Displaying publications 1 - 20 of 54 in total

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  1. Chua AW, Chua MJ, Harrisberg BP, Kumar CM
    Anaesth Intensive Care, 2020 Jan;48(1):25-35.
    PMID: 31914784 DOI: 10.1177/0310057X19891737
    Matched MeSH terms: Cataract Extraction*
  2. Yahya AN, Sit JA, Raman S
    MyJurnal
    The success of cataract surgery is accessed by the improvement in visual acuity and accuracy of the post-operation refractive outcome against the pre-operation refractive target. Hence, the benchmark of 85% of patients achieving a final spherical equivalent within 1D of the desired target is used to monitor the refractive outcome. Meanwhile, the unaided visual acuity threshold of 6/12 after cataract operation is chosen as a yardstick because it allows patients to perform instrumental activities of daily living (IADL) independently without relying on spectacles.
    Matched MeSH terms: Cataract Extraction*
  3. Rochmah TN, Wulandari A, Dahlui M, Ernawaty, Wulandari RD
    PMID: 32824872 DOI: 10.3390/ijerph17166010
    Cataracts are the second most prioritized eye disease in the world. Cataracts are an expensive treatment because surgery is the only method that can treat the disease. This study aims to analyze the cost effectiveness of each operating procedure. Specifically, phacoemulsification and Small Incision Cataract Surgery (SICS) with Disability-Adjusted Life Years (DALYs) as the effectiveness indicator is used. This study is an observational analytic study with a prospective framework. The sample size is 130 patients who have undergone phacoemulsification and 25 patients who have undergone SICS. The DALY for phacoemulsification at Day-7 (D-7) is 0.3204, and at Day-21 (D-21), it is 0.3204, while the DALY for SICS at D-7 is 0.3060, and at D-21, it is 0.3158. The incremental cost effectiveness ratio (ICER) for cataract surgery at D-7 is USD $1872.49, and at D-21, it is USD $5861.71, whereas the Indonesian Gross Domestic Product (GDP) is USD $4174.90. In conclusion, the phacoemulsification technique is more cost effective than the SICS technique. The ICER value is very cost effective at D-7 post-surgery compared to at D-21 post-surgery because the ICER is less than 1 GDP per capita per DALY.
    Matched MeSH terms: Cataract Extraction/methods*
  4. Thevi T, Abas AL
    Kathmandu Univ Med J (KUMJ), 2021 2 18;18(70):122-132.
    PMID: 33594017
    Background Cataract surgery which is the only scientific method to treat cataracts has evolved from large incisions of intracapsular cataract excision to extracapsular cataract exicison and now modern day phacoemulsification. Anaesthesia too has progressed from general anaesthesia to local and topical anaesthesia. A variety of intraocular lenses are available ranging from rigid to foldable, multifocal and toric. Day care surgeries are becoming the norm these days. Objective Cataract surgery has advanced with new techniques and modalities. We studied the trends of cataract surgery and outcomes over the years. Method We performed secondary data analysis (National Eye Database) of cataract surgery patients in Hospital Melaka (2007 - 2014). Result Most patients were 60-69 years (mean 65.0 years). Primary cataract rose (p<0.05) but there was no difference in laterality and first or second eye (p>0.05). More patients presented with Hypertension and Diabetes (p<0.05). Pterygium encroaching the cornea showed a rise (p<0.05). Phacoemulsification (80.8%) showed a rise while Extracapsular Cataract Extraction (ECCE) (15.4%) declined (p<0.05). More Specialists operated and fewer combined surgeries were performed (p<0.001). Type of anaesthesia did not change (p>0.05). Operative complications reduced (p<0.001). Anterior chamber, scleral fixated and foldable intraocular lenses usage reduced (p<0.05). There was no change in pre-operative visual acuity (p>0.05) but postoperative vision showed a rise in good outcomes (p<0.05). Conclusion Melaka Hospital shows a rise in phacoemulsification and a decline in Extracapsular Cataract Extraction. More patients presented with primary cataracts. More Specialists operated and there was a reduction in intraoperative and postoperative complications. Post-operative visual outcomes showed a remarkable improvement. This improvement is in keeping with the aim of improved vision for all by 2020.
    Matched MeSH terms: Cataract Extraction*
  5. Wai YZ, Chong YY, Lim LT, Chan JB, Chandrasekaran S
    BMC Res Notes, 2023 Jun 22;16(1):116.
    PMID: 37349840 DOI: 10.1186/s13104-023-06391-2
    BACKGROUND: To describe the preferred cataract surgery practices among Malaysian ophthalmologists and medical officers in comparison with the recommended practices.

