Purpose:  To perform pediatric cataract surgery audit at a tertiary care center in Karachi. Study Design:  Descriptive observational study. Place and Duration of Study:  From January, 2016 to July, 2018 at Ophthalmology Department of Jinnah Postgraduate Medical Center, Karachi. Material and Methods:  All patients with congenital cataract were included in study regardless of presence or absence of systemic association. Patients who were lost to follow up at three months were excluded from the study. Hospital records were reviewed retrospectively and data on patient demographics, preoperative presentations, intraoperative complications and postoperative visual outcomes was documented on predesigned proformas. All patients underwent lens aspiration, posterior capsulotomy and anterior vitrectomy. Surgeries were performed under general anesthesia. Preoperative and postoperative visual acuity was assessed with ability to fix and follow light/objects, Kay picture test and Snellen’s chart according to patient’s age. Results:  Three hundred and twenty six eyes underwent surgery for congenital cataract and sixty for traumatic cataract. Number of male patients was 54.93% and female was 45.07%. The average age of patients with congenital cataract was 5.01 years and that for traumatic cataract was 7.8 years. Amblyopia, nystagmus and strabismus were the commonest ocular comorbidities. Uncorrected visual acuity ranged from 6/18 to light perception preoperatively. Postoperatively 55% children with congenital cataract and 15% children with traumatic cataract had visual acuity better than 6/24. Conclusion:  Early surgery in congenital cataract gives good visual outcomes. In traumatic cataract extraction, the final visual outcome depends on other effects of trauma on ocular structures.

Purpose: To evaluate outcomes of trabeculectomy in terms of IOP control and its safety in terms of peroperativeand post-operative complications in Primary Congenital Glaucoma.Study Design: Interventional Case-Series.Place and Duration of Study: Helpers Eye Hospital, Quetta, from June 2017 to December 2018.Material and Methods: Thirty eyes of 17 patients were included in this case series after diagnosis of primarycongenital glaucoma. Patients with secondary congenital glaucoma due to trauma, surgery, inflammation, SturgeWeber Syndrome, Neurofibromatosis, cataract, uveitis, aphakia and pseudophakia were excluded from the study.Informed consent was taken from parents. Examination under anesthesia was done before surgery to recordpreoperative IOP, corneal diameter and anterior and posterior segment abnormalities. Primary trabeculectomywas done. Post-operative IOP and corneal diameter was recorded at 1st, 3rd and 6th month and every 6 monthsthereafter under general anesthesia. IOP at 12th month of surgery was the final outcome which was consideredsignificant if IOP was less than 21 mm Hg with stable corneal diameters.Results: Mean preoperative IOP was 25.8 mm Hg. Twenty-three (76.66%) eyes out of 30 eyes were consideredsuccessful with mean IOP of 15.3 mm Hg at last follow-up while 7 (23.33%) cases of failure were observed withpostoperative mean IOP of 27.71 mm Hg. These patients underwent additional surgeries to control IOP.Hyphema was the only complication observed in this study. Postoperative cataract developed in 5 eyes.Conclusion: Primary trabeculectomy is an effective operation and safe surgery for primary congenital glaucoma

Purpose: To find out frequency of eyelid lesions at a tertiary care hospital. Study Design: Descriptive observational Place and Duration of Study: Jinnah Postgraduate Medical Centre Karachi, from March 2013 to December 2018. Methods: Records of patients operated for eyelid lesions were reviewed. Tumors arising from eyelids, may or may not be extending to other tissues were included in study. Data included age, gender, type of lesion, site of lesion, Histo-pathologic diagnosis, management and follow up. Result: A total of 150 patients with lid lesions were managed which included 50% benign and 50% malignant lesions. There were 77 (51.3%) males and 73 (48.7%) females. Age range was 3 to 85 years. The most commonly diagnosed lid lesion was squamous cell carcinoma (n=45, 30%), 60% among malignant lesions. It was followed by epidermal inclusion cyst (n=25, 16.7%), 33.33% of benign lesions. Patients with benign lesion were younger than 30 years while patients with malignant lesions were more than 50 years of age. Majority of the affected population was aged males, farmers and laborers, with history of prolong sunlight exposure. Among 150 lesions, 126 (84%) underwent excision biopsy and 24 (16%) underwent exenteration. Excision Biopsy was performed in all 75 (100%) benign lesions and 51 (68%) malignant lesions. Exenteration was performed in 24 (32%) malignant lesions. Conclusion: Owing to a large percentage of malignant eyelid lesions, population at risk should be educated about eyelid tumors, its early diagnosis, treatment and follow up.