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Yuen KSC, Chan DDN, Chan WM, Lam DSC. A brief history of punctoplasty: the 3-snip revisited. Eye (Lond) 2006; 20:402-3; author reply 403. [PMID: 15832180 DOI: 10.1038/sj.eye.6701888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Lam DSC, Chan CKM, Mohamed S, Lai TYY, Li KKW, Li PSH, Tsang CW, Chan WM, Shanmugam MP. A prospective randomised trial of different doses of intravitreal triamcinolone for diabetic macular oedema. Br J Ophthalmol 2006; 91:199-203. [PMID: 16973659 PMCID: PMC1857621 DOI: 10.1136/bjo.2006.102848] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare the safety and efficacy of different doses of intravitreal triamcinolone (ivTA) in treating clinically significant diabetic macular oedema (CSMO). METHODS 63 eyes of 63 patients with CSMO and central foveal thickness (CFT) of > or =250 microm on optical coherence tomography were randomised to receive 4 mg (n = 23), 6 mg (n = 20) or 8 mg (n = 20) ivTA. Patients were followed up for 6 months, and changes in best-corrected visual acuity (BCVA), optical coherence tomography CFT, standardised change in macular thickness (SCMT), and side effects such as intraocular pressure and cataractogenesis were compared between the three groups. RESULTS After ivTA injection, improvements of BCVA and CFT occurred in all groups. The mean BCVA improvement at 6 months was significantly higher for the 8 mg group compared with the 4 mg group, with 9.9 and 3.1 improvement in letters on the Early Treatment of Diabetic Retinopathy Study chart, respectively (p = 0.047). The mean SCMT at 6 months for the 4, 6 and 8 mg groups was 28.7%, 42.3% and 60.5%, respectively (p = 0.06). The proportion of eyes with SCMT > or =75% at 6 months was higher in the 8 mg group, but the difference failed to reach significance (p = 0.06). Ocular hypertensive responses (>21 mm Hg) occurred in 39%, 30% and 55% of eyes in the 4, 6, and 8 mg groups, respectively (p = 0.27). CONCLUSIONS Higher doses of ivTA may prolong the duration of visual benefit in diabetic CSMO and seemed to result in more sustained reduction in macular oedema. Further studies are warranted to investigate the optimum dose of ivTA in treating diabetic CSMO.
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Shanmugam PM, Lam DSC. Optic pit associated serous macular detachment. Int Ophthalmol 2006; 26:119-20. [PMID: 16957874 DOI: 10.1007/s10792-006-9005-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2006] [Accepted: 08/03/2006] [Indexed: 11/27/2022]
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Gopwani R, Liu DTL, Lee VYW, Lam DSC. Pars plana vitrectomy for RD. Ophthalmology 2006; 113:1688-9; author reply 1689-90. [PMID: 16949454 DOI: 10.1016/j.ophtha.2006.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Accepted: 05/19/2006] [Indexed: 11/19/2022] Open
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Luk FOJ, Leung DYL, Yuen HKL, Lam DSC. Late leakage of filtering bleb in a patient with orbital pseudotumor. Eur J Ophthalmol 2006; 16:611-3. [PMID: 16952103 DOI: 10.1177/112067210601600418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report an unusual case of spontaneous late leakage of filtering bleb in a patient with orbital pseudotumor. METHODS Single case report. RESULTS A 53-year-old woman developed spontaneous leakage of bleb in her right eye 23 years after trabeculectomy with application of mitomycin-C (MMC). Two weeks later, her symptoms were blurring of vision, increasing redness, and dull ocular pain in the right eye. The inflammatory signs were suggestive of endophthalmitis, orbital cellulites, or pseudo-tumor. Absence of ophthalmoplegia, fever, and raised white cell count, together with the computed tomographic scan finding, confirmed the diagnosis of orbital pseudotumor. She responded well to oral steroids. CONCLUSIONS Orbital pseudotumor may initially present with spontaneous late leakage in a bleb augmented by MMC. Orbital pseudotumor should be added to the list of differential diagnoses when facing a patient with an inflamed, chemotic, proptotic eye in the presence of a late bleb leak.
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Cheng ACK, Young AL, Law RWK, Lam DSC. Prospective Randomized Double-Masked Trial to Evaluate Perioperative Pain Profile in Different Stages of Simultaneous Bilateral LASIK. Cornea 2006; 25:919-22. [PMID: 17102667 DOI: 10.1097/01.ico.0000226363.19054.2a] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the perioperative pain profile in simultaneous bilateral LASIK. METHODS Fifty consecutive Chinese patients undergoing simultaneous bilateral LASIK were randomly allocated to have either the right or left eye operated first. The pain scores for each eye at speculum placement, microkeratome cut, laser ablation, and at 15, 30, and 45 minutes after the procedure were recorded. In addition, an overall score for the whole operation was evaluated immediately after the procedure for each eye. Comparisons between eyes and among different stages of the procedures were analyzed. RESULTS The second eye was significantly more painful than the first eye at the stage of speculum placement and microkeratome pass (P < 0.001). Laser ablation was the least painful stage for both eyes. There were no statistical differences in pain scores for the postoperative period. CONCLUSION Higher pain scores were associated with the stages involving eyelid manipulation. In patients with small palpebral fissures where stretching of the eyelid structures are anticipated, supplementary anesthesia for the lid region should be considered when required.
