bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Glaucoma Capsulare: Outcomes and Complications of Trabeculectomy
Authors: Soomro Abdul Rafio , Soomro Fayaz Ahmed , Hussain Munawar , Soomro Abdul Qadeem , Qazi Asif Mashood , Tariq Anas Bin 
Published: April 2021

Purpose: To analyze the results of filtration surgery in cases of Glaucoma Capsulare.
Study Design: Experimental study.
Place and Duration: Al-Ibrahim Eye Hospital, Karachi, from January 2018 to December 2018.
Methods: Forty eyes of forty patients, between 50 to 80 years of age, with Glaucoma Capsulare, not controlled with topical medication were included in the study. Patients not willing for filtration surgery and those who had any other ocular disease were excluded. Pre-operative examination, including visual acuity, retinoscopy, intra ocular pressure and fundus examination was done. Complete blood count, blood sugar and urine complete were also carried outto rule out any other illness. All collected data was analyzed through software SPSS version 20.
Results: There were 26 (65.0%) males and 14 (35.0%) females. Mean age was 62.1 ± 12.44 years. Mean IOP was 34.0 ± 2.43 mm of Mercury. At first follow-up mean IOP (mm.Hg) was 11.44 ± 3.2 and at 12 weeks follow-up, the IOP was 10.14 ± 4.1. Angle 0 – I (closed angle) was seen in 6 (15.0%), Angle grade II – III (Open angle) was seen in 10 (25.0%) and grade III – IV (open angle) was seen in 24 (60.0%) patients. Visual acuity 6/9 were in 4 (10.0%), 6/12 – 6/18 in 10 (25.0%), 6/18 – 6/24 was in 12 (30.0%) and visual acuity 6/36 – 6/60 was noted in 14 (35.0%) patients. Early complications were flat anterior chamber in 4 (10%) and corneal edema in 4 (10%) patients. However late complications were hyphema and cataract in 2 (5%) and 25 (62.5%) patients respectively.
Conclusion: Trabeculectomy significantly lowers the intraocular pressure in patients with Glaucoma Capsulare.
Key Words: Glaucoma Capsulare, Trabeculectomy, Gonioscopy, Hyphema, Pseudoexfoliation glaucoma.
Deep Sclerectomy with Low-Tension Sutures versus Tight-Tension Sutures without Space-Maintaining Implant in Controlling Intraocular Pressures
Authors: Zia Rashid , Jain Nikhil , Dardzhikova Albena 
Published: April 2021

Purpose: To compare the IOP lowering effect and post-operative complications of low tension sutures versus tight tension sutures in deep sclerectomy.
Study Design: Quasi experimental study.
Place and Duration of Study:
Methods: Twenty seven eyes undergoing deep sclerectomy operation with normal strength sutures (TS) were compared with 21 eyes undergoing a modified technique in which low tension sutureswere tied to only approximate anatomy (LS). Both sets of patients were operated on by the same experienced surgeon with similar technique except for the tensile strength of suture; same antimetabolite in similar concentration was used with identical pre and post-operative care. Outcome measures were post-operative intraocular pressure, number of medications needed and complications.
Results: IOP decreased significantly in both groups, in TS group by 12.6 mm Hg (p < 0.001) and in the LS groups by 18.9mm Hg (p < 0.001). Greater IOP drop was seen in LS group versus TS group (p = 0.046). In LS group number of eye drops required post operatively were significantly less than TS group (p = 0.007). After follow up only one patient in the loose suture group still required IOP-lowering medication. There were minimal complications in both groups, 1 patient in the LS group and 7 in TS group required a YAG Goniotomy.
Conclusion: Using low tension sutures in deep sclerectomy increases the IOP lowering effect of the surgery and reduces the number of medications the patient requires post operatively.
Co-relation of Myopia with the Use of Smart Phones and Outdoor Activities
Authors: Imtiaz Hafiza Sadia , Sharjeel Muhammad , Malik Irfan Qayyum 
Published: April 2021

