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Purpose: To determine the outcomes of intravitreal Bevacizumab 1.25 mg in 0.05 ml combined with supra)choroidal triamcinolone acetonide 0.05 ml in terms of safety and efficacy, while treating macular edema associated with central retinal vein occlusion (CRVO). Study Design: Interventional case series. Place and Duration of Study: This study was conducted at ophthalmology department of Hayatabad medical complex, Peshawar from July 2021 to December 2021. Methods: Total 34 patients of CRVO with macular edema were included in the study. After complete ocular examination each patient received one injection of intravitreal bevacizumab (1.25 mg/0.05 ml) along with supra-choroidal triamcinolone acetonide (2 mg/0.05 ml), followed by similar monthly injections for two months. Visual acuity and central macular thickness and intra-ocular pressure (IOP) were assessed at presentation and then monthly for 3 months. Visual acuity was measured in Log-MAR, central foveal thickness on SD-OCT and IOP was measured with Goldmann Applanation Tonometer. The data was analyzed using SPSS version 24. For comparison of means, the paired-t test was used. A significance level of <0.05 was set for significance. Results: There were 22 (64.7%) males and 12 (35.5%) females. Mean age of the patients was 53.18 ± 13.39 years. Central foveal thickness decreased significantly at 3 months post treatment (p ˂ 0.001). Visual acuity also significantly increased from presentation to 3rd month post treatment (p ˂ 0.001), and the intra-ocular pressure remained within normal range from presentation to 3rd month post treatment. Conclusion: Both supra-choroidal triamcinolone acetonide and intravitreal bevacizumab are safe and effective in the treatment of macular edema secondary to CRVO. [ABSTRACT FROM AUTHOR]

Objective: To determine surgical outcome after cataract surgery in post pars plana vitrectomised eyes. Methodology: This was an interventional study conducted at Department of Ophthalmology, Khyber Girls Medical College, Hayatabad Medical Complex, Peshawar, from 1st February 2016 to 30th November 2016. A total of 73 eyes of 73 patients who underwent cataract surgery in previously vitrectomised eyes were assessed for surgical outcome. Cataract surgeries were performed by manual small incision cataract surgery (MSICS) or phacoemulsification with intraocular lens (IOL) implantation. Visual acuity was recorded at baseline and at 40th post-operative day. Intraoperative and postoperative complications were documented. For statistical data analysis, snellen's visual acuity was converted to Log MAR. Visual outcome was graded as improvement, stable or deterioration. The data were analyzed using SPSS version 20. Results: The mean age of our patients was 45 ±7 years. Males were 64.4% while 35.6% were females. In our study, 82.19% cases had improvement in visual acuity, 10.96% patients had stable visual acuity and 6.84% had deterioration from baseline visual acuity. The difference between baseline and follow up visual acuity was statistically significant (p =0.045). Most common intraoperative complication was posterior capsular plaque (28.7%) and most common postoperative complication was retinal detachment (13.7%). Conclusion: Cataract surgery improved visual outcome in significant number of eyes that had undergone pars plana vitrectomy despite intraoperative and postoperative challenges. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess visual outcome and post-operative complications after silicone oil removal in pseudophakic vitrectomized patients. METHODS: This interventional case series study was conducted at Department of Ophthalmology, Medical Teaching Institution Lady Reading Hospital, Peshawar, Pakistan from February 2019 to January 2020. A total of 32 eyes of 32 patients were enrolled in the study after fulfilling inclusion and exclusion criteria using nonrandom consecutive sampling technique. All patients had pars plana vitrectomy with silicone oil done 6 months ago and were pseudophakic. Silicone oil removal was carried out in all patients and visual outcome and surgical complications assessed on 1st and 14th post-operative day. Final examination was done after six months. Statistical analysis was done by using Statistical Package for Social Sciences (version 21) by applying paired sample t-test. RESULTS: Amongst 32 patients, 20 (62.5%) were male and 12 (37.5%) were female. Age of the patients ranged from 16 to 60 years with a mean age of 35±13.97 years. Pre operatively mean best corrected visual acuity (BCVA) was 1.45±0.52 Log Mar. On the last post-operative follow up after six months mean BCVA was 1.21±0.55 Log Mar. Visual acuity improved in 24 (75%), remained stable in 3 (9.4%) and worsening in visual acuity was seen in five (15.6%) cases. Visual improvement was statistically significant (p-value 0.001) using paired ttest. Most common complications were retinal detachment (n=4: 12.5%), secondary glaucoma (n=4: 12.5%) and epi-retinal membrane (n=2; 6.3%). CONCLUSION: Vision improves in majority of pseudophakic patients after silicone oil removal. [ABSTRACT FROM AUTHOR]

Objective: To determine surgical outcome and residual co-morbidities after surgical intervention in eyes having Open Globe Injury (OGI) with retained Intra Ocular Foreign Body (IOFB). Methodology: A prospective interventional case series was carried out at the department of Ophthalmology, Khyber Institute of Ophthalmic Medical Sciences (KIOMS), Hayatabad Medical Complex (HMC), Peshawar from 1st September 2012 to 30th November 2013. Patients who were followed post-operatively for at least 90 days were included. Eyes having open globe injury (OGI) and intraocular foreign body (IOFB) who had surgical intervention were included in our study. Visual outcome was determined comparing final best corrected visual acuity (BCVA) with initial BCVA. Co-morbidities were noted at final follow up. For data analysis, Snellen's VA was converted to log MAR VA. Data was analyzed by SPSS version 16. Results: Total of 35 patients were included in our study. Male were 94.3% compared to 5.3% females. Mean age was 32.42 years. Bomb blast injury was cause of eye trauma in 60% cases while 40% were doing hammer and chisel work at the time of trauma. IOFB was impacted in anterior segment in 20% cases while it was impacted in posterior segment in 80% cases. IOFB removal was achieved in 33(94.28%) cases; silicone oil was used as temponade in 48.57% cases. Primary repair was required in 40% cases while rest 21(60%) eyes had self sealed wound. Primary surgical intervention in the form of Pars Plana Vitrectomy, IOFB removal with the use of intraocular magnet or forceps was carried out in 71% cases. Mean BCVA log MAR improved from initial BCVA of 2.20 to 1.20. Common comorbidities at final visit were corneal scars, macular scars and cataract. Conclusion: Bomb blast injuries are most common cause of OGI with IOFB in our region. Significant visual improvement occurs in most of the cases after skilled vitreo-retinal surgical interventions. Common ocular co-morbidities are corneal scar, macular scar and cataract. [ABSTRACT FROM AUTHOR]