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Chan WM, Liu DTL, Lam DSC. Precautions in ophthalmic practice in a hospital with a major acute SARS outbreak: an experience from Hong Kong. Eye (Lond) 2006; 21:305-6. [PMID: 16946743 PMCID: PMC7091713 DOI: 10.1038/sj.eye.6702580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Long Q, Chu R, Zhou X, Dai J, Chen C, Rao SK, Lam DSC. Correlation Between TGF-β1 in Tears and Corneal Haze Following LASEK and Epi-LASIK. J Refract Surg 2006; 22:708-12. [PMID: 16995554 DOI: 10.3928/1081-597x-20060901-13] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the incidence and degree of corneal haze formation following laser subepithelial keratomileusis (LASEK) and epithelial laser in situ keratomileusis (epi-LASIK), and examine its correlation with tear film transforming growth factor-beta1 (TGF-beta1) levels. METHODS This prospective, interventional, clinical trial included 20 eyes (20 patients) randomly assigned to undergo LASEK or epi-LASIK. The level of TGF-beta1 in tear fluid was measured preoperatively and 1, 3, and 5 days postoperatively. Corneal haze was graded at 1 and 3 months after surgery, and the relationship with TGF-beta1 levels was determined. RESULTS Mean preoperative spherical equivalent refraction was -4.50 +/- 1.44 diopters (D) (range: -1.50 to -6.00 D) for LASEK eyes and -4.90 +/- 1.26 D (range: -1.75 to -6.00 D) for epi-LASIK eyes. Although mean corneal haze scores at 1 month were significantly higher in LASEK-treated eyes than in epi-LASIK treated eyes (P=.031), these scores were similar at 3 months (P=.608). Tear fluid TGF-beta1 levels were similar in LASEK and epi-LASIK eyes before surgery (P=.458) and significantly higher in the LASEK group at 1, 3, and 5 days postoperatively (P=.015, P=.023, and P=.039, respectively). A positive correlation was noted between tear TGF-beta1 levels on the first postoperative day and the degree of corneal haze at 1 month (r=0.501, P=.016). CONCLUSIONS Less corneal haze was noted after epi-LASIK than LASEK. A positive correlation between corneal haze and tear fluid TGF-beta1 levels on the first postoperative day suggest a possible mechanism for the observed difference.
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Lai TYY, Fan DSP, Lai WWK, Lam DSC. Peripheral and posterior pole retinal lesions in association with high myopia: a cross-sectional community-based study in Hong Kong. Eye (Lond) 2006; 22:209-13. [PMID: 16946749 DOI: 10.1038/sj.eye.6702573] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To evaluate the prevalence and factors associated with posterior pole and peripheral retinal lesions in Chinese subjects with high myopia. METHODS Three hundred and thirty-seven asymptomatic adults with high myopia of refractive error <or=-6 D were examined in a cross-sectional community-based study. All subjects underwent cycloplegic refraction, ultrasound biometry and dilated fundal examination. Statistical analysis was performed to assess factors associated with the presence of posterior pole and peripheral retinal lesions. RESULTS The mean age of the 337 subjects was 36.0 years and the mean spherical equivalent refractive error was -10.2 D. Thirty-eight eyes (11.3%, 95% CI=8.1-15.2%) were found to have one or more posterior pole lesions and subjects with posterior pole lesion had significantly older age, longer axial length and higher degree of myopia (all P<0.001) compared with subjects without posterior pole lesion. After controlling for axial length, both the severity of refractive error and older age were significantly associated with the presence of posterior pole lesion (both P<0.001). For peripheral retinal lesions, 189 eyes (56.1%, 95% CI=50.6-61.5%) were found to have one or more peripheral retinal lesions. The presence of peripheral retinal lesion was associated with younger age and higher degree of refractive error (P=0.046 and 0.002, respectively). CONCLUSION Posterior pole and peripheral retinal degenerative lesions were found in a considerable proportion of subjects with high myopia. As some of these retinal lesions might predispose to visual impairment, highly myopic individuals should be educated on the symptoms of various eye conditions and seek care immediately if symptoms arise.
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Fan DSP, Rao SK, Yu CBO, Wong CY, Lam DSC. Changes in refraction and ocular dimensions after cataract surgery and primary intraocular lens implantation in infants. J Cataract Refract Surg 2006; 32:1104-8. [PMID: 16857495 DOI: 10.1016/j.jcrs.2006.01.097] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2005] [Accepted: 01/17/2006] [Indexed: 11/26/2022]
Abstract
PURPOSE To study refraction and axial length changes after cataract extraction and primary intraocular lens (IOL) implantation in children younger than 1 year of age. SETTING Two regional hospitals. METHODS After determining the IOL power for emmetropia, 80% of the value was used to choose the IOL for implantation to counter anticipated myopic shift with age. The main outcome measures were changes in refraction and axial length 3 years after surgery. RESULTS Thirty-four eyes of 20 children (mean age 6.7 months +/- 3.9 [SD]) were studied. Refraction in the immediate postoperative period was +4.53 +/- 1.45 diopters (D). Three years after surgery, the mean refraction was -2.49 +/- 3.08 D (P<.001). Twenty-two eyes (64.7%) had surgery during the first 6 months of life (group 1) and had a shorter axial length at surgery (mean 18.92 +/- 1.32 mm) compared with 12 eyes (35.3%) that received surgery between 7 and 12 months (group 2, mean 20.29 +/- 1.00 mm) (P = .007). However, the final axial length was greater in group 1 (mean 22.67 +/- 1.04 mm) than in group 2 (mean 21.23 +/- 0.26 mm) (P = .019). CONCLUSIONS Primary IOL implantation is an option for children having cataract surgery in the first year of life. Significant myopic shifts occurred, and this seemed to be more pronounced in younger children. It appears that rethinking current strategies for IOL power calculation may be required to achieve more optimal refractive outcomes.
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Leung DYL, Rao SK, Lam DSC. Pressure phosphene self-tonometry in a patient with Posner-Schlossman syndrome. Clin Exp Ophthalmol 2006; 34:513-5. [PMID: 16925696 DOI: 10.1111/j.1442-9071.2006.01274.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Studies have shown that pressure phosphene tonometry (PPT) may be applied to glaucoma patients. It has the potential for patients to self-monitor the intraocular pressure (IOP) at home. We describe the successful use of this approach in a patient with Posner-Schlossman syndrome. In the first part of the study, we investigated whether our patient could use PPT accurately and reliably. In the second part of the study, our patient performed daily home self-tonometry, and was educated to seek ophthalmic assessment if his self-measured IOP was >or=21 mmHg. The outcome measurements included IOP and the number of unscheduled attendances for ophthalmic assessment. The use of PPT reduced his number of unscheduled hospital visits from 0.82 to 0.47 visits per month. PPT can be applied with accuracy, reliability and safety in patients with Posner-Schlossman syndrome, with potential benefits in reducing unnecessary ophthalmic attendances by nearly 50%.