Purpose: To determine the frequency of myopia among children and to find out the role of smart phone usage and outdoor activities in myopia development and progression.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Ophthalmology department DHQ-UTH Gujranwala, from January 2019 to June 2019.
Methods: After approval from the hospital ethical committee and informed consent from each participant, a descriptive cross-sectional study was carried out with a sample size of 250 patients. Patients of either gender between 4 – 14 years of age using smart phones for ≥ 2 hours daily and found to have refractive error were included in this study. Routine ophthalmic examination was carried out, data was recorded on proforma, and daily usage of smart phones and weekly outdoor activity in hours along with school grade, family history and previous history of using refractive glasses was also determined and documented. Data was analyzed using SPSS v.20
Results: 250 patients were included in this study, out of which 142 (56.8%) were male and 108 (43.2%) were female. Mean age was 10.1 ± 2.45 years. Mean outdoor activity was 0.95 ± 0.98 hours per week while mean daily smart phone usage was 2.89 ± 0.93 hours. Pearson correlation coefficient for daily smart phone usage and UCVA was +0.297 (0.3) which showed a positive moderate association between two variables while the value obtained for UCVA and weekly outdoor activity was – 0.51 that depicted a negative strong association.
Conclusions: In conclusion, myopia occurrence is higher among smart phone users showing a moderate positive correlation while outdoor activities reduce myopia prevalence and progression depicting strong negative correlation.
Key Words: Refractive Errors, Myopia, Visual acuity, Smartphone.
Color Vision Defects among Textile Mill Workers in Lahore
Authors: Omair Qazi Muhammad , Imtiaz Hifza , Iqbal Maryam 
Published: April 2021

Purpose: To find out the color vision defects among textile mill workers in Lahore.
Study Design: Descriptive cross sectional study.
Place and Duration of Study: University of Lahore from June 2019 to December 2019.
Methods: Study was done at different textile mills in Lahore, Pakistan. Self-designed proforma was used to record data including age, gender, occupation, any medication or surgery. The workers with best corrected visual acuity of 6/6 and refractive error less than 3.00 D of sphere or astigmatism less than 1 D of cylinder with no history of ocular surgeries were included in the study. Color vision was assessed using Ishihara Isochromatic color plates. Examination of the anterior segment and posterior segment was done by using slit lamp Biomicroscopy and 90 D of condensing lens.Data was entered and analyzed using the SPSS version 22.
Results: During this study 1,250 textile mill workers fulfilled the inclusion criteria. Six hundred fifty were males and 600 were females. Only 10 workers were suffering from color vision deficiency, which was 0.8% of the total sample size. All of the color vision deficiency patients were male of different age group.
Conclusion: It has been concluded that although textile industry is based on colors, there is no proper color vision examination in our textile sector. Colour vision deficiency awareness should be increased so that everyone in the community is well aware of it. The test of color vision must be made compulsory in pre-employment examination at public and private sector at every Level.
Surgical Approach to Control Advanced Coats Disease
Authors: Özdek Şengül , Üçgül Ahmet Yücel 
Published: April 2021

Coats disease, first described by George Coats in 1908, is commonly a unilateral clinical entity characterized by leaky telangiectatic vessels leading to progressive subretinal exudation and exudative retinal detachment (ERD).1 It is generally seen in pediatric population and has a distinct male predilection of over 90%. Shields et al.2 classified Coats disease into five stages as follows: Stage 1: presence of retinal telangiectasia only, Stage 2: telangiectasia and exudation (2A: extrafoveal exudation, 2B: foveal exudation), Stage 3: exudative RD (3A: subtotal RD, 3B: total RD), Stage 4: total RD and neovascular glaucoma, Stage 5: advanced end-stage disease.
Disease progression can be controlled with ablative therapies such as laser photocoagulation (LFK) and cryotherapy in the early stages of Coats disease. However, ablative therapies are not effective in the late stages (Stage 3 – 4) due to excessive subretinal exudation and ERD. Therefore, adjunctive surgical approaches have become popular in the treatment of advanced Coats disease. This helps in effective ablation of leaky abnormal vessels.
Types of Pattern Strabismus and Their Surgical Outcomes after Adjustable Strabismus Surgery
Authors: Nadeem Sana 
Published: April 2021

