Anna Marie WT Tan

National University Health System, Singapore

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Publications (2)4.69 Total impact

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    ABSTRACT: Background The aim of this study was to compare the efficacy and safety of micropulse and continuous-wave diode trans-scleral cyclophotocoagulation in refractory glaucoma.DesignRandomised, comparative, exploratory study in a tertiary hospital settingParticipantsPatients with refractory, end-stage glaucomaMethods48 patients were randomised to either treatment. The intraocular pressure, visual acuity, number of medicines and repeat treatment were monitored for 18 months. Complications that include visual acuity decline, prolonged anterior chamber inflammation, phthisis bulbi, scleral thinning and ocular pain were noted.Main Outcome MeasureIntraocular pressure between 6–21mmHg and at least a 30% reduction with or without anti-glaucoma medications after 18 months.ResultsA successful primary outcome was achieved in 75% of patients who underwent micropulse cyclophotocoagulation and 29% of patients who received continuous wave cyclophotocoagulation after 12 months (p<0.01). At 18 months, successful outcome was 52% and 30% (p=0.13) respectively. The mean intraocular pressure was reduced by 45% in both groups (p=0.70) from a baseline of 36.5 mmHg and 35.0 mmHg (p=0.50) after 17.5 ± 1.6 months (range 16-19) follow-up. No significant difference in retreatment rates or number of intraocular pressure lowering medications was noted. The ocular complication rate was higher in continuous wave treated eyes (p=0.01).Conclusion Diode trans-scleral cyclophotocoagulation in both micropulse and continuous modes was effective in lowering intraocular pressure. The micropulse mode provided a more consistent and predictable effect in lowering intraocular pressure with minimal ocular complications.
    No preview · Article · May 2014 · Clinical and Experimental Ophthalmology
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    ABSTRACT: Transscleral diode laser cyclophotocoagulation (TSCPC) is an established method of treatment for refractory glaucoma, but is associated with significant complications. This study evaluates the efficacy and safety of a new form of TSCPC using micropulse diode laser and trans-pars plana treatment with a novel contact probe. Prospective interventional case series of 40 eyes of 38 consecutive patients with refractory glaucoma treated with micropulse TSCPC with a novel probe. Outcomes measured were success, hypotony and response rates. The mean age of patients was 63.2 +/- 16.0 years. The mean follow-up period was 16.3 +/- 4.5 months. The mean intraocular pressure (IOP) before micropulse TSCPC was 39.3 +/- 12.6 mmHg. Mean IOP decreased to 31.1 +/- 13.4 mmHg at 1 day, 28.0 +/- 12.0 mmHg at 1 week, 27.4 +/- 12.7 mmHg at 1 month, 27.1 +/- 13.6 mmHg at 3 months, 25.8 +/- 14.5 mmHg at 6 months, 26.6 +/- 14.7 mmHg at 12 months and 26.2 +/- 14.3 mmHg at 18 months (P < 0.001 at all time points). No patient had hypotony or loss of best-corrected visual acuity. The overall success rate after a mean of 1.3 treatment sessions was 72.7%. Micropulse TSCPC is a safe and effective method of lowering IOP in cases of refractory glaucoma and is comparable with conventional TSCPC.
    Full-text · Article · Apr 2010 · Clinical and Experimental Ophthalmology