BACKGROUNDTo study the pre-and post-operative characteristics and evaluate the surgical outcomes in patients undergoing external dacryocystorhinostomy for nasolacrimal duct obstruction with or without any previous episodes of dacryocystitis. MATERIALS AND METHODSThis hospital based study was carried out at the Postgraduate Department of Ophthalmology, Government Medical College, Srinagar. A series of 76 patients with nasolacrimal duct obstruction, who underwent external dacryocystorhinostomy were studied. The preoperative evaluation included the following parameters: age, gender, residence, occupation, duration of symptoms, history of previous dacryocystitis, previous DCR, side of obstruction and presence of any other diseases (Systemic or ocular). Patients were examined at 1 week, 1 month, 3 months and 6 months following surgery. Surgical success was determined by the postoperative patency on syringing and resolution of symptoms at the end of six months. Patient satisfaction and complication rates were also assessed. RESULTSOut of the 76 patients evaluated, 42 were females and 34 were males. The mean age of patients was 58.6±14 years. The mean duration of symptoms was 2.7 years. Left sided obstruction was more common (41 patients) than right-sided obstruction (33 patients).Bilateral obstruction was present in 2 patients; 30 patients had previous history of dacryocystitis, while 46 patients had no such history. The success rate was 88.4% for patients without previous history of dacryocystitis and 83.3% for patients with previous history of dacryocystitis. CONCLUSIONThe nasolacrimal duct obstruction is commoner in females than males in Kashmiri population. External dacryocystorhinostomy is an efficacious, safe and cost-effective treatment for the nasolacrimal duct obstruction. The surgical outcome is similar in patients with and without any previous history of dacryocystitis. The complication rate is low and overall patient satisfaction is high.

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Aims: To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR) and the possible risk factor(s), we studied 69 children (42 girls and 27 boys) with VUR attending the Pediatric opd. Study Design: Prospective Observational study. Place and duration of Study: Department of pediatrics, Sher I Kashmir Institute of Medical Sciences, Srinagar, Kashmir between June 2017 to June 2018. Methodology:  All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m) technetium dimercapto–succinic acid scintigraphy. Results: Grade of reflux and number of urinary tract infection (UTI) episodes (≥3) were found to be statistically significant risk factors for renal scarring (P <0.05). However, there was no significant association with gender, familial history and laterality of the disease (P >0.05). Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05). Conclusions: It was concluded that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

PURPOSETo evaluate the efficacy of phacotrabeculectomy with Intraocular Lens (IOL) implantation in patients with pseudoexfoliative glaucoma. MATERIAL AND METHODSThis study included 46 eyes of 46 patients diagnosed with pseudoexfoliative glaucoma and clinically significant cataract. All eyes underwent phacotrabeculectomy with intra ocular lens implantation. Efficacy was measured by evaluating the changes in mean intraocular pressure, mean logMar BCVA, drug number, bleb status and complications. RESULTPostoperative reduction of IOP was very satisfactory for the whole group. The mean pre-operative IOP±SD was 31.27±7.82 mmHg. After the procedure, the mean IOP decreased to a level of 14.05±4.22 mmHg at first week and 13.68±9.27 mmHg at 1 month. The mean IOP values at 3 months were 13.77±3.52 and 14.12±3.19 mmHg at 6 months. The mean IOP at final visit was 14.57±3.44 mmHg. The mean value of pre-operative logMAR BCVA was 0.98±45. It improved to a mean value of logMAR BCVA 0.36±37 at one month, logMAR BCVA 0.37±37 at 6 months and logMAR BCVA 0.39±65 at the final visit after one year. CONCLUSIONPhacoemulsification, IOL implantation and trabeculectomy is an efficacious and safe procedure for treating eyes with co-existing pseudoexfoliation glaucoma and cataract. KEYWORDSPhacotrabeculectomy, Pseudoexfoliation Syndrome, Pseudoexfoliation Glaucoma.HOW TO CITE THIS ARTICLE: Nazir A, Akbar E, Qureshi ST, et al. Phacotrabeculectomy with intraocular lens (IOL) implantation in patients with co-existing pseudoexfoliative glaucoma and cataract.