Open Access Case study

Novel Application of Vasofix Cannula for Punctal and Canalicular Laceration

Prabhakar Srinivasapuram Krishnacharya, Shamshiya Naaz, Raghavendar Reddy, Anuj Kumar Singhal

Ophthalmology Research: An International Journal, Page 1-5
DOI: 10.9734/or/2019/v11i130117

Aim: Purpose of present study is to investigate the efficacy of vasofix cannula in preserving punctum position and canalicular patency.

Presentation of Case: A thirty four year old male patient presented with multiple right both eyelid injuries consisting of lower punctum, vertical and horizontal canalicular laceration, lower eyelid tear with tarsal plate fracture with pretarsal orbicularis muscle splitting, laceration near lateral canthus running for about an inch horizontally and vertical upper lid laceration near upper punctum inflicted by flying zinc sheet at work place. Examination revealed normal and intact ocular functions. Ocular movements were full with unremarkable fundoscopy. CT orbit showed no orbital fractures and intraocular foreign body. Vasofix cannula 24 Gauge inserted into lower punctum and canaliculus, and anchored to lid margin by vicryl 10-0 along with lid laceration repair under local anesthesia.

Discussion: Punctal position, canalicular support and patency were maintained with no infection or extrusion. There was no epiphora or ocular irritation during 10 weeks of follow up.

Conclusion: This case study describes management of monopunctal and horizontal as well vertical canalicular laceration by vasofix cannula acting as a stent. Anatomical and physiological functions restored with acceptable cosmetic appearance. Added advantage is that all time availability of cannula in all operation theatres. Although Vasofix cannula is semi flexible in nature can be used as a stent for canalicular intubation purpose.

Open Access Original Research Article

Evaluation of Ocular Anterior Chamber Depth and Body Mass Index in Normal Blacks in a Nigerian City

I. N. Aprioku, C. S. Ejimadu

Ophthalmology Research: An International Journal, Page 1-8
DOI: 10.9734/or/2019/v11i130116

Aim: To evaluate ocular anterior chamber depth (ACD) and body mass index (BMI) in a normal population in Port Harcourt City Local Government Area (LGA), with a view to determine formulae in estimating intraocular lens power for cataract surgeries and possible association with angle closure glaucoma and other ocular pathological conditions.           

Methods: This is a multi-stage study with inclusion criteria of Visual Acuity > 6/18, age greater than 18 years with no history of past ocular surgeries or trauma. Data obtained through a structured proforma included age, sex, tribe, occupation and level of education. Body Mass Index (BMI) was measured using a standard height and weight automated scale (SECA 769,220). Comprehensive ocular examination done and Anterior Chamber Depth (ACD) measured using Amplitude (A) scan ultrasonography (SONOMED PACSCAN 300AP). Data was analyzed using SPSS (Version 17), and p value was set at ≤ 0.05.

Results: Four hundred and sixty six (466) subjects participated in the study made up of two hundred and twelve (212) males (45.5%) and two hundred and fifty four (254) females (54.5%) with M: F ratio of 1:1.2. The age range was 18-92 years and mean age of the subjects studied 43.0±14.2 years. Findings revealed mean ACD and Body Mass Index to be 3.1±0.5 mm and 26.9±6.2 kg/m2 respectively. The mean ACD was greater in males than females. There was a statistically significant relationship between age and ACD. Obesity was found to be higher in females (n=97; 78.2%) compared to the males among those with BMI >30Kg/m2 and this was found to be statistically significant (p=0.0001). A larger proportion of subjects with normal BMI and overweight BMI 25-29.5 Kg/m2 were males. There was a statistically significant difference in the ACD values between genders among those overweight (BMI 25- 29.5 Kg/m2) and the obese (BMI >30 Kg/m2).

Conclusion: There was a statistically significant difference in the ACD values between genders among those overweight.

Open Access Original Research Article

Demographics and Pattern of Ocular Diseases in Patients with Chronic Kidney Disease at the University of Port Harcourt Teaching Hospital

Rachael O. Aliu, Elizabeth A. Awoyesuku, Chinyere N. Pedro-Egbe

Ophthalmology Research: An International Journal, Page 1-9
DOI: 10.9734/or/2019/v11i130118

Aims: To determine the demographics and pattern of ocular diseases in patients with Chronic Kidney Disease at the University of Port Harcourt Teaching Hospital.

Study Design: This was a hospital-based cross-sectional study.

Place and Duration of Study: This study was carried out at the Dialysis clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria from February 2013 to February 2014.