Purpose: To study the different types of pattern strabismus and their surgical outcomes after adjustable strabismus surgery.
Study Design: Prospective, interventional study.
Place and Duration of Study: Eye department, Fauji Foundation Hospital, Rawalpindi (June, 2016 to March, 2019).
Methods: A total of 40 consecutive patients with pattern strabismus were included in the study. After complete orthoptic assessment, the patients underwent either rectus muscle transposition or oblique muscle surgery, by adjustable squint surgery. The pre-operative evaluation of different strabismus patterns, deviations, and post-operative results were measured and analyzed. The amount of postoperative pattern change was measured at 6 weeks postoperatively, to assess the success of the surgeries.
Results: Out of 40 patients, 33 were females and 7 were males. The age ranged from 7 to 69 years (mean 18.05 ± 9.6). All patients were operated by using adjustable suture technique. “V” pattern was seen in 26 cases (65%) and “A” pattern was seen in 12 (30%) cases. The mean preoperative pattern was 13.2 ± 8.09 PD (prism diopters), and the mean postoperative pattern was 2.05 ± 2.96 PD. Surgical success was defined as the amount of pattern collapse at 6 weeks, the period at which a stable alignment was achieved. The difference between the preoperative and postoperative pattern deviation was statistically significant (p = 0.000). Correction of the pattern was seen in 92.5% of patients at average follow up of 50.87 ± 14.02 days.
Conclusions: Pattern Strabismus can be corrected by varying rectus muscle transpositions or oblique muscle surgery during routine adjustable strabismus surgery.
Key Words: Strabismus, V pattern, A pattern, Y pattern, X pattern, lambda pattern, muscle transposition.
Corneal Endothelial Cell Density and Retinal Nerve Fiber Layer in Primary Open Angle Glaucoma, Normal Tension Glaucoma and Ocular Hypertension
Authors: Khan Bakht Samar , Nawaz Abid , Shami Lyla , Irshad Zubaida , Ahmad Mansoor 
Published: April 2021

Purpose: To compare the corneal endothelial cell density (CED) and retinal nerve fiber layer thickness (RNFL) in primary open angle glaucoma (POAG), normal tension glaucoma (NTG) and ocular hypertension (OHT).
Study Design: Cross sectional Observational study.
Place and Duration of Study: Khyber Teaching Hospital, Peshawar, from April 2016 to March 2018.
Methods: Patients having a single IOP reading of 21 mm Hg or more with glaucomatous cupping, visual field defect and open angle were labeled as POAG. Patients with IOP less than 21 mm Hg with same findings were labeled as NTG. Those eyes with raised IOP (more than 21 mm Hg), normal visual field and optic disc were labeled as OHT. Corneal endothelial cell count, central corneal thickness and retinal nerve fiber layer (RNFL) thickness were measured in patients of POAG, NTG and OHT. These were compared with normal age matched values.
Results: Thirty eyes with POAG, 10 with OHT and 10 with NTG were included in the study. In patients with POAG there was 13.33% CED and 27.7% mean RNFL thickness loss. In patients with NTG there was 3.06% CED and 34.04% mean RNFL thickness loss. In patients with OHT there was 7.17% CED and 5.5% mean RNFL thickness loss.
Conclusion: The loss of both RNFL thickness and CED occurs in POAG, OHT and NTG. Severe loss of RNFL thickness occurs in POAG and NTG while severe loss of CED occurs in POAG and OHT. Mild loss of RNFL thickness occurs in OHT while mild loss of CED occurs in NTG.
Key Words: Specular Microscopy, Optical Coherence Tomography, Nerve Fiber Layer, Open Angle Glaucoma, Ocular Hypertension.
Effects of Intra-vitreal Injection of Bevacizumab as an Adjunct during Phacoemulsification in Diabetic Maculopathy
Authors: Bodla Ali Afzal , Minahil Kazmi Syeda , Tariq Noor , Moazzam Ayema , Muneeb Aman Muhammad 
Published: April 2021

