BACKGROUND Smoothening of the corneal surface after primary pterygium excision is a costeffective, time saving technique to treat anterior corneal scars and high corneal astigmatism related to pterygium. We wanted to compare the visual acuity and astigmatism before and after pterygium operation using crescent knife. METHODS This prospective follow up study was conducted on a total of 40 patients with primary pterygium inducing visually significant astigmatism. Visual acuity, K reading, astigmatism were recorded before surgery and at 1 week, 6 weeks and 12 weeks following surgery whereas corneal clarity was assessed post operatively. The pterygium remnant tissue over cornea was polished using a crescent knife. Data was compiled using MS Excel and analysed using SPSS version 2.0. RESULTS Mean age of patients was 48.88 ± 11.72 years and about 30 (75%) of study population was composed of females and only 25% patients were male. Mean Best Corrected Visual Acuity (LogMAR) preoperatively was 0.22 ± 0.16, whereas that at 12 th week was 0.11 ± 0.09 and the improvement was statistically significant. Also a significant improvement in flat K and K average and corneal clarity at various follow up was observed (p<0.01) the mean astigmatism also reduced significantly (p<0.01). CONCLUSIONS There is a significant improvement in vision and corneal clarity following pterygium excision and corneal polishing using crescent knife. Also, corneal polishing led to significant reduction in astigmatism and improvement in flat and average K readings.

The aim of this study was to evaluate the visual outcome and central macular thickness (CMT) after intravitreal injection of bevacizumab followed by focal laser for the treatment of Diabetic Macular Edema (DME). Patients and methods: This is a prospective, observational study. A total of 30 eyes of 30 patients with Diabetic macular edema were included in this study. The following data were recorded at baseline and during the follow-up periods (≤6 months): bestcorrected visual acuity (BCVA), slit-lamp biomicroscopy, CMT and intraocular pressure measurement by applanation tonometry. All eyes received intravitreal bevacizumab at a dose of 1.25 mg in 0.05 ml followed by focal laser after 2 weeks. Results: This study included 30 eyes of 30 patients, the mean age of the patient 59.4±8.5 years. There were 19 males and 11 females. The mean baseline BCVA in LogMAR was 0.78±0.23, and the final mean BCVA at 6 months had improved to 0.45±0.20. Significant improvement was seen in all the patients over the study period (p<0.001). Mean CMT at baseline was 485±122 μm, which decreased to a mean of 321±82μm at the end of the follow-up period (6 months). Conclusion: Primary treatment for DME with intravitreal bevacizumab followed by focal laser results in improvement of vision and reduces CMT. Combined therapy seems to be an effective modality for treatment of DME.

To assess the effectiveness of intravitreal ranibizumab compared with bevacizumab for the treatment of macular edema associated with retinal vein occlusion (RVO). Methods: This was a retrospective study of 64 eyes with macular edema associated with RVO. Patients received either 1.25 mg of intravitreal bevacizumab (n = 32) or 0.5 mg of intravitreal ranibizumab (n = 32). Visual acuity, clinical bio-microscopic examination and central macular thickness (CMT) by Optical Coherence Tomography (OCT) was assessed at 6 weeks post injection. The CMT before and six weeks after the injection as assessed by OCT were compared. Statistical analysis was performed using paired student t-test. The improvement in CMT was also compared between the two groups, statistical analysis was performed using un-paired student t-test. Results: The best-corrected visual acuity significantly improved from logarithm of the minimal angle of resolution (logMAR) 0.792 ±0.36 at baseline to 0.575 ± 0.34 at 6 weeks in the bevacizumab group (p =0.001) and from logMAR 0.851 ± 0.35 at baseline to 0.336 ± 0.20 at 6 weeks in the ranibizumab group (p = 0.001), which is statistically significant difference. The reduction in CMT was from 545.44 ± 176.43 μm at baseline to 378.34 ±95.13 at 6 weeks in the bevacizumab group (p = 0.001) and 524.25± 195.94 μm at baseline to 243±80.72 μm at 6 weeks in the ranibizumab group (p=0.001) which was also a statistically significant difference (p = 0.001). Conclusions: Both ranibizumab and bevacizumab were effective for the treatment of RVO. The visual outcome and reduction in macular thickness was better by ranibizumab at the earliest follow-up of 6 weeks.

The present study is aimed to assess the prevalence of steroid-induced glaucoma in vernal kerato-conjunctivitis patients treated with topical steroids and to determine the association between different types of topical steroids and the presence of steroid-induced glaucoma. This study was conducted as a hospital-based cross-sectional study on patients belonging to the age range of 8 years to18 years who were already diagnosed with vernal kerato-conjunctivitis and were using topical steroids as treatment. Detailed clinical history and ophthalmologic examination were done. Depending upon the potency of steroids and their intra-ocular pressure raising potential, patients were categorized into one of the 4 groups (A, B, C, D). Intra-ocular pressure levels were raised in 32.9% of the patients managed with topical corticosteroids. Steroid-induced glaucoma was observed in 15 (6.1%) of the patients with vernal kerato-conjunctivitis. Steroid-induced glaucoma was significantly associated with prolonged duration of corticosteroids and high potency corticosteroid use (p&#60;0.05). Steroid-induced glaucoma is one of the common complications of injudicious and long-term use of topical corticosteroids particularly high potency steroids. Approximately one-third of the patients on treatment for vernal kerato-conjunctivitis are corticosteroid responders. High potency steroids and prolonged use of steroids are factors associated with steroid-induced glaucoma.

No abstract