    METHODS: An online questionnaire was sent out in April 2021, to Malaysian Ophthalmologists and medical officers who perform cataract surgeries. The questions were focused on the preferred cataract surgery practices of the participants. All data obtained were collected, tabulated and analysed.

    RESULTS: A total of 173 participants responded to the online questionnaire. 55% of the participants were within 31-40 years of age. 56.1% preferred peristaltic pump over venturi system. 91.3% of participants practised povidone iodine instillation to the conjunctival sac. With regards to the main wound incision, more than half of the surgeons (50.3%) preferred fixed superior incision and 72.3% of them preferred 2.75 mm microkeratome blade. Most of the participants (63%) were inclined towards C-Loop clear intraocular lens (IOL) with a single-handed push preloaded system. 78.6% of the surgeons routinely use carbachol in their cataract surgery.

    CONCLUSIONS: This survey provides some insight into the current practices among Malaysian ophthalmologists. Most of the practices are in line with international guidelines for preventing postoperative endophthalmitis. This article could help trainees and ophthalmologists benchmark and observe the common cataract surgery practices among their seniors and peers in Malaysia.

    Matched MeSH terms: Cataract Extraction*
  6. Thevi T, Reddy SC, Shantakumar C
    Malays Fam Physician, 2014;9(2):41-7.
    PMID: 25883764 MyJurnal
    The aim of the study was to compare the outcomes of phacoemulsification (Phaco) and extracapsular cataract extraction (ECCE) in a district hospital setting.
    Matched MeSH terms: Cataract Extraction
  7. Sukumaran K
    Med J Malaysia, 1983 Dec;38(4):272-4.
    PMID: 6599981
    Matched MeSH terms: Cataract Extraction
  8. Bariah Mohd-Ali, Nazirin Arsad, Zainora Mohammed
    MyJurnal
    It is possible that different techniques used to measure axial length (AL) and anterior chamber depth (ACD) is the cause of discrepancy in refractive outcomes of cataract surgery. This study evaluated the agreement and repeatability of AL and ACD measurements using immersion and contact A-scan biometry techniques and compared the refractive outcomes from both techniques. Twenty four patients were evaluated for agreement and repeatability of AL and ACD measurements using the two different methods. The results were analyzed using Bland and Altman plots. Another 60 patients with age-related cataract were selected to compare the refractive outcomes between both methods. The IOL power was calculated using Sanders- Retzlaff- Kraff- Theoretical (SRK-T) equation. Refraction was determined between four to six weeks postoperatively and the results were analyzed using paired t-test. The results of this study showed good agreement between both techniques was noted with no significant difference detected between measurements (p > 0.05). Significant correlation was found in all parameters (AL: r = 0.99; p < 0.01, r = 0.99; p < 0.01) ACD: r = 0.91; p < 0.01, r = 0.97; p < 0.01). No significant difference in refractive outcomes of post cataract surgery was detected between the two techniques (p = 0.07). This study concludes that contact A-scan biometry and immersion techniques provide reliable results and should not be the cause of discrepancy in the refractive planned and outcome of cataract surgery.
    Matched MeSH terms: Cataract Extraction
  9. Shunmugam M, Ang GS, Lois N
    Surv Ophthalmol, 2014 Mar-Apr;59(2):192-216.
    PMID: 24138895 DOI: 10.1016/j.survophthal.2013.03.006
    A giant retinal tear (GRT) is a full-thickness neurosensory retinal break that extends circumferentially around the retina for three or more clock hours in the presence of a posteriorly detached vitreous. Its incidence in large population-based studies has been estimated as 1.5% of rhegmatogenous retinal detachments, with a significant male preponderance, and bilaterality in 12.8%. Most GRTs are idiopathic, with trauma, hereditary vitreoretinopathies and high myopia each being causative in decreasing frequency. The vast majority of GRTs are currently managed with a pars plana vitrectomy; the use of adjunctive circumferential scleral buckling is debated, but no studies have shown a clear anatomical or visual advantage with its use. Similarly, silicone oil tamponade does not influence long-term outcomes when compared with gas. Primary and final retinal reattachment rates are achieved in 88% and 95% of patients, respectively. Even when the retina remains attached, however, visual recovery may be limited. Furthermore, fellow eyes of patients with a GRT are at higher risk of developing retinal tears and retinal detachment. Prophylactic treatment under these circumstances may be considered but there is no firm evidence of its efficacy at the present time.
