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Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine 04/2011; 17(2):163-4.
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ABSTRACT: To evaluate the efficacy of latanoprost given 2 hours preoperatively to prevent ocular hypertension in the early period after phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation.
Departments of Ophthalmology, United Christian Hospital and Prince of Wales Hospital, Hong Kong, China.
Sixty-four eyes of 64 patients with uncomplicated cataract having phacoemulsification with PC IOL implantation were included in this prospective randomized double-masked clinical trial. The eyes were randomly assigned to 1 of 2 groups: application of latanoprost 0.005% 2 hours before surgery or no latanoprost (control). Intraocular pressure (IOP) was measured 3 and 24 hours postoperatively. The anterior chamber was examined for the level of cells and flare using a slitlamp biomicroscope. The level of significance was 5%.
The decrease in the mean IOP was not statistically significantly different between eyes receiving latanoprost 2 hours preoperatively and control eyes 3 hours (P =.843) and 24 hours (P =.721) postoperatively.
A single application of latanoprost given 2 hours before phacoemulsification and PC IOL implantation did not produce a statistically significant IOP-lowering effect when compared with a control group in the first 24 hours after surgery.
Journal of Cataract [?] Refractive Surgery 12/2001; 27(11):1792-5. · 2.26 Impact Factor
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ABSTRACT: To report the efficacy and safety of combined phacoemulsification, intraocular lens implantation, and limited goniosynechialysis, followed by diode laser peripheral iridoplasty, in the treatment of cataract and chronic angle-closure glaucoma.
Patients with chronic angle-closure glaucoma with total synechial angle closure and intraocular pressures higher than 21 mm Hg on maximally tolerated medications, and concurrent cataract, underwent phacoemulsification with posterior chamber intraocular lens implantation and goniosynechialysis followed by diode laser peripheral iridoplasty to the inferior half of the angle. Intraoperative complications, postoperative visual acuity, intraocular pressures, and complications were evaluated.
Seven eyes of seven patients received the operation, and the mean follow-up was 8.9 months (range, 2-16 months). The mean preoperative intraocular pressure was 33.0 +/- 4.8 mm Hg. The mean postoperative intraocular pressure at most recent follow-up was 13.3 +/- 2.9 mm Hg. The absolute success rate (intraocular pressure less than 21 mm Hg without medication) was 100%. The visual acuity of all eyes improved by more than two Snellen lines. Postoperative complications included intraocular pressure spike, hyphema, and transient corneal decompensation.
It appears that phacoemulsification with intraocular lens implantation combined with inferior 180 degree goniosynechialysis followed by diode laser peripheral iridoplasty is an effective and safe surgical procedure for treating chronic angle-closure glaucoma with total synechial angle closure and cataract.
Journal of Glaucoma 09/2001; 10(4):309-15. · 1.78 Impact Factor
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ABSTRACT: To report the rate of ultrasonically visible vitreous incarceration and longitudinal changes of incarcerated vitreous in pars plana sclerotomies after conventional suturing or sutureless technique using ultrasound biomicroscopy.
Twenty-five consecutive eyes (25 patients) undergoing primary three-port pars plana vitrectomy participated. The first 16 pars plana vitrectomies were performed with standard conventional sutured sclerotomies, and the following nine pars plana vitrectomies were performed with modified sutureless sclerotomies. Patient demographics, diagnoses, procedures, and complications were recorded. Each patient had ultrasound biomicroscopy performed 1 week before surgery, and also after surgery at 1 week, 2 weeks, 3 weeks, 4 weeks, 2 months, 3 months, and 6 months. Visible vitreous incarceration was graded as 0 to 3.
Vitreous incarceration was seen in 41 of 48 sclerotomies (85.4%) in the conventionally sutured group, and in 23 of 27 sclerotomies (85.2%) in the sutureless group, with no significant difference in severity among sclerotomies within each group and between the two groups. There was a significant difference in the rate of vitreous incarceration between diabetic patients with proliferative retinopathy and others (P =.002). No progressive change of visible vitreous incarceration was noted in any eye during the 6-month postoperative period. No sclerotomy-related complications occurred during the study period.
