Displaying all 11 publications

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  1. Lim AK, Goh PP, Azura R, Mariam I
    J Cataract Refract Surg, 2011 Apr;37(4):655-9.
    PMID: 21420589 DOI: 10.1016/j.jcrs.2010.10.050
    PURPOSE: To determine the prevalence of and risk factors for AcriFlex 50CSE hydrophilic acrylic intraocular lens (IOL) opacification approximately 3 years after implantation.
    SETTING: Selayang Hospital, Selangor, Malaysia.
    DESIGN: Cross-sectional study.
    METHODS: Patients who had AcriFlex 50CSE IOL implantation in 2005 and 2006 were identified from operating logbooks and recalled via telephone and letters. Opaque IOLs were explanted and sent for scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS).
    RESULTS: The review showed that 18 patients had died and 67 had declined examination or could not be contacted, leaving 239 eyes for evaluation. The age of the patients ranged from 25 to 85 years. Of the patients, 83 (34.7%) were Malay, 127 (53.1%) Chinese, and 29 (12.1%) East Indian. The male:female ratio was 1:1. Fourteen eyes of 13 patients (5.4%) had IOL opacification; 1 had bilateral opacification. Five eyes had fine deposits, and 9 eyes had dense opaque deposits. Seven opaque IOLs required explantation. There was no correlation between age (P=.645), sex (P=.319), or race (P=.860) and IOL opacification. Pearson chi-square analysis showed a strong association between diabetes mellitus and IOL opacification (P=.019). Nine (69.2%) of the 13 patients with opacification had diabetes. Scanning electron microscopy and EDS showed calcium and phosphate deposits on the optic surface and intralenticularly near the anterior surface of the optic.
    CONCLUSIONS: Results indicate that diabetes mellitus is a risk factor for AcriFlex hydrophilic acrylic IOL opacification. In some cases, opacification affected vision, necessitating explantation. The pathophysiology of this complication is unknown.
    FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
  2. Shin HC, Subrayan V, Tajunisah I
    J Cataract Refract Surg, 2010 Aug;36(8):1289-95.
    PMID: 20656150 DOI: 10.1016/j.jcrs.2010.02.024
    PURPOSE: To evaluate changes in anterior chamber depth (ACD) and intraocular pressure (IOP) after phacoemulsification in eyes with occludable angles and compare the results with those in eyes with normal open angles.
    SETTING: Eye Clinic, Ipoh General Hospital, Ipoh, Perak, Malaysia.
    METHODS: Patients with nonglaucomatous eyes with open angles or with occludable angles were recruited. Ocular biometric measurements (ACD, axial length [AL], lens thickness and position) and IOP (tonometry) were performed preoperatively and 1 day and 1, 4, 9, and 12 weeks postoperatively.
    RESULTS: The open-angle group and occludable-angle group each comprised 35 patients. The occludable-angle group had a shallower ACD, shorter AL, thicker and relatively anterior lens position, and higher IOP preoperatively; postoperatively, there was a significant increase in ACD and a significant reduction in IOP (P
  3. Lim KL, Fam HB
    J Cataract Refract Surg, 2009 Dec;35(12):2144-8.
    PMID: 19969221 DOI: 10.1016/j.jcrs.2009.06.031
    PURPOSE: To determine the distribution of higher-order corneal and ocular aberrations in a healthy refractive surgery population.
    SETTING: Island Hospital, Penang, Malaysia.
    METHODS: In this prospective observational study, 1 eye of ethnic Chinese refractive surgery patients was evaluated with an Orbscan II corneal topographer and a Zywave Hartmann-Shack aberrometer with a 6.0 mm pupil. Height data were analyzed to derive the higher-order aberrations (HOAs) from the 3rd to 5th Zernike order.
    RESULTS: The mean spherical equivalent in the 70 eyes evaluated was -6.46 diopters +/- 3.10 (SD). The mean total corneal HOA was 0.574 +/- 0.218 microm (range 0.269 to 1.249 microm) and the mean total ocular HOA, 0.525 +/- 0.354 microm (range 0.138 to 2.145 microm). There was no statistically significant correlation with age. The mean 3rd-order ocular aberration was 0.399 +/- 0.287 microm; the mean 4th-order, 0.297 +/- 0.223 microm; and the mean 5th-order, 0.108 +/- 0.101 microm. Corneal spherical aberration was greater than ocular spherical aberration (mean 0.312 +/- 0.114 microm versus 0.200 +/- 0.170 microm). Multilinear regression showed that the only dependent that predicted ocular spherical aberration was anterior corneal asphericity (r(2) = 0.227, F = 17.95, P
  4. Fam HB, Lim KL
    J Cataract Refract Surg, 2006 Aug;32(8):1281-7.
    PMID: 16863962 DOI: 10.1016/j.jcrs.2006.02.060
    PURPOSE: To determine an index that distinguishes keratoconus and keratoconus-suspect eyes from normal eyes with Orbscan (Bausch & Lomb) corneal elevation maps.
    SETTING: Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, and iLaser Centre, Island Hospital, Penang, Malaysia.
    METHODS: In this initial phase of this multicenter nonrandomized retrospective study, 1 eye of 166 normal subjects, 15 keratoconus patients, and 11 keratoconus suspects was examined at 1 clinic. The anterior best-fit sphere (BFS), posterior BFS, anterior elevation, posterior elevation, and maximum and minimum keratometries were analyzed. Two indices with the highest sensitivity and specificity classifying these conditions were identified using receiver operating characteristic curves. These 2 indices were evaluated in a subsequent validation study using 1 eye of 221 normal subjects, 43 keratoconus patients, and 23 keratoconus suspects from another clinic.
    RESULTS: The anterior elevation and anterior elevation ratio (anterior elevation ratio = anterior elevation/anterior BFS) best classified the different groups. An anterior elevation ratio of 0.5122 mm or less had 99% sensitivity and 95.2% specificity while a ratio 16.5 mum or less had 80.1% sensitivity and 80.8% specificity in discriminating normal eyes from keratoconus and keratoconus suspects. The results were similar in the validation study. In addition, these anterior elevation and anterior elevation ratio cutoff values had high sensitivity and specificity in identifying keratoconus suspects from normal eyes in the validation study.
    CONCLUSION: Anterior corneal elevation parameters are clinically relevant measures for detecting keratoconus and suspected keratoconus eyes.
  5. Lim KL, Fam HB
    J Cataract Refract Surg, 2006 Nov;32(11):1814-9.
    PMID: 17081863
    To determine the values for the anterior best-fit sphere (BFS) and posterior BFS in an Asian population using the Orbscan II (Bausch & Lomb) slit-scanning Placido disk corneal topographer.
  6. Lai YK, Fan RF
    J Cataract Refract Surg, 1996;22 Suppl 1:830-4.
    PMID: 9279680
    PURPOSE: To compare the efficacy of heparin-surface-modified (HSM), poly(methyl methacrylate) (PMMA) posterior chamber intraocular lenses (IOLs) with that of unmodified PMMA IOLs in reducing postoperative complications caused by inflammatory reactions after extracapsular cataract extraction in an Asian population.