Purpose: To study the effects of Intra-vitreal injection of Bevacizumab as an adjunct during phacoemulsification in patients with diabetic retinopathy.
Study Design: Quasi experimental study.
Methods: Hundred diabetic patients who were scheduled to undergo phacoemulsification were included in the study. They were equally divided into two groups; Bevacizumab and control group. Complete ocular examination and macular thickness and volume were determined using an OPTOVUE-OCT machine. The patients in the Bevacizumab group were given intra-vitreal injection of 1.25 mg/0.05ml of Bevacizumab at the time of Phacoemulsification. A written ethical approval was obtained and the study was conducted according to principles of declaration of Helsinki.
Results: The bevacizumab group manifested low value of CMT one month post-surgery as compared to the control group (262.2 ± 32.2 and 288.5 ± 54.1, respectively) with P = 0.01. The Total Macular volume, and Best-corrected visual acuity in the two groups showed no significant difference one month after surgery. Amongst the patients who developed postsurgical macular edema, four patients did not possess a positive history for diabetic retinopathy and 3 of them had Non Proliferative Diabetic Retinopathy. We found no significant relationship between the post-surgical macula edema with the presence of mild Non Proliferative Diabetic Retinopathy. (Fisher's test, P = 0.321).
Conclusion: The ocular anti-VEGF therapy substantially reduces macular edema secondary to post-surgical inflammation in diabetic patients. It effectively reduces the central macular thickness although the results are not found to be statistically significant when compared with the control group.
Key Words: Diabetes mellitus; diabetic macular edema; diabetic retinopathy: Bevacizumab.
Results of Intravitreal Bevacizumab as an Adjunct to mETDRS Grid Laser in Diabetic Macular Edema
Authors: Khanzada Mahtab Alam , Ahmed Munawar , Mirza Azfar Ahmed , Mari Ghazi Khan , Mahmood Muhammad Arshad 
Published: April 2021

Purpose: To assess the efficacy of Intravitreal Bevacizumab as an adjuvant to grid laser photocoagulation in patients with diffuse macular edema (DME) in type II diabetes.
Study Design: Quasi experimental study.
Place and Duration of Study: Institute of ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, from September 2016 to November 2018
Methods: Ninety five patients with diffuse macular edema in type II diabetes were selected by convenient sampling. Group I patients were treated with ETDRS grid laser photocoagulation. Group II patients were treated with ETDRS grid laser photocoagulation followed by intravitreal bevacizumab after one week monthly for 2 months and then as per need. All patients were examined after 1st, 2nd and 3rd month and mean change in best corrected visual acuity (BCVA) and central macular thickness (CMT).Statistical analysis was done on SPSS version 20.0. Paired t-test was used to compare mean values and p valve < 0.05 was accepted as statistically significant.
Results: The results of study were compared with the baseline values. The mean change in BCVA in group 1 was from 46 ± 18 letters to 52 ± 17. BCVA in group 2 was from 46 ± 18 letters to 56 ± 17 (P < 0.001). The decrease in macular edema thickness was more in group II than group I (P < 0.001).
Conclusion: Macular Grid laser with or without Intravitreal Bevacizumab significantly improves vision and decreases macular edema but combined treatment led to more stable improvement in DME during follow-up.
Key Words: Modified ETDRS laser, Bevacizumab, Macular edema, Anti-VEGF.
Comparative Study of Intraocular Pressure Measurements with Airpuff, iCare and Goldmann Applanation Tonometers
Authors: Mirza Umair Tariq , Sadiq M. Usman , Sadiq M. Irfan , Raza Ali , Khan Waseem Ahmed 
Published: April 2021