Ultrasound biomicroscopy showed no difference in the amount of visible vitreous incarceration in conventionally sutured or sutureless sclerotomies. There was no visible longitudinal change in the incarcerated vitreous during the 6 months of follow-up in uncomplicated cases.
American Journal of Ophthalmology 09/2001; 132(2):172-7. · 4.22 Impact Factor
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ABSTRACT: To determine the incidence of acute primary angle-closure glaucoma in the Hong Kong Chinese population, and to identify risk factors for this condition.
Prospective study.
University teaching hospital, Hong Kong.
Patients with acute primary angle-closure glaucoma presenting between 1 March 1998 and 29 February 2000.
Demographic data, presenting symptoms and signs, temporal details of the presentation, and precipitating factors. The crude regional incidence was calculated according to the Hong Kong population census of 1991 and the age-specific incidence was calculated.
Seventy-two cases (72 eyes of 72 patients) of acute primary angle-closure glaucoma were recruited. The crude incidence was 10.4 per 100,000 per year in the population aged 30 years and older. Patients at higher risk of attacks were those aged 70 years or older (age-specific incidence, 58.7 per 100,000 per year) and females, who had a relative risk of 3.8 compared with males (95% confidence interval, 1.7-8.4). Only four (5.6%) patients had a positive family history of acute primary angle-closure glaucoma. Seventeen (23.6%) patients were noted to have an upper respiratory tract infection before the attack, and 25 (34.7%) patients had taken antitussive agents. There was a statistically significant inverse correlation between the monthly attack rate and the monthly rate of influenza (Spearman's rank correlation coefficient = -0.388; P=0.031).
There is a high incidence of acute primary angle-closure glaucoma among Chinese residents of Hong Kong, with elderly females at highest risk. A significant proportion of patients reported upper respiratory tract infection or the use of antitussive medication prior to attacks.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine 07/2001; 7(2):118-23.
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Ophthalmology 04/2001; 108(3):428-9. · 5.45 Impact Factor
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ABSTRACT: To study the efficacy and safety of diode laser peripheral iridoplasty as a first-line treatment of acute primary angle-closure glaucoma (PACG) without the use of systemic anti-glaucoma medications.
Nine consecutive patients with acute PACG were recruited into the study. Each patient received topical pilocarpine (4%), timolol (0.5%), apraclonidine (1%), and immediate diode laser peripheral iridoplasty as primary treatment. The intraocular pressures (IOPs) 15, 30, and 60 minutes after diode laser peripheral iridoplasty were documented by Goldmann applanation tonometry.
The mean IOP of this group of patients was reduced from 66.3 +/- 9.7 mm Hg, before diode laser peripheral iridoplasty, to 36.6 +/- 16.4 mm Hg at 15 minutes, 26.3 +/- 12.6 mm Hg at 30 minutes, and 18.9 +/- 8.4 mm Hg at 60 minutes after diode laser peripheral iridoplasty. In seven of the nine patients, the corneal edema cleared up 1 hour after diode laser peripheral iridoplasty. In the remaining patient, the cornea cleared up 12 hours after diode laser peripheral iridoplasty. No significant complications were encountered.
Diode laser peripheral iridoplasty, together with topical antiglaucoma medications without adjunctive systemic carbonic anhydrase inhibitors and hyperosmotic agents, appeared to be effective and safe in controlling the IOP in acute PACG.
Journal of Glaucoma 04/2001; 10(2):89-94. · 1.78 Impact Factor
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British Journal of Ophthalmology 02/2001; 85(1):121. · 2.90 Impact Factor
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ABSTRACT: To report the efficacy and safety of inferior 180 degrees goniosynechialysis followed by diode laser peripheral iridoplasty in the treatment of chronic angle-closure glaucoma with total synechial angle closure.
