Open Access Minireview Article

Pattern of Ophthalmic Procedures Performed at a New Peripheral Eye Clinic in a Semi-urban Area in Port Harcourt, Nigeria - A 5 Year Review

Ireju Onyinye Chukwuka, Elizabeth Akon Awoyesuku

Ophthalmology Research: An International Journal, Page 1-6
DOI: 10.9734/or/2020/v12i130136

Aim: A number of ophthalmic procedures are essential in the management of ocular disorders and are an integral part of ophthalmic practice all over the world. 

As different therapeutic methods evolve, some ophthalmic procedures have become outdated and some have been modified or replaced by various forms of laser therapy, leading to an increase in uptake of ophthalmic procedures in this country. Also though our patients still prefer non-surgical therapy, when surgery is performed, the results are much improved leading to greater patient satisfaction. This is a result of the use of more sophisticated and expensive surgical equipment and better surgical techniques. The ophthalmic procedures analyzed here were carried out in a general ophthalmic clinic without any subspecialty affiliation.

Methodology: This is a retrospective review of ophthalmic procedures carried out in a specialist facility over a five year period. Information on age, sex and type of ocular procedure was retrieved from case notes of patients and entered into excel sheets. Data was exported from excel sheets for statistical analysis.

Results: A total of 111 patients had Ophthalmic procedures over the 5 –year period under review with a mean age of 56.7±18.5 years and age range from 7 to 89 years. Sixty-three of the patients (56.8%) were males while forty-eight (43.2%) were females (M:F = 4:3). The commonest ophthalmic procedure carried out was cataract extraction which accounted for 48.6% of cases followed by yag laser capsulotomy (19.8%) and pterygium excision (18%). No surgical or laser procedures for glaucoma were performed during this period.

Conclusion: Ophthalmic procedures are a very important mode of treatment of eye disorders. The most common procedure performed in our study was cataract extraction and more males than females underwent both cataract surgery and pterygium excision while more females had laser capsulotomy.

Open Access Original Research Article

Comparison of Conjunctival Autograft Technique Using Autologous Blood as Glue Versus Suture Technique in Pterygium Surgery

Suchita Singh, Prabha Sonwani, M. Shrivastava

Ophthalmology Research: An International Journal, Page 7-14
DOI: 10.9734/or/2020/v12i130137

Aim: To compare the post-operative inflammation, surgical time and complications in conjunctival autografting with oozed autologous blood versus sutures in primary pterygium surgery.

Study Design: Prospective interventional study.

Place and Duration of Study: Department of Ophthalmology, CIMS, Bilaspur (C.G), India. (Jan 2017-May 2018).

Methodology: 80 eyes of 80 patients (25 to 75 years) presented with primary pterygium up to grade 3 were included in this prospective interventional study presented in eye OPD, CIMS, Bilaspur (CG). All the procedures and post-operative evaluation was done by the same surgeon. All the patients were divided into two groups on alternate basis. 40 patients received conjunctival autografting with oozed autologous blood (CAGb) and 40 patients received sutures (CAGs). These two groups were then compared for post-operative inflammation, surgical time and complications (day 1, day 5, 2 weeks, 1 month and 3 month).

Result: Total 80 patients were evaluated after surgery. Progressive pterygium was observed in more than 50% cases in both groups. Post-operative inflammation and discomfort was significantly lower in CAGb group compared to CAGs group (P<.001). Mean surgical time was also significantly less in CAGb group (11.6±2 min) compared to CAGs group (21.6±3min) (P<.001). In CAGb group 5% patients had graft displacement while none in CAGs group. Granuloma formation was higher in CAGs group (12.5%) compared to CAGb group (7.5%). Subgraft haemorrhage was 10% in CAGb and 17.5% in CAGs group. Dellen formation was seen in 3 patients in CAGb and 4 patients in CAGs. Recurrence rate was higher in suture group (5/40 in CAGs vs 1/40 in CAGb).

Conclusion: Our study concludes that placement of conjunctival autograft with oozed autologous blood as adhesive after pterygium excision is an effective, less inflammatory and less time consuming approach, with significantly lower rates of post-operative complications. This can be used as a better alternative to suture technique.

Open Access Original Research Article

An Audit of IO6 YAG Laser Capsulotomies Done between January 2017 - December 2017 in St. Joseph Eye Hospital, Mgbirichi, Owerri, Imo State and Viandra Eye Clinic, Port Harcourt, Rivers State of Nigeria

K. Odogu Victor, Chinawa Ndubuisi Elijah, Ubaka Christiana

Ophthalmology Research: An International Journal, Page 15-21
DOI: 10.9734/or/2020/v12i130138

Aim: To audit the YAG Laser Capsulotomy procedures done over a 12 month period from January to December 2017.

Objective: To review YAG LASER capsulotomies done over a 12 months period from January  2017 – December 2017.

Methods: The audit was retrospective in nature, involving collation of parameters such as age, sex, presenting visual acuity, post laser visual acuity, complications and post operative management from the patient records. The lasers were performed with SYL 9000 Ophthalmic yttrium aluminum garnet (YAG) Laser systems [Lightmed Corporation, Taiwan]. This is a class 3b Laser with a wavelength of 1064 nm and Q-switched operational mode and a spot size of 8 um.