Purpose: To compare the difference in intraocular pressure (IOP) measurements by Airpuff, iCare and Goldmann Applanation Tonometers (GAT).
Study Design: Comparative analytical study.
Place and Duration of Study: Department of Ophthalmology, Mohi-ud-Din Teaching Hospital, Mirpur Azad Kashmir, from June 2020 to August 2020.
Methods: Twenty-five patients (50 eyes) were included in this study. IOP was measured in each eye firstly by Airpuff tonometery, then by iCare tonometery and lastly by Goldmann applanation tonometer. Three consecutive readings were taken in each eye. If there was a difference of 2 mm Hg or more among the readings, measurement was repeated. Once we got three readings, their average was taken and analyzed. Comparison of IOP readings between these tonometers was done.
Results: Mean IOP was 15.84 ± 2.736 mm Hg with Airpuff Tonometer, 14.48 ± 2.435 mm Hg with iCare Tonopen and 14.74 ± 2.489 mm Hg with Goldman Applanation Tonometer. The difference between the mean Airpuff and Goldman Applanation Tonometer readings was 1.10 mm Hg which was not statistically significant (p-value = 0.083). The difference between the mean Goldman Applanation Tonometer and iCare Tonopen readings was 0.26 mm Hg which is also not statistically significant (p-value = 0.867). But, the difference between the mean iCare Tonopen and Airpuff Tonometer readings was -1.36 mm Hg which was statistically significant (p-value = 0.02).
Conclusion: It is concluded that IOP readings taken by iCare Tonopen and Airpuff Tonometer are comparable to those taken by Goldman Applanation Tonometer and iCare Tonopen underestimates the IOP when compared with Airpuff Tonometer.
Key Words: Airpuff Tonometer, Glaucoma, Goldmann Applanation Tonometer, iCare Tonometer, Intraocular Pressure.
Role of Optical Coherence Tomography (OCT) in Early Detection of Subclinical Cystoid Macular Edema after Nd-YAG Laser Capsulotomy
Authors: Shaikh Muhammad Adnan , Dareshani Shela , Faiz-ur-Rab Khowaja , Saleem Tariq , Ali Mazhar 
Published: April 2021

Purpose: To determine role of optical coherence tomography (OCT) in early detection of subclinical cystoid macular edema (CME) after Nd-YAG laser capsulotomy in patients with posterior capsular opacification (PCO).
Study Design: Descriptive case-series.
Place and Duration of Study: Department of Ophthalmology Unit 1, Dow University of Health Sciences and Civil Hospital Karachi from 1-July-2015 to 31-Dec-2015.
Methods: A total of 72 eyes with unilateral or bilateral visually significant PCO following uncomplicated cataract surgery with posterior chamber intraocular lens implantation were included in the study. Patients with corneal opacities, glaucoma, retinopathy, maculopathy, optic neuropathy, complicated cataract surgery, previous ocular surgery other than cataract surgery and High refractive errors were excluded from the study. Best-corrected visual acuity (BCVA), Slit lamp examination, posterior segment examination and macular thickness was measured using spectral domain (TOPCON 3D OCT) optical coherence tomography before laser and at 1 week and at 1 month after laser.
Results: Mean age was 55.76 ± 5.28 with Confidence interval of 55.02 – 56.49 years. Eighty-one were males and 122 were females. Subclinical cystoid macular edema (CME) was found in 10 (14%) patients. Out of the patients who had CME, 3 were in age group of 40-55 years and seven were in age group of 56-70 years. P value was found to be significant i.e. (P = 0.039).
Conclusion: Optical coherence tomography OCT is a non invasive and useful tool for early detection and management of subclinical cystoid macular edema after Nd-YAG laser capsulotomy in patients having posterior capsular opacification (PCO).
Key Words: Cystoid Macular Edema, Nd-YAG laser, Posterior Capsular Opacification. Optical Coherence Tomography (OCT).
Internal Limiting Membrane (ILM) Peeling for Macular Edema Secondary to Branch Retinal Vein Occlusion (BRVO)
Authors: Khaqan Hussain Ahmad , Imtiaz Usman , Baksh Hasnain Muhammad , Ur Rehman Hafiz Ateeq , Naz Raheela 
Published: April 2021