Methodology: The Sample size was estimated to be 85 adult patients and cconsecutive adult patients with chronic renal failure who are having haemodialysis were enrolled into the study. The patients who met the inclusion criteria were randomly booked at the Dialysis Clinic and had no prior knowledge of the study; hence there was no bias in case selection. Ethical approval was obtained from the institutions ethical committee. Each participant had a comprehensive ocular examination including fundus photography. Subjects needing further evaluation and treatment were referred to the Eye Clinic of the Ophthalmology Department of the University of Port Harcourt Teaching Hospital, Port Harcourt.

Results: A total of 170 eyes of 85 persons were examined in this study (100% coverage). A total of 30 (35.4%) females and 55 (64.6%) males were examined giving a male to female ratio of 1.8:1.

Approximately half of the study subjects (54.1%) had no previous eye problem prior to developing chronic renal failure while about a quarter (n= 20, 23.5%) had refractive error and difficulty in reading near prints .After diagnosis of chronic kidney disease however a total of 40 (47%) of study subjects had visual impairment while 2(2.4%) were blind and 43(50.6%) of the study population however had normal vision.

Conclusion: Chronic Kidney disease is an important cause of ocular morbidity in our environment with majority of those affected being males in the third to fifth decades of life. Posterior segment disorders were the commonest disorders seen.

Open Access Original Research Article

Serum Vitamin D & Dry Eye Syndrome

Shaveta ., Shah Nawaz

Ophthalmology Research: An International Journal, Page 1-4
DOI: 10.9734/or/2019/v11i130119

Introduction: Dry eye syndrome [DES] is one of the commonest ocular disorders characterized by tear film instability, visual discomfort & disturbance with ocular surface inflammation potentially leading to damage to the ocular surface. Serum Vitamin-D deficiency has been reported to be associated with DES.

Aim: To determine the Serum 25-hydroxy-vitamin-D levels in patients diagnosed as having DES.

Methods: We conducted a prospective observational study and included in our study, serum vitamin D levels of the first 40 patients over the age of 18 years presenting with signs and symptoms and later diagnosed to have DES [confirmed with ocular surface disease index-OSDI questionnaire, Schirmer I test, kerato-epitheliopathy examination and tear-film breakup time-[TBUT] were analysed.

Results: Schirmer's I test, interpreted as mild [11-15mm/5min], moderate [6-10 mm/5 min] and severe [<5mm/5min] had 8, 17 and 15 patients, respectively, with a mean value of 8 mm/5 min Schirmers I test. The minimum and maximum of Fluorescein TBUT measured in seconds was 4 and 10 seconds, respectively, with a mean of 6.2 seconds. Twenty four of our test subjects were found to have deficient Serum Vit 25[OH] D levels, nine had insufficient levels and seven had normal levels.

Conclusion: Vitamin D deficiency is prevalent in patient having DES.

Open Access Original Research Article

Cytochrome P450 Family 1 B1 Gene Mutations in Primary Congenital Glaucoma Affected Egyptian Patients

Amanne Feisal Esmael, Hanaa Abdel-Sadek Oraby, Soheir Mohamed El Nahas

Ophthalmology Research: An International Journal, Page 1-11
DOI: 10.9734/or/2019/v11i130120

Aims: Primary congenital glaucoma (PCG) is a leading cause of childhood blindness. The cytochrome P450 family 1, subfamily B, polypeptide 1 (CYP1B1) is the most mutated gene that is associated with PCG. Very few studies have examined the promoter region and exon1 of the CYP1B1 gene. This work was planned to contribute to the description of the possible causative mutations of CYP1B1 gene that are related to PCG affected Egyptian patients.

Patients and Methods: Patients diagnosed as glaucomatous based on their symptoms and detailed ophthalmological examinations at the time of presentation underwent an intraocular pressure lowering surgical procedure. Investigations were further proceeded on the molecular level. Sequencing-based mutation screen for the promoter region, exon1 and the coding region of exon3 of CYP1B1 gene have been performed in two related consanguineous PCG affected families and four other sporadic Egyptian patients using the polymerase chain reaction (PCR) assay; where PCR products were sequenced, and further analyzed.

Results: Sequencing analysis revealed three novel mutations in PCG affected patients one in the promoter region (g.G2872A) and two in exon1 (g.C3268T and g.C3332T). Two additional mutations in exon3 (p.L432V and p.N453S) reported for the first time in PCG affected Egyptian patients. Clinical and genetic data of the two consanguineous families revealed that although the four parents have the same variations as their sons, they are ophthalmologically free.

Conclusion: Regular ophthalmic examinations of siblings and parents of these affected patients should take place for early detection of any form of glaucoma to allow prompt diagnosis and early treatment when needed.

Clinical examination and molecular genetic data could contribute to early diagnosis and prevention of the visual impairment caused by PCG. This study provides groundwork for expanded genetic investigations in Egypt paving the way for genetic counseling to help affected families make informed medical and personal decisions.