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Gopwani R, Cheng L, Tang W, Lam DSC. Surgical Technique for Recurrent Pterygium. Ophthalmology 2006; 113:1469-70; author reply 1470. [PMID: 16877085 DOI: 10.1016/j.ophtha.2006.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Accepted: 03/17/2006] [Indexed: 11/22/2022] Open
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Liu DTL, Lee VYW, Lam DSC. Clinical evaluation of the arched blade for cataract surgery. ACTA OPHTHALMOLOGICA SCANDINAVICA 2006; 84:559; author reply 559-60. [PMID: 16879586 DOI: 10.1111/j.1600-0420.2006.00661.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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214
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Fan DSP, Yip WWK, Yu CBO, Rao SK, Lam DSC. Updates on the surgical management of paediatric cataract with primary intraocular lens implantation. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2006; 35:564-70. [PMID: 17006585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
With the advent of modern surgical techniques, paediatric cataract has become much more manageable. Intraocular lens (IOL) implantation is the standard of care for patients over the age of 2 years. The use of IOL in young infants is still controversial. In addition, there are still unresolved issues, such as the minimum age at which IOL can be safely implanted, IOL power selection and IOL power calculation. The current trends in the management of the above challenges are discussed. Although numerous reports on the prevention and management of posterior capsule opacification have been published, there are ongoing intensive debates and research. Long-term postoperative complications like glaucoma and rhegmatogenous retinal detachment are problems that cannot be overemphasised and these issues are also reviewed.
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Leung DYL, Kwong YYY, Ma CH, Wong WM, Lam DSC. Canaliculitis associated with a combined infection of Lactococcus lactis cremoris and Eikenella corrodens. Jpn J Ophthalmol 2006; 50:284-5. [PMID: 16767387 DOI: 10.1007/s10384-005-0318-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2005] [Accepted: 09/12/2005] [Indexed: 10/24/2022]
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216
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Wong AL, Leung DYL, Lam DSC. Accommodation Affected by Warming? Ophthalmology 2006; 113:1249-50; author reply 1250-1. [PMID: 16815415 DOI: 10.1016/j.ophtha.2006.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2005] [Accepted: 04/07/2006] [Indexed: 11/27/2022] Open
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217
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Lai TYY, Chan WM, Li H, Lai RYK, Liu DTL, Lam DSC. Safety enhanced photodynamic therapy with half dose verteporfin for chronic central serous chorioretinopathy: a short term pilot study. Br J Ophthalmol 2006; 90:869-74. [PMID: 16597666 PMCID: PMC1857171 DOI: 10.1136/bjo.2006.090282] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2006] [Indexed: 11/04/2022]
Abstract
AIM To evaluate short term safety of an enhanced photodynamic therapy (PDT) protocol with half dose verteporfin for treating chronic central serous chorioretinopathy (CSC). METHODS 20 eyes of 18 patients with symptomatic chronic CSC underwent PDT using 3 mg/m2 verteporfin. Verteporfin was infused over 8 minutes followed by indocyanine green angiography guided laser application 2 minutes later. Serial optical coherence tomography (OCT) and multifocal electroretinography (mfERG) recordings were performed before PDT, at 4 days, 2 weeks, and 1 month after PDT. The best corrected visual acuity (BCVA), OCT central retinal thickness, and mean mfERG response amplitudes and peak latencies were compared longitudinally. Subgroup analysis was further performed for eyes with or without pigment epithelial detachment (PED). RESULTS At 1 month after PDT, the median BCVA improved from 20/40 to 20/30 (p = 0.001). The mean central retinal thickness also reduced from 276 microm to 158 microm (p < 0.001) and 17 (85%) eyes had complete resolution of serous retinal detachment and/or PED. MfERG showed no significant changes in the mean N1 and P1 response amplitude and latency for all eyes. Subgroup analysis demonstrated that eyes without PED had a significant increase in the mean central mfERG P1 response amplitude with reduction in P1 peak latency at 1 month post-PDT. For eyes with PED, transient reduction in the mean central P1 response amplitude was observed at 4 days post-PDT. CONCLUSIONS The modified safety enhanced PDT protocol with half dose verteporfin appeared to be a beneficial treatment option for patients with chronic CSC, especially in eyes without serous PED. Further controlled study is warranted to demonstrate the long term safety and efficacy of this treatment option.
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Rao SK, Basti S, Lin A, Iyer GK, Seethalakshmi G, Lam DSC. The itching, burning eye: diagnostic algorithm and management options. COMPREHENSIVE OPHTHALMOLOGY UPDATE 2006; 7:157-67; discussion 169-70. [PMID: 17007728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The healthy ocular surface is a complex, composite unit that is essential for patient comfort and visual function. A number of components need to work in an integrated manner to ensure that this is achieved, and a variety of causes can result in the final common symptom complex that can be termed the itching, burning eye. Many of these causes may be due to relatively common and simple issues related to lid disease, allergies, tear dysfunction, excessive computer use, exposure to polluted environment, and convergence problems. However, a smaller group may have potentially more serious pathology due to causes such as underlying immune dysfunction, or tumors; rarely, intraocular conditions and some neurological causes may present with ocular redness and grittiness. Failure or delay in the diagnosis of these latter entities can result in significant morbidity to the eye. This article will clarify issues related to the functioning of the ocular surface, provide a diagnostic algorithm for managing these patients, and discuss the current knowledge in the management of these conditions once they are diagnosed. It is targeted at the practicing ophthalmologist and should help him or her to manage this problem effectively.