    Matched MeSH terms: Cataract Extraction/adverse effects
  10. Aziz S, Asokumaran T, Intan G
    Med J Malaysia, 2011 Mar;66(1):64-5.
    PMID: 23765148 MyJurnal
    Blunt ocular trauma may result in expulsion of the intraocular lens in a patient who has undergone cataract surgery. This case report describes a patient who presented with an extrusion of intraocular lens following blunt ocular trauma post-operatively. The authors emphasise the importance of patient counselling and protection of the operated eye after surgery.
    Matched MeSH terms: Cataract Extraction*
  11. Thevi T, Reddy SC, Chinna K
    International Eye Science, 2014;14(8):1367-1372.
    DOI: 10.3980/j.issn.1672-5123.2014.08.01
    AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.
    METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.
    RESULTS: Complications occurred in 11.1% of the total 1007 patients operated. Posterior capsule rupture (3.6%) was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction (ICCE) and phacoemulsification converted to extracapsular cataract extraction (ECCE) were significantly associated with more complications (P<0.001). The visual outcome was significantly poor in patients with complications (P<0.001).
    CONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.
    Matched MeSH terms: Cataract Extraction*
  12. Singh K
    Med J Malaysia, 1976 Sep;31(1):38-41.
    PMID: 1088175
    Matched MeSH terms: Cataract Extraction/adverse effects*
  13. Rizal, A.M., Muhammad, M., Aljunid, S.M., Normalina, M., Faridah Hanom, A., Chuah, K.L., et al.
    MyJurnal
    Background: A randomised single blinded clinical trial comparing the effectiveness of two methods of cataract surgery with intraocular lens implantation: extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was carried out at Hospital Universiti Kebangsaan Malaysia (HUKM) between March 2000 and August 2001. Methods: The effectiveness of cataract surgery was assessed from the quality of life specifically for vision via Visual Function 14 (VF-14) preoperatively, one week, two months and six months after surgery. Results: The result showed that there was a significant increased in VF-14 scores after a week, two months and six months postoperation compared to the score before surgery for both techniques. However there was no significant difference in VF-14 scores when compared between ECCE and PEA. Conclusions: This study indicated that both techniques give equal benefit to cataract patients. Since effectiveness of cataract surgery with intraocular lens implantation is unrelated to operative procedures, less costly technique should be promoted.
    Matched MeSH terms: Cataract Extraction
  14. Bariah, M.A ., Leong, S.Y.
    MyJurnal
    Introduction: The corneal endothelium is made up of an extremely thin layer of non -regenerating cells essential in keeping the cornea clear. The purpose of this study was to quantify the corneal endothelial cells morphology, visual acuity (VA) and refractive error in patients having femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS). Methods: Clinical data from 56 eyes were included in this study. 28 eyes had FLACS surgery and another 28 eyes had CPS. Distance VA, refractive error, corneal thickness and endothelial cells morphology were evaluated pre-operatively and at 1 month follow up. Refractive error was determined subjectively and VA was taken using Snellen chart. Specular microscope was used to measure endothelial cells morphology and central corneal thickness. Mann Whitney test and Spearman correlation analysis were used to analyse the results. Results: There were no statistically significant difference in the mean endothelial cell density (p=0.24), mean central corneal thickness (p=0.68), mean coefficient of variance (p=0.19), mean hexagonality (p=0.44), VA (p=0.72) and postoperative refractive outcome (p=0.66) between both groups. The duration of surgery was noted to have no statistically significant difference between both groups (p=0.08), while the cumulative dissipated energy and torsional time showed a significant difference between groups (p=0.01 and p