Five patients with chronic angle-closure glaucoma and total synechial angle closure whose intraocular pressures were higher than 21 mm Hg while taking maximally tolerated medications underwent goniosynechialysis followed by diode laser peripheral iridoplasty to the inferior half of the angle. Intraoperative complications, postoperative visual acuity, intraocular pressures, and complications were evaluated.
Five eyes of five patients received the operation and the mean follow-up was 7.6 months (range, 6-12 months). The mean preoperative intraocular pressure was 33.8 +/- 5.8 mm Hg. The mean postoperative intraocular pressure at most recent follow-up was 15.8 +/- 2.2 mm Hg. Postoperative complications included transient increase in intraocular pressure, hyphema, and cataract. The success rate (intraocular pressure less than 20 mm Hg with or without medication) was 80.0%.
It appears that 180 degrees goniosynechialysis followed by diode laser peripheral iridoplasty is an effective and safe surgical procedure for treating chronic angle-closure glaucoma with total synechial angle closure.
Journal of Glaucoma 11/2000; 9(5):388-91. · 1.78 Impact Factor
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Eye 09/2000; 14 ( Pt 4):675-6. · 1.85 Impact Factor
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ABSTRACT: To evaluate the efficacy and safety of the Ahmed glaucoma valve implant in Chinese eyes with complicated glaucomas.
This retrospective study reviewed the final intraocular pressure, visual outcome, and incidence of complications in all patients with the Ahmed glaucoma valve implant performed at the Prince of Wales Hospital, Hong Kong, between June 1996 and November 1998.
A total of 65 eyes from 60 patients were treated with the Ahmed glaucoma implant. At a mean follow up (SD, median) of 21.8 (9.2, 28. 0) months (range 6-37 months), the mean intraocular pressure was reduced from 37.0 (SD 12.1) mm Hg before the implant surgery to 16.1 (12.4) mm Hg at the last follow up after surgery. The success rate of intraocular pressure control of <22 mm Hg was achieved in 73.8% of operated eyes. Transient postoperative hypotony with shallow anterior chamber occurred in 10.8% of cases. The most common postoperative complication was the formation of encapsulated bleb (24.6%).
The Ahmed glaucoma valve implant appears to be effective and relatively safe for treating complicated glaucomas in Chinese eyes. The success rate is comparable with those reported in non-Asian eyes. Formation of postoperative encapsulated bleb is, however, more commonly encountered.
British Journal of Ophthalmology 07/2000; 84(7):718-21. · 2.90 Impact Factor
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Eye 07/2000; 14 ( Pt 3A):412. · 1.85 Impact Factor
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Retina 02/2000; 20(5):567-8. · 2.81 Impact Factor
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Eye 09/1999; 13 ( Pt 4):584-5. · 1.85 Impact Factor
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Ophthalmology 07/1999; 106(6):1042-3. · 5.45 Impact Factor
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ABSTRACT: To study the effectiveness and safety of a modified sutureless sclerotomy technique in pars plana vitrectomy.
We rotated the scleral tunnels of the original sutureless sclerotomy technique through 90 degrees, thus rendering them parallel to the corneoscleral limbus. This modified technique was applied to 25 consecutive eyes (25 patients) that had pars plana vitrectomy during a 2-month period.
Twenty (80%) of 25 eyes (25 patients) did not require suturing of the sclerotomy sites associated with pars plana vitrectomy. Eight (11%) of 75 sclerotomy sites required suturing to ensure watertight closure. No clinically significant complications were encountered.
The modified sutureless sclerotomy technique was found to be safe, more convenient, and easier to perform, especially in eyes with small interpalpebral space.
American Journal of Ophthalmology 07/1999; 127(6):731-3. · 4.22 Impact Factor
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ABSTRACT: To study the efficacy and safety of limited (180 degrees) argon laser peripheral iridoplasty (ALPI) as a first-line treatment for acute primary angle closure glaucoma (PACG) without the use of systemic anti-glaucomatous medications.