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Lai TYY, Ngai JWS, Chan WM, Lam DSC. Visual Field and Multifocal Electroretinography and their Correlations in Patients on Hydroxychloroquine Therapy. Doc Ophthalmol 2006; 112:177-87. [PMID: 16804707 DOI: 10.1007/s10633-006-9006-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Accepted: 03/15/2006] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effects of hydroxychloroquine on visual field and multifocal electroretinography (mfERG) and their correlations in patients taking hydroxychloroquine. METHODS This was a cross-sectional study in which patients on hydroxychloroquine therapy underwent automated 10-2 threshold static visual field examination and mfERG recordings. Non-parametric unadjusted and age-adjusted Spearman correlation coefficients rho were calculated between the cumulative dose of hydroxychloroquine and the visual field mean deviation (MD) and pattern standard deviation (PSD) values; and the mfERG response amplitudes and peak latencies. Correlation analysis was also performed between the visual field MD and PSD values and the mfERG response amplitudes and peak latencies. RESULTS A total of 26 eyes in 13 patients were analyzed. The mean duration of hydroxychloroquine therapy was 4.9 years and the mean cumulative dose was 574 g. No significant correlation was found between the cumulative dose of hydroxychloroquine and the visual field MD and PSD values. There were significant correlations between the cumulative dose of hydroxychloroquine and mfERG N1 and P1 response amplitudes for the central rings (ring 1-3). The correlations between the dose of hydroxychloroquine and mfERG N1 and P1 response amplitudes were strongest for the paracentral ring 2 (rho =-0.63 and rho =-0.62, respectively, P = 0.001). Significant correlations were also found between the visual field MD values and mfERG response amplitudes of various ring eccentricities. CONCLUSIONS In patients on hydroxychloroquine, mfERG response amplitude correlated with both the 10-2 visual field MD values and with the cumulative dose of hydroxychloroquine used. The use of mfERG can provide objective measurement of retinal function in patients on hydroxychloroquine and may provide supplementary quantitative information to visual field findings.
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Rao SK, Cheung N, Lam DSC. Prophylaxis for pseudophakic cystoid macular oedema: a long way to go. Clin Exp Ophthalmol 2006; 34:295-6. [PMID: 16764645 DOI: 10.1111/j.1442-9071.2006.01245.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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221
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Leung CKS, Tham CCY, Mohammed S, Li EYM, Leung KS, Chan WM, Lam DSC. In vivo measurements of macular and nerve fibre layer thickness in retinal arterial occlusion. Eye (Lond) 2006; 21:1464-8. [PMID: 16751755 DOI: 10.1038/sj.eye.6702457] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
AIM To investigate the structure-function relationship in patients with retinal arterial occlusion by measuring the macular and the peripapillary retinal nerve fibre layer (RNFL) thickness and the visual sensitivity. METHODS This is an observational case series with three patients with central retinal arterial occlusion (CRAO) and two patients with branch retinal arterial occlusion (BRAO). The macular/peripapillary RNFL thickness and the visual field were measured with Stratus optical coherence tomography (OCT) and Humphrey visual field analyzer, respectively, at least 1 year after the diagnosis of CRAO or BRAO. RESULTS The macular thickness, in particular the inner retinal layer, and the peripapillary RNFL thickness were reduced in patients with retinal arterial occlusion. The decrease in the macular and the peripapillary RNFL thickness corresponded to the sites of retinal arterial occlusion with diffuse and segmental thinning found in CRAO and BRAO, respectively. Visual field defects were found in the corresponding locations of macular and RNFL thinning, and closely correlated with the degree of the structural damage. CONCLUSIONS Structural damages in terms of reduction in the macular and peripapillary RNFL thickness were evident in patients with retinal arterial occlusion. A close structure-function correlation was found and a worse functional outcome is associated with a more extensive thinning of the macula and RNFL. OCT measurements of the macular/peripapillary RNFL thickness provide useful indicators to reflect the severity of the disease in retinal arterial occlusion and serve as a new paradigm to study and monitor the disease longitudinally.
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Cheng ACK, Rao SK, Cheng LL, Lam DSC. Assessment of pupil size under different light intensities using the Procyon pupillometer. J Cataract Refract Surg 2006; 32:1015-7. [PMID: 16814062 DOI: 10.1016/j.jcrs.2006.02.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2005] [Accepted: 12/12/2005] [Indexed: 11/27/2022]
Abstract
PURPOSE To study the relationship between pupil size and light intensity using the Procyon pupillometer. SETTING University based clinic. METHODS In this retrospective study, 20 consecutive patients had pupil size assessment with the Procyon pupillometer under 3 different light conditions--4, 0.4, and 0.04 lux. Correlation was established using the log unit of the light intensity and pupil size. RESULTS The correlation coefficient for the association between pupil size and log unit of light intensity in all eyes was significant (P<.001). The mean correlation coefficient for the association between pupil size and log unit of light intensity in all patients was 0.968 +/- 0.089 (SD) in the right eye and 0.970 +/- 0.031 in the left eye. CONCLUSION The linear relationship between the pupil size and the log unit of the light intensity showed a tight correlation in all cases. These results can be useful in the comparing pupil size with pupillometers that work under different light conditions.