    Matched MeSH terms: Cataract Extraction
  15. Thanigasalam T, Sahoo S, Kyaw Soe HH
    Malays J Med Sci, 2014 Jul;21(4):51-3.
    PMID: 25977622
    This study was done to correlate the occurrence of posterior capsule rupture among patients with pseudoexfoliation during phacoemulsification. This was a retrospective audit of patients who underwent phacoemulsification type cataract surgery from January 2011 to December 2012 in a tertiary hospital in Malaysia. Data was obtained from the National Eye Database (NED) of Malaysia. The data was analysed using SPSS version 21.0. By using logistic regression analysis, it was found that there was no significant increase in the occurrence of posterior capsule rupture among patients with pseudoexfoliation. Hence, we concluded that there was no correlation between the occurrence of posterior capsule rupture and the presence of pesudoexfoliation among patients who underwent phacoemulsification.
    Matched MeSH terms: Cataract Extraction
  16. Jasman AA, Shaharuddin B, Noor RA, Ismail S, Ghani ZA, Embong Z
    BMC Ophthalmol, 2010;10:20.
    PMID: 20738840 DOI: 10.1186/1471-2415-10-20
    Despite growing number of intraocular lens power calculation formulas, there is no evidence that these formulas have good predictive accuracy in pediatric, whose eyes are still undergoing rapid growth and refractive changes. This study is intended to compare the prediction error and the accuracy of predictability of intraocular lens power calculation in pediatric patients at 3 month post cataract surgery with primary implantation of an intraocular lens using SRK II versus Pediatric IOL Calculator for pediatric intraocular lens calculation. Pediatric IOL Calculator is a modification of SRK II using Holladay algorithm. This program attempts to predict the refraction of a pseudophakic child as he grows, using a Holladay algorithm model. This model is based on refraction measurements of pediatric aphakic eyes. Pediatric IOL Calculator uses computer software for intraocular lens calculation.
    Matched MeSH terms: Cataract Extraction*
  17. Chin KW, Law NM, Chin MK
    Med J Malaysia, 1994 Jun;49(2):158-63.
    PMID: 8090095
    Phenylephrine in concentrations of either 2.5% or 10% is widely used as a mydriatic agent in ophthalmic surgery. Its potential cardiovascular effects are seldom recorded as ophthalmic surgery is not usually monitored by an anaesthetist. A prospective randomised double blind study was carried out in 89 consecutive cases of uncomplicated cataract surgery in the presence of an anaesthesiologist ensuring the continuous monitoring of blood pressure, heart rate, electrocardiography and pulse oximetry. All these patients were given a drop of either normal saline, 2.5% or 10% phenylephrine in addition to mydriacyl prior to surgery. Blood pressure readings were found to be significantly higher in non-hypertensive patients receiving phenylephrine at the start of the operation and at five, 10, 15 and 20 minutes intra-operatively and the first three hours post-operatively. Blood pressure readings in hypertensive patients, on the other hand, were also found to increase after phenylephrine administration, though not statistically significant. 10.3% of the 10% phenylephrine group and 3% of the 2.5% phenylephrine group required intraoperative intravenous hypotensive agent to control the blood pressure. There were no arrhythmias or ischaemic changes observed intraoperatively. None of the patients complained of palpitation, headache or chest discomfort. There was no oxygen desaturation observed. We concluded that significant hypertensive effects can arise after phenylephrine eye drop administration. Hence, it should be used cautiously with intraoperative monitoring of the cardiovascular status during cataract surgery.
    Matched MeSH terms: Cataract Extraction*
  18. Loo CY, Kandiah M, Arumugam G, Goh PP, John E, Gurusami B, et al.
    Int Ophthalmol, 2004 Mar;25(2):81-7.
    PMID: 15290886
    PURPOSE: To determine the cost efficiency and to compare the cost effectiveness of conventional extracapsular cataract surgery (ECCE) and phacoemulsification at three hospitals of the Malaysian Ministry of Health (MOH).

