To compare the efficacy and safety of sutureless glue-free versus suture technique for autogenous conjunctivolimbal grafting in primary pterygium excision. A prospective observational study was conducted in thirty consecutive patients of primary progressive pterygium after taking their informed written consent and ethical clearance in a tertiary eye care centre of Northern India. Patients were randomly divided equally into group “A” and “B” each constituting fifteen patients. Group A patients underwent suture technique and group “B” patients underwent sutureless technique for conjunctivolimbal graft placement. Comparison of both groups was done in terms of intraoperative time, postoperative symptoms and recurrence over a period of one year. Data was compiled and entered into Microsoft Excel software and SPSS version 21.0 was used for data analysis.The mean duration of surgery was 42 min and 30 min in group A and B respectively and this difference was found to be statistically significant (p=0.0001). On 1 postoperative day, pain and foreign‐body sensation was present in 12 patients in group A, while only 1 patient of group B had these symptoms and this difference was statistically significant (p = 0.00014). Postoperative hyperaemia was seen in 8 patients of group A and 6 patients of group B which was statistically insignificant (p = 0.564). Only two patients in group A had conjunctival chemosis while no patients in group B developed chemosis, and the difference was statistically insignificant (p = 0.964). Subconjunctival haemorrhage was seen in 2 patients of Group A and 1 patient of Group B which resolved over a period of 2-3 weeks. Conjunctivolimbal graft was found to be more stable in group A while it was misplaced in 1 patient of group B and the difference was statistically insignificant (p = 1.000). Only 1 patient of group A developed suture related complication i.e suture granuloma. Over a period of 1 year follow up, only 1 patient of group A had recurrence of pterygium.Sutureless glue-free technique is a time saving, cost effective and better surgical modality in comparison to conventional suture technique for autogenous conjunctivolimbal grafting in primary pterygium resection.
Background: Occupational ocular injuries are quite common among industrial and agricultural workers. It is an important cause of preventable vision loss in developing as well as developed countries. The principal objective of our research work was to study epidemiological profile of occupational ocular injuries and use of protective eye wear at workplace in North India.Methods: A prospective, hospital based observational study was conducted on 400 patients of occupational ocular injuries attending emergency services and OPD in Regional Institute of Ophthalmology, PGIMS Rohtak, Haryana, India during June 2016 to March 2020.Results: Out of 400 patients of occupational ocular injuries, majority were male (92%) and most common age group affected was 31-40 years (48%) followed by 21-30 years (30%). Most common injured patients were of manufacturing industry (45%) followed by construction site (30%) and agriculture based industry (25%). Metallic foreign body (70%) was found to be the most common cause of occupational ocular injury in 70% cases followed by chemical injury in 10% cases. Ocular injuries were more common in temporary workers (65%) who were not having proper safety training and not using protective devices at workplace.Conclusions: Occupational ocular injuries most commonly affect young productive population leading to temporary or permanent vision loss. Avoidance of protective glasses and lack of basic safety training make them more vulnerable for ocular injuries. Therefore, all workers should be encouraged to adopt basic safety measures and proper safety training should be given to them. It will not only help in reducing the ocular morbidity, but will also enhance the economic productivity.
Background: Mycotic keratitis is a potential sight-threatening infection and a leading cause of ocular morbidity worldwide. It is inherently difficult to treat due to the delayed diagnosis and fungistatic nature of available topical medications.
Aims and Objectives: The aim is to compare the safety and efficacy of intrastromal voriconazole alone and in combination with intracameral voriconazole in recalcitrant fungal keratitis cases.
Materials and Methods: A prospective, hospital-based, interventional study was conducted in 40 cases of fungal keratitis involving >50% stromal thickness and not showing a good response to conventional antifungal treatment even after 4 weeks. Cases were randomly divided into two groups: group A and group B of 20 each; group A patients received intrastromal voriconazole, while group B patients were given intrastromal+intracameral voriconazole combination in 50 mg/0.1 mL dose. Cases were examined daily for 1 week and then every week for 4 weeks to monitor progression.
Results: Out of 20 cases in group A, 14 (70%) patients got improved, while 18 (90%) patients in group B showed significant improvement after 4 weeks, and the difference was statistically significant (P=0.02). In group A, the average number of injections given to the patients was 3.65±1.56 for 15.2±8.79 days, while in group B, the average number of injections given to the patients was 2.65±1.44 for 13.2±7.768 days, with a statistically significant difference (P=0.033).
Conclusion: Intrastromal and intracameral voriconazole combination is a cost-effective and highly efficacious modality in managing recalcitrant cases of fungal keratitis. It should be recommended in cases with thick hypopyon and Aspergillus as the causative fungi that do not respond to conventional treatment.
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