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Lai WW, Fan H, Li H, Lam DSC. Combined phacoemulsification and pars plana vitrectomy for macular hole treatment. ACTA OPHTHALMOLOGICA SCANDINAVICA 2006; 84:445-6. [PMID: 16704725 DOI: 10.1111/j.1600-0420.2005.00609.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
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224
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Liu DTL, Lee VYW, Chiu TYH, Lam DSC. Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients. J Cataract Refract Surg 2006; 32:183; author reply 183. [PMID: 16564965 DOI: 10.1016/j.jcrs.2005.12.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Indexed: 10/24/2022]
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225
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Liu DTL, Lee VYW, Chan VCK, Lam DSC. Severe anaphylactic reaction after intracameral antibiotic administration during cataract surgery. J Cataract Refract Surg 2006; 32:188; author reply 188. [PMID: 16564975 DOI: 10.1016/j.jcrs.2005.12.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Indexed: 11/25/2022]
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226
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Chan CKM, Mohamed S, Shanmugam MP, Tsang CW, Lai TYY, Lam DSC. Decreasing efficacy of repeated intravitreal triamcinolone injections in diabetic macular oedema. Br J Ophthalmol 2006; 90:1137-41. [PMID: 16707525 PMCID: PMC1857409 DOI: 10.1136/bjo.2006.093211] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIM Intravitreal triamcinolone (IVTA) results in transient improvements in diabetic macular oedema (DMO), necessitating repeated injections. The authors report a case series of 10 eyes of 10 patients with DMO, who received a repeat injection of 4 mg IVTA, at least 26 weeks after the first injection of the same dose. METHOD Pre-injection and at 2, 4, 9, and 17 weeks post-injection, best corrected visual acuity (BCVA) and central foveal thickness (CFT) on optical coherence tomography, after the first and repeat injections, were compared using paired t test. Side effects were monitored. RESULTS BCVA, CFT, intraocular pressure (IOP), and cataract scores were not significantly different before initial and repeat injections (given at 32.5 (SD 3.5) weeks after the first injection). Transient improvements of BCVA and CFT were achieved after both injections. However, after the repeat injection, the BCVA was significantly worse at all time points (p<0.05) and so were the best achieved CFT and the CFT at 4 weeks post-injection (p = 0.034 and 0.011 respectively), compared with the initial injection. Post-injection maximum IOPs and increase in cataract scores were not significantly different between the two injections. CONCLUSION A repeat injection of 4 mg of IVTA may not be as effective as an initial injection for the treatment of DMO.
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Lai TYY, Kwok AKH, Au AWH, Lam DSC. Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with indocyanine green-assisted internal limiting membrane peeling. Graefes Arch Clin Exp Ophthalmol 2006; 245:148-54. [PMID: 16705448 DOI: 10.1007/s00417-006-0352-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2005] [Revised: 01/30/2006] [Accepted: 04/07/2006] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To evaluate the changes in macular function and potential retinal toxicity in epiretinal membrane (ERM) surgery with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling using multifocal electroretinography (mfERG). METHODS Thirteen eyes of 13 patients were randomly assigned to have ERM surgery with ILM peeling using 0.5 mg/ml or 1.25 mg/ml ICG staining. Patients were examined at baseline and at 3 and 6 months postoperatively. The postoperative mfERG N1 and P1 response amplitudes and peak latencies of various ring eccentricities were assessed and compared with baseline to determine any serial changes. RESULTS After surgery, the median best-corrected visual acuity improved from 20/70 at baseline to 20/30 at 6 months postoperatively (Wilcoxon signed-ranks test, P=0.004). At 3 months postoperatively, the 0.5 mg/ml group showed no significant changes in N1 and P1 response amplitudes and peak latencies, whereas the 1.25 mg/ml ICG group showed significant reductions in N1 and P1 response amplitudes compared with baseline. No significant changes in mfERG responses were observed in either group at 6 months after surgery. CONCLUSIONS Our mfERG findings suggested that the use of a higher concentration of ICG for ILM staining might result in transient retinal functional impairment postoperatively. The lowest possible concentration of ICG should be used intraoperatively to minimize potential retinal toxicity.
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Fan DSP, Tang EWH, Rao SK, Xiu-Qin Z, Lam DSC. The use of peribulbar anaesthesia in paediatric cataract surgery (age 7-15 years) in a mobile eye camp in China. ACTA ACUST UNITED AC 2006; 84:384-7. [PMID: 16704703 DOI: 10.1111/j.1600-0420.2005.00599.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the feasibility and acceptability of the use of peribulbar anaesthesia (PA) in paediatric cataract surgery in rural areas in China, where there are limitations in expertise and equipment for general anaesthesia (GA). METHODS We prospectively evaluated the feasibility and acceptability of carrying out paediatric cataract surgery under PA in children aged 7-15 years. Informed consent was obtained from the subjects and their parents. Children were assessed for their suitability for PA. Peribulbar anaesthesia was given as a peribulbar block using a 2% lidocaine, 0.5% bupivacaine-hyaluronidase mixture administered before lens aspiration with intraocular lens implantation. The acceptability of the PA was evaluated by questionnaire. RESULTS A total of 19 patients were recruited. Their mean age was 12 +/- 2 years (range 7-15 years). None required conversion to GA. All subjects regarded PA as either totally acceptable (63.2%) or acceptable (36.8%). The mean pain scores (from 0 to 100) during the injection and surgery were 28 +/- 26 and 6 +/- 8, respectively. Seventeen patients (89.5%) said they would prefer PA if choices in anaesthesia were offered again. CONCLUSIONS Peribulbar anaesthesia can be considered as a viable option in selected children undergoing cataract surgery when facilities for safe and optimal general anaesthesia are unavailable.
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Tham CCY, Li FCH, Leung DYL, Kwong YYY, Yick DWF, Chi CC, Lam DSC. Intrableb triamcinolone acetonide injection after bleb-forming filtration surgery (trabeculectomy, phacotrabeculectomy, and trabeculectomy revision by needling): a pilot study. Eye (Lond) 2006; 20:1484-6. [PMID: 16691258 DOI: 10.1038/sj.eye.6702372] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Lam RF, Lai WW, Chan WM, Liu DTL, Lam DSC. Vitrectomy for Diabetic Macular Edema with and without Internal Limiting Membrane Removal. Ophthalmologica 2006; 220:206; author reply 206-7. [PMID: 16679799 DOI: 10.1159/000091768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2005] [Accepted: 09/16/2005] [Indexed: 11/19/2022]
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Liu DTL, Lee VYW, Kwok MKM, Chan WM, Lam DSC. Correlation study between optical coherence tomography and fluorescein angiography in post-membrane peeling recalcitrant macular oedema. Clin Exp Ophthalmol 2006; 34:282-3. [PMID: 16671913 DOI: 10.1111/j.1442-9071.2006.01206.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Correlation between optical coherence tomography and fluorescein angiography in a post-membrane peeling patient indicated a surgically disturbed retinal vessel as the cause of recalcitrant macular oedema.
