocular history and examination. To document baseline macular edema, SD-OCT was done. The recruited patients received 0.1ml of suprachoroidal Triamcinolone injection (40mg/ml) using a 30 gauge syringe. Follow up was performed at one week, one month and third month after injection. At each follow up, best corrected visual acuity, central macular thickness and retinal nerve fiber thickness were documented. Data was analysed using SPSS version 36.0. Comparison of BCVA, central macular thickness and retinal nerve fibre layer thickness (RNFL) before and after injection was analyzed by paired sample t-test with p value of ≤ 0.05 as significant. Results:  Out of 65 patients, 29 (44.62%) were females. Mean age of patients was 54 ± 8.4 years (range 40 to 80 years). Central macular thickness after suprachoroidal Triamcinolone injection changed from 556.2 ± 10.9 to 313.6 ± 7.2 ųm. Change in visual acuity was 0.9 ± 0.01 to 0.6 ± 0.02. Pre-treatment and post-treatment visual acuities demonstrated a substantial change after undergoing treatment along with decrease in central macular thickness with p value ˂ 0.001. Conclusion:  Suprachoroidal Triamcinolone injection results in anatomical as well as functional improvement in diabetic patients with refractory macular edema.