Outcome of phacoemulsification without anti-vascular endothelial growth factor in patients with treatment naïve diabetic retinopathy.

INTRODUCTION: This retrospective, non-randomized, observational study was conducted at ASG Eye Hospital, Kathmandu to evaluate the outcome of phacoemulsification without anti-Vascular Endothelial Growth Factor (VEGF) in patients with treatment naïve diabetic retinopathy. MATERIALS AND METHODS: Records of all patients who underwent phacoemulsification without Bevacizumab in treatment of naïve patients with any grade of non-proliferative Diabetic Retinopathy (NPDR) were seen. Pre-operative and post-operative visual acuity along with central macular thickness (CMT) was compared. RESULTS: The study comprised 32 eyes of 20 patients with treatment naïve non-proliferative Diabetic Retinopathy who underwent phacoemulsification. Twelve were men and eight were women with an average age of 69.2 years (range 55 years to 83 years). The average preoperative central macular thickness as measured on optical coherence tomography was 254.63± 20.25 microns and 1-month postoperative central macular thickness was 254.72± 19.96 microns; the study did not find any significant difference (p-value 0.918). The average difference in the central macular thickness between the 1-month postoperative and preoperative values was 0.09 microns. CONCLUSION: Uneventful phacoemulsification in eyes with treatment naïve diabetic retinopathy does not cause an increase in central macular thickness after surgery and thus anti-Vascular Endothelial Growth Factor as an adjunct is not mandatory.

External Dacryocystorhinostomy and Patient Satisfaction: Perspective of General Ophthalmologist.

INTRODUCTION: This study aimed to evaluate patient satisfaction over time in patients undergoing external dacryocystorhinostomy for primary nasolacrimal duct obstruction when done by a general ophthalmologist. MATERIALS AND METHODS: This prospective interventional case series was done in a secondary level eye hospital in the Midwestern region of Nepal from 1st January 2018 to 30th December 2018. Fifty-four consecutive adult patients diagnosed with primary nasolacrimal duct obstruction who underwent external dacryocystorhinostomy performed by a general ophthalmologist were included. The surgical success rate was determined at six months on the basis of the resolution of symptoms with patency on syringing. Postoperative patient satisfaction was evaluated 6 months after surgery with a standardized Glasgow Benefit Inventory and post-intervention questionnaire. RESULTS: A total of 54 eyes were operated on within the study period and a larger number of surgeries were done in the age group 26-30 years. Female constituted 79.6 % and male 20.4% with a ratio of 3.9:1. Overall surgical success rate 6 months after surgery was 96.30%. The mean total Glasgow benefit inventory (GBI) score was 48.83 ± 23.87 (95% CI, 42.96- 56.95), mean general subscale score was 52.70± 23.28 (95% CI, 46.49-60.38), social support subscale was 49.69 ± 44.68 (95% CI, 41.15-60.35) and physical health subscale score was 37.07 ± 41.19 (95% CI, 27.48-49.26). CONCLUSION: The external dacryocystorhinostomy surgeries performed by general ophthalmologists achieved an excellent surgical success rate and good patient satisfaction proven by a validated questionnaire.