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Abstract
PURPOSE To study the effects of Complex Tropicamide (0.5% Tropicamide and 0.5% phenylephrine HCI) and Saline solution on corneal thickness in adult myopic patients with the Orbscan II system. SETTING Department of Ophthalmology, Yantai Yuhuangding Hospital. DESIGN Prospective, nonrandomized, clinical trial. METHODS The thinnest pachymetry of the cornea was obtained before and 1.5 hours after administration of three drops of Complex Tropicamide to the left eyes of 58 patients (58 eyes) and Saline solution to their 31 right eyes, respectively. The corneal thickness of the other 27 right eyes before and 1.5 hours after eyelid closure without exposure to eye drops was used as the control group. RESULTS The thinnest pachymetry of the cornea was significantly higher after exposure to eye drops in the Tropicamide group (23.36 +/- 15.01 microm; t = -11.855, P < 0.001). Similar findings were also noted in the Saline group (7.13 +/- 8.11 microm, t = -4.894, P < 0.001). The difference between the two groups was also significant (t = 6.737, P < 0.001). There were no statistically changes in corneal thickness in control group. The drops tested have no effect on the location of the thinnest corneal site and its distance form the visual axis. CONCLUSION Eye drops including Saline solutions may have significant effects on the corneal thickness in myopia, and this may have implications for corneal refractive surgery.
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Li KKW, Tam BSM, Lam SW, Chan WM, Lam DSC. 25-Gauge Vitrectomy. Ophthalmology 2006; 113:888-9. [PMID: 16650693 DOI: 10.1016/j.ophtha.2006.01.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Accepted: 01/23/2006] [Indexed: 11/24/2022] Open
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Cheng ACO, Yuen HKL, Lucas PW, Lam DSC, So KF. Characterization and Localization of the Supraorbital and Frontal Exits of the Supraorbital Nerve in Chinese: An Anatomic Study. Ophthalmic Plast Reconstr Surg 2006; 22:209-13. [PMID: 16714932 DOI: 10.1097/01.iop.0000217795.30085.7a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To elucidate the characteristics and location of the supraorbital and frontal exits of the supraorbital nerve in Chinese skulls and to compare these findings with other ethnic populations. METHODS The anatomy of the supraorbital nerve exits was studied in 97 adult Chinese skulls (194 orbits). The characteristics and location of the supraorbital nerve exits were determined. Analyses were performed to compare differences between sexes and sides. Data were then compared with those of the other populations. RESULTS Supraorbital exits were found in all 194 orbits. Among these, 89 (45.9%) were foramina. Frontal exits were found in 69 of the 194 (35.6%) orbits in which 18 were foramina (9.3%). The location of the supraorbital exits showed a skewed distribution toward the medial aspect of the superior orbital rim. The median distance between the supraorbital exits and the facial midline was 24.56 mm. Eighty percent of the supraorbital exits lay between 20.77 mm and 30.52 mm from the facial midline. The mean frontal exit was 7.02 mm medial to the supraorbital exits. Compared with other populations, a higher proportion of Chinese have foramina above the superior orbital rim as the exits for the supraorbital neurovascular bundle. The location of the supraorbital nerve exit is highly variable in all studied populations. CONCLUSIONS In a significant proportion of Chinese, the supraorbital nerve exits are located toward the medial aspect of and above the superior orbital rim. Extra care should be taken during dissection around this region to avoid damage to the supraorbital nerve.
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Abstract
PURPOSE To report the management and outcome of late onset traumatic dislocation of LASIK flaps. METHODS This retrospective, interventional case series presents three patients with late onset LASIK flap dislocation following mechanical trauma 1 to 7 years postoperatively. RESULTS In all cases, the flap was surgically repositioned. Epithelial ingrowth was removed and diffuse lamellar keratitis was treated with an intensive steroid regimen. All patients returned to their preoperative best spectacle-corrected visual acuity. Aggressive steroid treatment during the perioperative period and meticulous handling of the epithelium are important in preventing further recurrence. CONCLUSIONS Laser in situ keratomileusis flaps may experience mechanical dislocation as late as 7 years postoperatively. Diffuse lamellar keratitis and epithelial ingrowth are associated with flap dislodgment.
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Lai TYY, Leung GM, Wong VWY, Lam RF, Cheng ACO, Lam DSC. How Evidence-Based Are Publications in Clinical Ophthalmic Journals? ACTA ACUST UNITED AC 2006; 47:1831-8. [PMID: 16638988 DOI: 10.1167/iovs.05-0915] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the methodological quality and level of evidence of publications in four leading general clinical ophthalmology journals. METHODS All 1919 articles published in the American Journal of Ophthalmology, Archives of Ophthalmology, British Journal of Ophthalmology, and Ophthalmology in 2004 were reviewed. The methodological rigor and the level of evidence in the articles were rated according to the McMaster Hedges Project criteria and the Oxford Centre for Evidence-Based Medicine levels of evidence. RESULTS Overall, 196 (24.4%) of the 804 publications that were included for assessment met the Hedges criteria. Articles on economics evaluation and those on prognosis achieved the highest passing rate, with 80.0% and 74.4% of articles, respectively, meeting the Hedges criteria. Publications on etiology, diagnosis, and treatment fared less well, with respective passing rates of 28.3%, 20.2%, and 14.7%. Published systematic reviews and randomized controlled trials were uncommon in the ophthalmic literature, at least in these four journals during 2004. According to the Oxford criteria, 57.6% of the articles were classified as level 4 evidence compared with 18.1% classified as level 1. Articles on prognosis had the highest proportion (43.0%) rated as level 1 evidence. Generally, articles that reached the Hedges threshold were rated higher on the level-of-evidence scale (Spermans rho = 0.73; P < 0.001). CONCLUSIONS The methodological quality of publications in the clinical ophthalmic literature was comparable to that in the literature of other specialties. There was substantial heterogeneity in quality between different types of articles. Future methodological improvements should focus on the areas identified as having the largest deficiencies.
