Objective:To evaluate the efficacy and complications of 20 gauge vitrectomy via corneal approach for the management of congenital cataract.Method:We performed anterior capsular vitreorhexis, lens matter aspiration (LMA), primary posterior vitrectorhexis and anterior vitrectomy via corneal approach using 20 gauge vitrectomy system in children younger than two years of age with congenital cataract between January 2014 to December 2014. The intra and postoperative complications were observed.Results:Twenty nine eyes of 21 children were included in this study. Congenital cataract surgery using 20 gauge vitrectomy system via corneal approach did not reveal any intra operative complication. Post operatively all children were able to freely open their operated eyes. Conjunctival congestion at the incision site in four eyes and mild anterior chamber reaction in 8 eyes were seen on 1st daywhich resolved at one week follow up. Other major post operative complications such as inflammatory membrane, irregular pupil, posterior/anterior syneache and opacification of visual axis were not seen during follow up period.Conclusion:The 20-gauge vitrectomy system via corneal approach is easy to perform, is less time consuming, safe and effective for the management of congenital cataract in younger children.

Purpose:  To compare per-operative and early post-operative complications between Manual Small Incision cataract surgery and Phacoemulsification in patients with Senile Cataract. Study Design:  Quasi experimental study. Place and Duration of Study:  Al-Ibrahim Eye Hospital Karachi from December 2018 to October 2019. Methods:  Two hundred and seventy patients with senile Cataract were recruited for this study by convenient sampling technique. They were divided equally into two groups. Group I underwent Manual Small Incision Cataract Surgery (MSICS), whereas Group II underwent Phacoemulsification. Per-operative and early post-operative complications were recorded on day 1 in both groups. Data was analyzed using SPSS 24.0. Independent t-test was carried out with P-value of ≤0.05 was considered statistically significant. Results:  Mean age group – I was 54.95 ± 11.0 and in Group – II was 57.09 ± 10.59 (p = 0.546). There were 72 (53.3%) males in group – I and 74 (54.8%) in group – II with a non-significant difference (p-value > 0.01). There was significant difference for posterior capsule rupture and striate keratitis between the two groups (p = 0.031 and 0.044 respectively). Rest of the study parameters was not statistically different in the both group. None of the groups had a nucleus drop and vitreous prolapse. No significant difference was seen between the two groups concerning iris trauma (p = 0.56), wound leakage (p = 0.15) and hyphema (p = 0.32). Conclusion:  There is no significant difference between per-operative and early post-operative complications between MSICS and Phacoemulsification in patients with senile cataract except posterior capsular rupture and striate keratopathy which were more common in phacoemulsification group. Key Words:  Cataract, Senile Cataract, Phacoemulsification, Small Incision Cataract Surgery.

Background: Nasolacrimal duct obstruction is listed under the heading of congenital diseases; on other hand it is also commonly present in adult age group. In population of Sindh we found these patients frequently. Through this study we revealed the surgical options for the treatment of Nasolacrimal duct obstruction in population of Sindh provenience of Pakistan. The objective of the study was to compare the outcomes of two different intubation techniques in treatment of Nasolacrimal duct obstruction between two age groups. Comparative study was conducted in the Department of Ophthalmology Al-Ibrahim Eye Hospital Karachi from May 2018 to June 2019.Methods: Total 136 numbers of patients were included on the bases of history, clinical examination and pre-operative syringing test. Non- probability convenient sampling was applied for data collection. Total 136 numbers of patients were divided into two groups on the bases of treatment and further subgroup on the bases of age ranges. Data were analyzed by SPSS version 20.0.Results: Frequency and percentage of recovery in six months in each subgroup with application of chi-square test. Frequency and percentage of post-operative complications prolong treatment and regurgitation and patency of tube in each group and subgroups.Conclusions: The results showed significant difference between the groups. Group A showed higher success rate with minimal percentage of complications and post-operative measurements in both age ranges as compare to Group B.

Oral intake of steroids has been associated with central serous chorio-retinopathy (CSCR) for long time. We report a 23 years old male who had exposure to green laser pointer after which he developed laser maculopathy. The treating ophthalmologist started oral steroids with patient developing CSCR in his left eye. He was referred to our retina clinic for further evaluation. On examination his vision was 6/6 Part in his right eye and 6/9 Part in his left eye. His dilated fundus examination revealed small foveal scar in his right eye and dull foveal reflex in his left eye. On OCT he had laser maculopathy in right eye and left fundus findings coincided with diagnosis of central serous chorio-retinopathy (CSCR). Patient was asked to discontinue his deltacortil tablets. The patient went back to his primary ophthalmologist who restarted deltacortil tablets. CSCR developed again. Key Words:  Maculopathy, burn, Steroids, Central Serous Chorio-retinopathy.

Background: Intravitreal silicone oil injection has been used to manage complicated retinal detachment. This study aims to analyse the efficacy of diode laser (TSCPC) in the management of secondary glaucoma following intravitreal silicone oil injection in complex retinal detachment surgery. Methods:  The medical records of 58 eyes of 58 patients retrospectively were reviewed. Patients who underwent TSCPC for the management of secondary glaucoma following intravitreal silicone oil injection in complex retinal detachment were included. Procedure performed under local anaesthesia. The laser power was set at 1500-2200 mW for 2 sec. At each follow-up visit, patients went under charting of their IOP measurements with anterior segment and fundus examination. Post procedural follow up visits were carried out as; at 1 week, 1st, 3rdand 6thmonths. The efficacy was measured as reduction in IOP up to ‰¤20 mmHg without further needs for medications at 6 months. Results: The IOP was reduced up to 19.26±10.15 mmHg. Comparisons of IOP at each interval with pre-treatment showed significant difference with p<0.0001. The efficacy of procedure was achieved in 77.6% patients. Age, gender and pre-operative IOP showed significant association with p<0.05. Conclusion: Diode laser TSCPC was effective and safe in reducing IOP. The IOP decreases gradually over six month follow up. The procedure is simple and cost-effective yet reasonably afforded by patients in low resources population. In spite of the retained intravitreal silicon oil patients with failed medical treatment for uncontrolled IOP can be treated with TSCPS.