Browsing by Author "H, Das"
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Publication Effectiveness of combination of permanent and releasable scleral flap sutures in trabeculectomy: A randomized clinical trial(Kathmandu University, 2006) R, Kumari; BP, Badhu; H, DasIntroduction: Trabeculectomy is a commonly used surgical treatment for glaucoma. Purpose: To evaluate the effectiveness of combination of permanent and releasable scleral flap sutures to minimize the immediate postoperative complications of trabeculectomy. Materials and methods: This study was carried out in Department of Ophthalmology, B P Koirala Institute of Health Sciences, Dharan, Nepal. Forty one eyes of 34 patients undergoing trabeculectomy were randomized to undergo either conventional trabeculectomy (Group A= 20 eyes) or trabeculectomy with combination of permanent and releasable scleral flap sutures (Group B =21 eyes). The parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD) and surgical complications over a period of 6 weeks. Results: Significantly higher number of eyes belonging to group A (14 eyes) had shallower anterior chamber than group B (7 eyes) on first post operative day (p=0.042). Six eyes (30%) in group A had peripheral or central irido- corneal touch in early postoperative period as compared to only one in Group B. Hypotony was noted in 3 eyes in each group. Two patients in group A required reformation of anterior chamber. Other surgical complications in the two groups were similar. Both the groups had a significant drop in IOP following surgery. However, there was no significant difference in the IOP between the two groups after 6 weeks (Group A: 10.95 ± 3.03 mmHg vs. Group B: 12.29 ± 4.67 mmHg; p=0.87). There was a significant drop in IOP following removal of sutures (15.19 ± 6.15 mmHg to 13.19 ± 6.13 mmHg; p=006) in group B. Conclusion: Use of combination of permanent and releasable scleral flap sutures is a safe technique that significantly reduces the incidence of immediate postoperative shallow anterior chamber after trabeculectomy. Key words: Trabeculectomy, Intra ocular pressure, anterior chamber depth, combination of releasable and permanent scleral flap suturesPublication Pattern of intraocular pressure changes following manual small incision cataract surgery(Kathmandu University, 2005) H, Das; BP, Badhu; A, PandaObjectives: To find out the pattern of changes in intraocular pressure after manual small incision cataract surgery. Methods: Consecutive patients (291 eyes of 291 patients) undergoing manual small incision cataract surgery were prospectively evaluated for change in IOP. Patients were further divided into two groups based on whether or not sutures were used to close the scleral tunnel. IOP was serially measured at day 1, 1st, 2 nd, 4 th , 6 th, 8 th and 12th week. Results: The mean post operative IOP in eyes where sutures were not applied (12.59± 3.02 mmHg, 12.59±2.34mmHg, 12.54±2.19mmHg and 12.40±2.99 mm Hg at day1, 2week and 4weeks respectively) was lower than that where sutures were used to close the wound (15.57± 3.86mmHg, 14.05±2.52mmHg, 14.43±3.39mmHg at day1, 2weeks and 4 weeks respectively). There was a drop of IOP from the preoperative IOP in both suture (1.15±3.29mm Hg) and non suture (3.29±3.07mm Hg) group at 3 months of follow up. Conclusion: There is a small drop of IOP following sutureless MSICS during long term follow up. Eyes where sutures are applied are more likely to have higher IOP than those without sutures at the initial post operative period. Key Words: Small incision cataract surgery, suture less cataract surgery, intraocular pressure.Publication Variation of intraocular pressure in patients with leprosy(Kathmandu University, 2005) SS, Javvadhi; H, Das; BP, Badhu; S, AgrawalIntroduction: There are various controversial reports on intraocular pressure (IOP) in patients with leprosy. Purpose: The current study was undertaken to study the level of intraocular pressure in leprosy patients and its association with the risk factors. Materials and methods: This was a prospective cross sectional comparative study. An ophthalmologist and a dermatologist evaluated consecutive 93 patients with leprosy. The risk factors studied were age, gender, bacillary index, clinical diagnosis, duration of disease and treatment; and ocular complications. The IOP in these patients was compared with healthy age and sex matched controls. Results: A total of 186 leprosy patients (93) and healthy controls (93) were studied. The mean applanation IOP for the right and left eyes in leprosy patients was 12.87 ± 1.20 mm of Hg and 13.22±2.70 mm of Hg respectively. This was found to be significantly lesser (p<0.001) than in the controls (RE=15.14±2.58 and LE=15.41±2.36mmHg). The untreated leprosy patients had significantly lower IOP than those with treatment (p<0.001). None of the risk factors were found to be independently associated with the decrease in IOP. The duration of treatment, however, showed a trend towards having a significant association (p=0.057) with the lower level of IOP. Conclusion: The level of IOP is lower in leprosy patients than in the healthy controls. Age, gender, bacillary index and presence of ocular complications due to leprosy are not independently associated with the decrease in IOP. The untreated leprosy patient tends to have a lower IOP. This finding can be used to monitor effectiveness of treatment of leprosy. Key words: Leprosy and intraocular pressure