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Wat CSK, Yuen HKL, Tse KK, Lam DSC, Chan N. Multiple Eyelid Defects in Cutaneous Langerhans Cell Histiocytosis. Ophthalmic Plast Reconstr Surg 2006; 22:216-8. [PMID: 16714935 DOI: 10.1097/01.iop.0000217567.90717.52] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Langerhans cell histiocytosis is a disorder characterized by the proliferation of histiocytes of the mononuclear phagocyte system. Cutaneous Langerhans cell histiocytosis can develop as a solitary lesion or more frequently as part of a multisystem disease. This report describes a case of cutaneous Langerhans cell histiocytosis affecting the eyelids, resulting in a coloboma-like defect. The clinical features and management are discussed.
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Fan DSP, Chan CKM, Cheng ACK, Rao SK, Yu CBO, Lam DSC. Multistage approach to uveitic cataract management in children. J Pediatr Ophthalmol Strabismus 2006; 43:172-5. [PMID: 16761640 DOI: 10.3928/01913913-20060301-07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Phototherapeutic keratectomy, cataract extraction and hydrophobic acrylic lens implantation, Nd:YAG laser capsulotomy, glaucoma valve implantation, and intravitreal steroid injections resulted in substantial visual improvement in three eyes of two children with complicated cataract due to severe uveitis. At follow-up of 6 months to 4 years, the children had clear corneas and normal intraocular pressures.
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Chan CKM, Mohamed S, Tang EWH, Shanmugam MP, Chan NR, Lam DSC. Encapsulated triamcinolone cyst after subtenon injection. Clin Exp Ophthalmol 2006; 34:360-2. [PMID: 16764657 DOI: 10.1111/j.1442-9071.2006.01223.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The authors report the formation of a subtenon cyst following subtenon triamcinolone injection for chronic recurrent uveitis in Behçet's disease. The steroid was inadvertently placed superficially in the anterior subtenon space and was encapsulated eventually to present as a subtenon cyst. The episode of uveitis recurrence, which did not regress, required treatment with a repeat posterior subtenon injection 2 months later. The cyst was removed 4.5 months after the initial subtenon injection, when the patient underwent a trabeculectomy for refractory glaucoma. Histological examination of the cyst revealed a fibrous encapsulated cavity filled with small birefringent crystals, consistent with an encapsulated triamcinolone collection. Fibrous encapsulation of triamcinolone crystals can arise after a superficially placed anterior subtenon injection and this may impede the absorption of the corticosteroid and hamper its effectiveness in treating ocular inflammatory diseases.
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Liu DTL, Rao SK, Lee VYW, Chan WM, Lam DSC. Unusual acute angle closure after air descemetopexy. Eye (Lond) 2006; 20:1378-9. [PMID: 16645631 DOI: 10.1038/sj.eye.6702217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Leung GYS, Young AL, Wong AKK, Rao SK, Lam DSC. Efficacy of 2% lignocaine gel in pterygium surgery. ACTA ACUST UNITED AC 2006; 84:445. [PMID: 16704724 DOI: 10.1111/j.1600-0420.2005.00626.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chan WM, Lai TYY, Tano Y, Liu DTL, Li KKW, Lam DSC. Photodynamic Therapy in Macular Diseases of Asian Populations: When East Meets West. Jpn J Ophthalmol 2006; 50:161-9. [PMID: 16604394 DOI: 10.1007/s10384-005-0259-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2005] [Accepted: 09/12/2005] [Indexed: 11/26/2022]
Abstract
PURPOSE We reviewed the indications, safety, and efficacy of photodynamic therapy with verteporfin in various macular diseases and vasculopathies, which are common in Asian populations, and compared the outcomes of photodynamic therapy in Asian patients with the outcomes in Caucasian patients. METHODS Relevant clinical and laboratory original articles, case reports, and review articles that have been published in the literature between January 1999 and October 2004 were searched in Medline. The potential differences in the response to photodynamic therapy between Asian and Caucasian patients were evaluated. Articles in foreign languages with English abstracts were included. RESULTS Macular diseases commonly seen in Asian populations, including choroidal neovascularization (CNV) of age-related macular degeneration, secondary to pathologic myopia or from an idiopathic cause, and choroidal vasculopathies such as central serous chorioretinopathy and polypoidal choroidal vasculopathy were included in the review. The results were tabulated and the differences with Caucasian populations were compared and highlighted. CONCLUSION Photodynamic therapy has been found to be an effective and noninvasive treatment for various subfoveal CNV and choroidal vasculopathies of the macula. Diverse behavior in different ethnic groups is observed.
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Ho TC, Lai WW, Lam DSC. Intravitreal triamcinolone compared with macular laser grid photocoagulation for the treatment of cystoid macular edema. Am J Ophthalmol 2006; 141:786-7; author reply 787-8. [PMID: 16564847 DOI: 10.1016/j.ajo.2005.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Accepted: 12/29/2005] [Indexed: 11/22/2022]
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Liu DTL, Li CL, Lee VYW, Lam DSC. Experimental implantation and long-term testing of an intraocular vision aid in rabbits. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 2006; 124:609-10; author reply 610. [PMID: 16606902 DOI: 10.1001/archopht.124.4.609-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Cheng ACK, Rao SK, Tang E, Lam DSC. Pachymetry Assessment With Orbscan II in Postoperative Patients With Myopic LASIK. J Refract Surg 2006; 22:363-6. [PMID: 16629068 DOI: 10.3928/1081-597x-20060401-12] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare central corneal thickness after LASIK for myopia, using ultrasonic pachymetry and Orbscan II measurements, and to evaluate changes in these measurements over time. METHODS Central corneal thickness measurements obtained by ultrasonic pachymetry and Orbscan II (Bausch and Lomb, Rochester, NY) in patients who underwent myopic LASIK between July 2002 and May 2003 were analyzed. The two measurements were assessed preoperatively and postoperatively at 1 day and 1, 3, 6, and 12 months. RESULTS In 237 eyes, using the correction factor 0.93, no significant difference was noted in the preoperative central corneal thickness measured by ultrasonic pachymetry (561.89 +/- 28.66 microm) and Orbscan pachymetry (562.28 +/- 28.18 microm) (P =.713). Postoperatively, the difference was statistically significant at day 1 and 1, 3, and 6 months (P < .001), but was not significant at 12 months (P = .130). CONCLUSIONS Orbscan II measurements of central corneal thickness after myopic LASIK are less than those measured by ultrasonic pachymetry; however, this difference decreases with time and may not be significant after 1 year.