    METHODS: Patient demography, pre-operative visual acuity, intra-operative complications, post-operative complications and post-operative visual acuity were recorded for two hundred and forty seven of the 400 patients who underwent cataract surgery during a 2-week period. The cost of surgery, which included capital, staff and overhead, and patient care consumable costs were assessed prospectively in 8 randomly sampled patients over a 3-month period. Cost efficiency refers to cost per cataract surgery. Cost effectiveness refers to cost per successful cataract surgery. This is estimated by the ratio of cost efficiency to the proportion of successful cataract surgery. Successful surgery was defined as best-corrected visual acuity (BCVA) of better than 6/12 at 3 months post-operatively.

    RESULTS: Proportion of patients who had post-operative visual acuity of 6/12 or better was higher in phacoemulsification group (94%) than in the ECCE group (81%). Conventional extracapsular cataract surgery with intraocular lens implant costs RM3442 (USD 905.79) and phacoemulsification with intraocular lens implant costs RM4288 (USD 1128.42).

    DISCUSSION: There was no significant difference in cost effectiveness between ECCE and phacoemulsification. The cost of cataract surgery in the MOH hospital was found to be high due to the high overhead costs.

    Matched MeSH terms: Cataract Extraction/economics*
  19. Thevi T, Maizura Z, Abas AL
    Indian J Ophthalmol, 2017 Jan;65(1):24-29.
    PMID: 28300736 DOI: 10.4103/ijo.IJO_452_16
    INTRODUCTION: As in all surgeries, complications during cataract surgery are unavoidable and cause distress to the surgeon and the patient. This study was conducted to know the factors contributing to complications in our settings, to be able to counsel patients about complications and outcomes and to reduce litigations.

    MATERIALS AND METHODS: The secondary data analysis was conducted using the National Eye Database from 2007 to 2014. Demographic features, ocular comorbidities, technique of surgery, grade of surgeons, types of intraoperative complications, and reasons for not obtaining good visual acuity following intraoperative complications were studied. Statistics was done using Statistical Package for Social Sciences version 20.

    RESULTS: Out of 12,992 eyes, 6.1% had intraoperative complications. The highest rate of complications was when more trainees (medical officers [MOs] and gazetting specialists) operated. Posterior capsule rupture (PCR) was the most common complication followed by vitreous loss and zonular dehiscence. Those aged below 40 years had more complications (P < 0.05), and females had more complications. Ethnicity did not affect complications. Pseudoexfoliation was the only comorbidity causing complications (P < 0.05). Phacolytic lenses had 8.118 times the odds of getting intraoperative complications. MOs and gazetting specialists got more complications. Good outcomes were obtained in cases without complications and those operated by specialists. High astigmatism was the main reason for poorer outcomes.

    CONCLUSION: Intraoperative complications were caused mostly by less experienced doctors and had poorer outcomes. Age below 40 years, females, the presence of pseudoexfoliation and phacolytic lenses had more complications. PCR was the most common complication.

    Matched MeSH terms: Cataract Extraction/adverse effects*
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