Purpose: To find out the anatomic and functional outcomes of pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling in patients with refractory macular edema associated with branch retinal vein occlusion (BRVO).
Study Design: Interventional case series.
Place and Duration of Study: Ophthalmology department at Lahore General Hospital, Lahore from 2015 to 2019.
Methods: Fifty-five eyes of patients presenting with refractory macular edema associated with branch retinal vein occlusion (BRVO) were recruited for this study. They were treated using 23-gauge pars plana vitrectomy and Brilliant Blue Green assisted internal limiting membrane peeling. Pre-operative and post-operative best-corrected visual acuity (BCVA) and macular edema were assessed by fluorescein angiography and optical coherence tomography (OCT). Monthly follow up was continued for one year.
Results: In 46 (83.6%) eyes, central macular thickness improved from 465 ± 91 µm at baseline to 295 ± 103 µm post-operatively, (P < 0.003) at one year of followup. In nine (16.3%) eyes, there was no improvement in central macular thickness. Improvement in best-corrected visual acuity (BCVA) was seen in 43 (78.1%) eyes. Out of these 43 eyes, 37 (86%) eyes had mean 3 Snellen lines improvement while six (13.9%) eyes had 2.4 Snellen lines improvement. In 12 eyes (21.8%) BCVA did not improve. No statistically significant difference was seen in post-operative BCVA between ischemic and non-ischemic BRVO (p > 0.05).
Conclusion: Twenty-three gauge vitrectomy with Brilliant Blue Green (BBG) assisted ILM peeling is effective in reducing refractory macular edema and improves visual acuity in ischemic and non-ischemic BRVO.
Key Words: Internal limiting membrane, Macular edema, Retinal vein occlusion, Brilliant Blue Green.
Pattern of Orbital Diseases at a Tertiary Oculoplastic Center
Authors: Idris Mohammad , Yaqoob Hassan , Khan Muhammad Adnan , Zar Adnan , Ullah Saif 
Published: April 2021

Purpose: To determine the causes and frequency of orbital involvement by systemic disorders and non-ocular trauma at a tertiary Oculoplastic centre.
Study Design: Descriptive cross-sectional retrospective study. Ophthalmology unit
Place and Duration of Study: Department of Ophthalmology, Lady Reading Hospital Medical teaching Institute, Peshawar from January 2012 and Dec 2016.
Methods: A total of 45 patients were included in this study. Patients’ demographics, clinical cause of orbitopathy and time delay between the problem noticed by the patient and presentation were recorded. Orbitopathy included the presence of corneal and conjunctival changes, optic nerve disorders, proptosis, orbital bone changes and soft tissue swelling of eyelids. The data was analyzed using SPSS software (version 22). The frequency (percentage) and mean ± standard deviation were reported for categorical variables.
Results: Mean age of the patients was 28.89 ± 22.02 years. There were 26 (57.8%) males 19 (42.2%) females. Commonest disorder was Bacterial Infection in 16 (35.6%) patients followed by Thyroid orbitopathy, which was seen in 14 (31.1%) cases. Other causes included Leukemia, Lymphoma, Retrobulbar Hemorrhage, Neurofibromatosis, Neuroblastoma, Maxillary Osteosarcoma, Teratoma and Fungal Infection. Time delay between presentation of orbital swelling and first noticed by patient was 147.02 ± 155.18 weeks in male while in female the time delay was 148.79 ± 146.47 weeks.
Conclusion: The commonest inflammation was due to thyroid, commonest infection was bacterial infection and commonest tumor was leukemia. Imaging and proper workup is important to properly treat any orbital disease.
Key Words: Orbit, Ocular trauma, Neuroblastoma, Orbital lymphoma.