Ten consecutive patients with PACG were recruited into the study. Each patient received topical pilocarpine (4%) and timolol (0.5%), and immediate limited ALPI as primary treatment. The intraocular pressures at 15, 30 and 60 min after ALPI were documented by Goldmann applanation tonometry.
The mean intraocular pressure (IOP) of this group of patients was reduced from 57.9 +/- 10.6 mmHg to 39.0 +/- 10.9 mmHg at 15 min, 28.3 +/- 9.1 mmHg at 30 min and 20.4 +/- 9.0 mmHg at 60 min after ALPI. No complications were encountered. In 8 of the 10 patients the corneal oedema cleared 1 h after ALPI. In the remaining 2 patients the corneal oedema cleared 2 h after ALPI.
Immediate limited ALPI, without adjunctive systemic anti-glaucomatous medications, appeared to be effective and safe in controlling the IOP in treating acute PACG with a duration of attack < or = 48 h. It may be as effective as 360 degrees ALPI, and therefore has a role in those patients in whom 360 degrees treatment is not possible.
Eye 01/1999; 13 ( Pt 1):26-30. · 1.85 Impact Factor
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ABSTRACT: This study aimed to examine the intraocular pressure (IOP)-lowering effects and safety of immediate argon laser peripheral iridoplasty (ALPI) as a first-line treatment for acute primary angle-closure glaucoma (PACG).
A prospective cohort study.
Ten consecutive patients with their first attack of PACG, with IOP of 40 mmHg or greater, were recruited into the study.
On presentation, each patient received topical pilocarpine (4%) and timolol (0.5%) and immediate ALPI as primary treatment. The IOPs at 15, 30, and 60 minutes after ALPI were documented by applanation tonometry. When the corneal edema had settled, laser peripheral iridotomy was performed as a definitive treatment.
The IOP, corneal edema, and complications from ALPI were measured.
The mean IOP of this group of patients was reduced from 59.5+/-10.4 mmHg to 28.7+/-14.9 mmHg at 15 minutes, 21.7+/-13.1 mmHg at 30 minutes, and 16.0+/-9.4 mmHg at 60 minutes after ALPI. No complications from the laser procedure were encountered during the study period. In nine of the ten patients, the corneal edema cleared up 1 hour after ALPI. In the remaining patient, the cornea cleared up 2 hours after ALPI.
From this preliminary study, immediate ALPI, without adjunctive systemic antiglaucoma treatment, appeared to be very effective in controlling the IOP and returning corneal clarity in acute PACG. Its safety also appeared reassuring and did not have the risks associated with conventional systemic therapies.
Ophthalmology 01/1999; 105(12):2231-6. · 5.45 Impact Factor
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ABSTRACT: To study the safety and efficacy of scleral intraocular lens (IOL) fixation in children.
A university practice.
This retrospective review evaluated the results and complications in 6 consecutive eyes of 3 children who had anterior vitrectomy, with or without lensectomy, and scleral IOL fixation to correct ectopia lentis or aphakia.
At a mean follow-up of 17.3 months (range 13 to 21 months), all eyes had a stable and well-positioned posterior chamber IOL and good visual improvement. The only complication was asymptomatic pupillary capture of the IOL in 3 eyes. Reversal of the pupillary capture was achieved by pupil dilation with the patient in a supine position.
The preliminary results of scleral IOL fixation in children are encouraging. The procedure's application in well-selected cases can be considered. However, its long-term safety and efficacy must be further assessed through studies with larger sample sizes and a longer follow-up.
Journal of Cataract [?] Refractive Surgery 12/1998; 24(11):1474-9. · 2.26 Impact Factor
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British Journal of Ophthalmology 05/1998; 82(4):460-1. · 2.90 Impact Factor