    SETTING: Departments of Ophthalmology, University of Malaya, Kuala Lumpur, Malaysia, and Tan Tock Seng Hospital, Singapore.

    METHODS: In a randomized, double-blind study performed at two centers, 51 patients received an HSM PMMA lens and 48, an unmodified PMMA IOL. Cell and pigment deposits were evaluated by slitlamp at 1 to 6 days, 2 to 3 weeks, and 3 to 6 months postoperatively.

    RESULTS: Significantly more eyes with unmodified IOLs had inflammatory cell deposits than those with HSM IOLs at 3 to 6 months (P < .001) and 12 to 14 months (P = .018) postoperatively. The HSM group also had significantly fewer cell deposits per patient at these two follow-ups. Significantly more eyes in the non-HSM group had pigment deposits 3 to 6 months after surgery (P = .049). One year postoperatively, about 85% of patients in both groups had a best corrected visual acuity of 0.5 or better.

    CONCLUSION: Heparin surface modification significantly reduced the inflammatory response to PMMA IOLs in an Asian population for at least 12 to 14 months.

  7. Khor HG, Cho I, Lee KRCK, Chieng LL
    J Cataract Refract Surg, 2020 02;46(2):215-221.
    PMID: 32126034 DOI: 10.1097/j.jcrs.0000000000000009
    PURPOSE: To determine the amount of waste produced from phacoemulsification surgeries and ways to curtail the problem.

    SETTING: Miri Hospital, Sarawak, Malaysia.

    DESIGN: Prospective study.

    METHODS: Phacoemulsification surgery cases were included in this study; nonphacoemulsification surgeries were excluded. The waste was subdivided into 3 main categories, general waste, clinical waste, and sharps. The waste produced by ophthalmologists and trainees was accounted for separately. The mean weight of waste per case was obtained by dividing the total weight of waste produced with the total number of cases.

    RESULTS: The total waste produced from a total of 203 cases of phacoemulsification surgeries was 167.965 kg, of which, 95.063 kg (56.6%) were clinical waste, 63.197 kg (37.6%) were general waste, and 9.705 kg (5.8%) were sharps; 32.193 kg (50.9%) out of the general waste pool were recyclable waste products. The mean waste production per case of phacoemulsification surgery for an ophthalmologist was 0.814 kg, 1.086 kg per case for a trainee. A case of phacoemulsification surgery would produce 0.282 kg of carbon dioxide equivalents in the setup based on the recyclable general waste.

    CONCLUSIONS: The average waste produced per case of phacoemulsification surgery in Miri Hospital was 0.827 kg. After excluding the recyclable material, the average waste produced per case was 0.669 kg. Following the 3 R's principles (reduce, reuse, and recycle) in the handling of waste production might reduce environmental impact.

  8. Lay Suan AL, Hamzah JC, Ken TS, Mansurali VN
    J Cataract Refract Surg, 2017 08;43(8):1031-1035.
    PMID: 28917402 DOI: 10.1016/j.jcrs.2017.05.031
    PURPOSE: To evaluate the efficacy and safety of intracameral mydriatics (lidocaine 1.0% and phenylephrine 1.5%) versus topical mydriatics (phenylephrine 2.5% and tropicamide 1.0%) in pupil dilation for phacoemulsification surgery in Malaysians.

    SETTING: Department of Ophthalmology, Penang General Hospital, Georgetown Penang, Malaysia.

    DESIGN: Prospective comparative case series.

    METHOD: Patients with immature cataract were randomized to the topical mydriatic group (topical group) or intracameral mydriatic group (intracameral group). Patients with small pupils and complicated cataracts were excluded. Pupil diameter changes were measured throughout the surgery. Additional pupil dilation maneuvers and complications were recorded.

    RESULTS: The study comprised 112 patients. There was no difference in mean pupil dilation between the intracameral group (4.86 mm ± 0.74 [SD]) and the topical group (4.88 ± 0.91 mm) (P = .86). However, the mean pupil size before capsulorhexis in the topical group (7.23 ± 1.08 mm) was significantly larger than in the intracameral group (6.40 ± 0.80 mm) (P = .01). The pupils in the intracameral group continued to dilate during surgery (0.44 ± 0.62 mm), while those in the topical group constricted (-0.41 ± 1.04 mm) (P 

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