Search

Anadi Khatri,1 Eli Pradhan,2 Sweta Singh,1 Roshija Rijal,1 Bal Kumar Khatri,3 Gyanendra Lamichhane,1 Muna Kharel4 1Department of Retina, Lumbini Eye Institute, Lumbini, Nepal; 2Department of Retina, Tilganga Institute of Ophthalmology, Kathmandu, Nepal; 3Department of Ophthalmology, Birat Eye Hospital, Biratnagar, Nepal; 4Department of Ophthalmology, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal Aim: Subthreshold lasers have gained popularity in the treatment of chorioretinopathy central serous chorioretinopathy (CSCR) and yellow (577 nm) lasers have completely revolutionized the treatment. However, there is very little literature regarding the use of a more common and conventional – green (532 nm) subthreshold laser for the treatment of chronic CSCR. We report the use of green (532 nm) laser for the treatment of chronic CSCR and its outcome.Methods: Eyes with nonresolving CSCR were treated with green subthreshold laser and evaluated at the end of 5 months. Visual acuity, central macular thickness (CMT), and macular volume (MV) at baseline and at 5 months following treatment were evaluated.Results: Thirteen eyes with chronic CSCR were treated with green laser in SP-Mode™. The mean duration of CSCR was 7.64±3.77 months at the time of treatment. The median age of the patients was 41 (35–57) years. The baseline mean best-corrected visual acuity (BCVA) was 0.96 logMAR ± 0.17, with mean baseline CMT of 503.8 µm ± 181.9 and MV of 12.8 mm3 ± 3.81. The mean CMT at 5 months was 211 µm ± 31.7 and mean MV was 9.65 mm3 ± 0.60, correlating to a mean decrease of 292 µm ± 79 in CMT and mean decrease of 3.18 mm3 ± 1.87 in the MV from baseline (P<0.05). The mean BCVA after treatment was 0.18 logMAR±0.09 (P<0.05). Two cases of CSCR with pigment epithelial detachment (PED) also had complete resolutio

Anadi Khatri,1 Sweta Singh,1 Roshija Rijal,1 Bal Kumar Khatri,2 Muna Kharel3 1Lumbini Eye Institute, Lumbini, Nepal; 2Birat Eye Hospital, 3Nepalese Army Insitute of Medical Sciences, Kathmandu, Nepal Purpose: To report a modified technique of sutureless intrascleral fixation of a posterior chamber intraocular lens with use of instruments of anterior segment surgery and its outcomes. Design: Prospective, noncomparative, interventional case series. Participants: Ninety-two eyes of 92 patients with aphakia and subluxated lens who underwent surgery were evaluated. Materials and methods: 27-gauge needles were introduced transclerally and guided by the viscocanula to externalize via the main wound. The haptics were loaded into the lumen and externalized from entry points. The haptics were then fixed in a scleral tunnel made by a 27-gauge needle. The best-corrected visual acuity (BCVA) and complications were determined. Results: Ninety two eyes which were operated and completed follow-up of 6 weeks were included in the study. The most common indications for scleral-fixated intraocular lens (SFIOL) were subluxated lens – 55 eyes (59%), and surgical aphakia – 31 eyes (34%). Sixty-nine eyes (75.7%) had a postoperative vision of uncorrected visual acuity of 6/18 on day 1. There was an improvement in mean logMAR BCVA (0.086±0.18) at 6 weeks as compared to preoperative visual acuity (p<0.05). BCVA of 6/12 or better was attained in 94% of the cases at 6 weeks. Special mentions need to be made for 6 (7%) of our cases. Three of the patients were cases of fully treated postoperative endophthalmitis who lacked capsular support. Two of the other cases had undergone pars plana vitrectomy for retinal detachment. Both had silicon oil removal done 1 month before the SFIOL procedure. One of the patients had Marfan’s syndrome. Conclusion: Our procedure is safe, easy, less traumatic, and less resource-demanding with good visual outcomes and can

Anadi Khatri,1 Jeevan Kumar Shrestha,2 Madhu Thapa,2 Bal Kumar Khatri,3 Muna Kharel3 1Department of Ophthalmology, Vitreo-Retina Fellow, Lumbini Eye Institute, Siddharthanagar, Nepal, 2Department of Ophthalmology, B. P. Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Maharajgunj, Kathmandu, Nepal, 3Birat Eye Hospital, Biratnagar, Nepal Background: Primary open-angle glaucoma (POAG) is a progressive optic neuropathy with numerous risk factors. Its severity with associated risk factors remains a widely debated topic. Aim: To evaluate the severity of POAG in patients with hypertension (HTN) and diabetes or both. Patients and methods: This hospital-based, cross-sectional descriptive study was conducted for a period of 18 months from January 2016 to June 2017. Diagnosed cases of POAG were evaluated for severity with associated risk factors. Results: A total of 221 patients were enrolled in the study. The mean age of the patients was 54.4 (SD ± 15.9) years with a male to female ratio of 0.93:1. Of the 221 patients, 68 (31%) had a family history of POAG. Mean intraocular pressure was 15.8±4.87 mmHg, and mean central corneal thickness was 535.4±34.9 μm. A total of 81 (36%) patients had HTN, 21 (9.50%) had diabetes mellitus (DM), and 15 (6.80%) had both HTN and DM. Analysis using SPSS version 20 was done. The severity of POAG was found to be significantly higher in patients with HTN, DM, or both when evaluated on the basis of anatomical and functional loss. Conclusion: POAG patients with HTN, DM, or both were found to have more severe POAG. Patients with these risk factors could represent “high-risk patients” with POAG. Patients with HTN and DM, or both may require evaluations on a more frequent basis to access the progression/severity of POAG. Keywords: glaucoma in Nepal, POAG in Nepal, severity of POAG, hypertension, diabetes, systemic disorders in POAG