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Liu DTL, Lee VYW, Lam DSC. Intraocular lens-capsular bag imaging with ultrahigh-resolution optical coherence tomography: pseudophakic human autopsy eyes. J Cataract Refract Surg 2006; 32:186-7; author reply 187. [PMID: 16564971 DOI: 10.1016/j.jcrs.2005.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2005] [Indexed: 10/24/2022]
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Liu DTL, Lee VYW, Chan WM, Lam DSC. Prognosis of pseudophakic retinal detachment. J Cataract Refract Surg 2006; 32:184; author reply 184. [PMID: 16564967 DOI: 10.1016/j.jcrs.2005.12.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2005] [Indexed: 11/28/2022]
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Chan WM, Lai TYY, Wong AL, Tong JP, Liu DTL, Lam DSC. Combined photodynamic therapy and intravitreal triamcinolone injection for the treatment of subfoveal choroidal neovascularisation in age related macular degeneration: a comparative study. Br J Ophthalmol 2006; 90:337-41. [PMID: 16488958 PMCID: PMC1856972 DOI: 10.1136/bjo.2005.081299] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM To evaluate the outcomes of combined intravitreal triamcinolone (IVTA) and photodynamic therapy (PDT) with verteporfin in the treatment of subfoveal choroidal neovascularisation (CNV) caused by age related macular degeneration (AMD). METHODS 48 eyes from 48 patients with subfoveal CNV caused by AMD were prospective recruited, with 24 eyes treated with combined PDT with IVTA and compared with a control group of 24 eyes which received PDT monotherapy. In the combined treatment group, IVTA was performed immediately after PDT as an outpatient procedure. The mean number of treatments, mean logMAR best corrected visual acuity (BCVA), mean line of visual acuity changes, and proportion of patients without moderate visual loss at 1 year were compared between the combined and monotherapy groups. RESULTS At 1 year the logMAR BCVA for the PDT with IVTA group changed from 0.88 to 0.95 (p = 0.32 compared with baseline), whereas the logMAR BCVA for the monotherapy group reduced from 0.74 to 1.09 (p<0.001 compared with baseline). A significantly higher proportion of patients who had PDT with IVTA did not develop moderate visual loss at 1 year compared with the monotherapy group (70.8% and 33.3% respectively, p = 0.009). Eyes which had combined treatment had significantly fewer lines lost compared with monotherapy alone (0.7 and 3.5 lines respectively, p = 0.015). Subgroup analysis showed that PDT with IVTA is effective in preventing visual loss in both predominately classic and occult CNV groups. The mean number of treatments for the combined and monotherapy groups was 1.5 and 1.96 respectively (p = 0.076). CONCLUSIONS Combined PDT with IVTA appeared more effective statistically at 12 months for stabilisation of vision (<3 logMAR lines change) compared with PDT monotherapy. Further randomised control trials might be justified to conclude the efficacy of PDT with IVTA.
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Chan WM, Liu DTL, Lai TYY, Li H, Tong JP, Lam DSC. Extensive submacular haemorrhage in polypoidal choroidal vasculopathy managed by sequential gas displacement and photodynamic therapy: a pilot study of one-year follow up. Clin Exp Ophthalmol 2006; 33:611-8. [PMID: 16402954 DOI: 10.1111/j.1442-9071.2005.01105.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Polypoidal choroidal vasculopathy (PCV) with peculiar vascular lesions presents frequently as recurrent submacular haemorrhage. The best treatment is still not certain. It is the authors' objective to evaluate the 1-year safety and efficacy of photodynamic therapy (PDT) using verteporfin for persistent macular PCV after pneumatic displacement of the massive submacular haemorrhage with intravitreal perfluoropropane (C(3)F(8)). METHODS A prospective, non-comparative, interventional case series on patients with extensive and thick submacular haemorrhage secondary to PCV, which was displaced pneumatically with intravitreal pure 0.4 ml C(3)F(8). Fluorescein angiography and indocyanine green angiography were repeated 1-2 weeks later to delineate any persistent active leaking polypoidal lesions, which were then treated with PDT. Retreatment might be considered in each follow up at every 3 months. RESULTS Six eyes of six patients with the mean age of 53.6 years had been recruited and completed 1-year follow up. The mean baseline Snellen equivalent best-corrected visual acuity (BCVA) was 6/92 and the mean final BCVA at 1 year was 6/17. The mean improvement in logMAR BCVA after the sequential treatments was seven lines (range +3 to +19 lines) (Wilcoxon signed-ranks test, P = 0.03). All patients had at least moderate visual gains. No patient suffered serious complications from PDT. CONCLUSIONS This first report on combined treatment with intravitreal gas injection and sequential PDT on PCV seems to be a well-tolerated option. Further comparative studies with larger sample size and longer follow up are warranted.
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Lai TYY, Wong VWY, Lam DSC. Asymmetrical ocular involvement and persistent fetal vasculature in an adult with osteoporosis-pseudoglioma syndrome. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 2006; 124:422-3. [PMID: 16534066 DOI: 10.1001/archopht.124.3.422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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