Results: The audit involved 106 subjects. The mean age was 56.76 years. Fifty nine (55.7%) subjects were females while 44.3% were males. Eleven (10.4%) subjects had bilateral neodymium‐doped yttrium aluminum garnet ND YAG laser treatment while 89.6% had unilateral treatment. Seventy five (72.8%) of the subjects had visual improvement following treatment. Seventy four (69.8%) had less than 3 mJ quantum of energy and only 5.7% required repeat treatment. Fifty (47.2%) had between one to three days post op treatment with anti-inflammatory and/or pressure reducing drugs.

Conclusion: Use of low energy in ND YAG laser treatment of Posterior Capsule Opacification offers good visual outcome, precludes the complication associated with higher energy treatment and does not necessarily lead to repeat treatment.

Open Access Original Research Article

Meiboscore Correlation between Contact Lenses Weares and No Contact Lenses Weares in a Young Population

E. Pateras, K. Karabatsas

Ophthalmology Research: An International Journal, Page 22-26
DOI: 10.9734/or/2020/v12i130139

Purpose: To compare the morphological changes in the meibomian glands and meibomian glands loss between contact lens and non-contact lenses wears in a young population. The contact lens wearers wore C.L. for max 6 years.

Methods: Examination of the meibomian gland (MG) by using a corneal topographer CSO MODI 2 incorporating Phoenix-Meibography Imaging software module from January to June 2019. 80 volunteered students of the University of West Attics participated, and all the subjects selected had no obvious ophthalmological symptoms, aged 19 to 22 years.

Results: The Arithmetic mean of Meiboscore for those who did not wear C.L. was 1,23 MGL, while for the C.L. wearers was 2,53 MGL.

Conclusion: This Clinical research compares the meiboscore of contact lens wearers at a young age (min. 4 years contact lens wearers) and those who never tried to wear. This study showed that there is a relation between meibomian glands loss (MGL) and contact lens wear. Our observations showed that there a small but positive correlation, as the total period of C.L. wear increases the meiboscore increases. In addition, cumulative frequency % showed this slight increase in meiboscore.

Open Access Original Research Article

The Reliability between Placido Topography and Scheimpflug Topography in Normal Corneas with Astigmatism less Than 0.50 Dc

E. Pateras, A. Nousi

Ophthalmology Research: An International Journal, Page 27-35
DOI: 10.9734/or/2020/v12i130140

Purpose: This Clinical research was targeted to experimentally investigate the reliability between Placido topography and Scheimpflug topography in normal corneas with astigmatism ≤ ±0.50 Dc by comparing the refractive powers at the 4 main meridians (180⁰ - 90⁰) in order to study any differences between the two topographers and their reliability. Comparing the reliability measurements of Placido disk topography (CSO- Modi 02 Corneal Topographer with Phoenix Full & Pupil Module Software) with those of a high-resolution rotating Scheimpflug camera (Pentacam-Oculus,) and assess the agreement between these two topographers in measuring corneal power in normal eyes without astigmatism (≤ 0.50 Dc).

Methods and Materials: Measurements were taken from 56 eyes corresponding to a proportion of patients, of which 26 were men with a mean age of ± 30 years and 30 were women with a mean age of ± 27 years. Refractive power maps were taken from the anterior cornea, having results for the steep meridian value (Ks), the flat meridian value (Kf), mean keratometric value (Km), and cornea astigmatism (Ks-Kf). The same examiner took all the data from measuring these 56 eyes. The results for each refractive map from the two topographers was taken with values for meridians (180⁰- 90⁰). Then the there was a statistical analysis comparing the values of (CSO) and (Pentacam) for those 56 eyes measured.

Results: The statistical analysis for all meridians based on the results and as far as normal corneas with astigmatism ≤ ±0.50 Dc are concerned, the Placido topography (CSO) and Scheimpflug imaging technique (Pentacam), can be considered as equivalent in terms of diagnostic credibility and accuracy for primary health care, fitting contact lenses, etc. as the correlation coefficient r did not show any important differences for both instruments. For the 90⁰ meridian the correlation coefficient was 0.79, Significance level P=0.0001 and 95% confidence interval ranges from 0.67 to 0.87. For the 180⁰ meridian the correlation coefficient was 0.48, Significance level P<0.0001 and 95% confidence interval ranges from 0.25 to 0.66.

Conclusion: In terms of diagnosis of pathology and follow-up, contact lens fitting especially for the anterior cornea surface these two instruments can work quite the same that’s why a small clinical practitioner should have at least a Placido topographer. Corneal topography is an important instrument in order to measure the shape and refractive power of the cornea. Corneal topography gives practitioners an important tool to fit contact lenses asses the power and the cornea shape and helps to evaluate complications of the contact lens in relation with the corneal surface. These instruments continue to develop techniques and software in order to investigate and evaluate corneal surfaces and the integrity of the tear film, so that they can provide better solutions for their contact lens patients.