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L P Ang

Publications and source records attributed to L P Ang.

11 recordsLinked to original sources
PubMed2001

Acute primary angle-closure: long-term intraocular pressure outcome in Asian eyes.

PURPOSE: To report the long-term outcome of intraocular pressure after laser peripheral iridotomy in Asian eyes with acute primary angle-closure. METHODS: Retrospective study of 111 eyes of 96 consecutive patients with acute primary angle-closure, presenting at the National University Hospital, Singapore, from 1990 to 1994. The presenting features of the affected eye and the treatment instituted were recorded. The subsequent long-term intraocular pressure outcome was analyzed. An increase in intraocular pressure on follow-up was defined as increase in intraocular pressure greater than 21 mm Hg and requiring treatment by medication or surgery. RESULTS: The mean follow-up period was 50.3 months (range, 9 to 107 months). The mean presenting intraocular pressure was 52.8 mm Hg (range, 28 to 80 mm Hg). One hundred ten eyes were treated with laser peripheral iridotomy, with resolution of the acute episode and intraocular pressure less than 21 mm Hg in all eyes after laser peripheral iridotomy. Of these, only 46 eyes (41.8%) were successfully treated with laser peripheral iridotomy alone in the long term. Sixty-four eyes (58.1%) developed an increase in intraocular pressure (requiring treatment) on follow-up, of which 49 eyes developed an increase in intraocular pressure within the first 6 months after acute primary angle-closure. Thirty-six eyes (32.7%) eventually underwent trabeculectomy because of uncontrolled intraocular pressure despite laser and medical therapy. CONCLUSIONS: In this study of Asian eyes, a high proportion (58.1%) of eyes with acute primary angle-closure developed an increase in intraocular pressure on long-term follow-up after resolution of the acute attack, despite the presence of a patent laser peripheral iridotomy. These results suggest a racial difference in the outcome of laser peripheral iridotomy after acute primary angle-closure in Asians, compared with Caucasians. Because a majority of eyes that develop an increase in intraocular pressure do so within the first 6 months of presentation, close monitoring of intraocular pressure is advised in the follow-up of patients with acute primary angle-closure.

Acute Disease↗
PubMed2000

Acute primary angle closure in an Asian population: long-term outcome of the fellow eye after prophylactic laser peripheral iridotomy.

PURPOSE: To study the long-term outcome of fellow eyes of Asian patients with acute primary angle closure (APAC) who underwent prophylactic laser peripheral iridotomy (LPI). DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Ninety-six consecutive patients with APAC at presentation to one Singapore hospital from January 1990 through December 1994. METHODS: The presenting features of the fellow eye were recorded, and the subsequent long-term intraocular pressure (IOP) outcome after LPI was analyzed. All fellow eyes were initially treated with pilocarpine 2% eyedrops four times daily before LPI, which was performed within 1 week of presentation. For any eye, a rise in IOP during follow-up was defined as a rise in IOP requiring treatment by medication or surgery. MAIN OUTCOME MEASURES: Incidence of acute angle closure and IOP. RESULTS: The mean follow-up period was 50.8 months (range, 9-99 months). Of the 96 patients, 15 patients had bilateral APAC, and APAC developed in one fellow eye before LPI could be performed. The remaining 80 fellow eyes were studied. No cases of APAC developed after prophylactic LPI. Seventy-one fellow eyes (88.8%) were successfully treated with LPI alone without the need for additional glaucoma treatment in the long term. Seven eyes (8.8%) had IOPs of 21 mmHg or less on presentation, but a rise in IOP developed on follow-up despite the presence of a patent LPI. Two fellow eyes (2.5%) had signs of preexisting chronic angle closure glaucoma at presentation and required further glaucoma treatment even after LPI. There were no significant complications from the procedure in any of the fellow eyes studied. CONCLUSIONS: In this Asian population with APAC, prophylactic LPI is safe and effective in preventing acute angle closure in fellow eyes. In addition, prophylactic LPI prevents long-term rise in IOP in 88.8% of fellow eyes (with approximately 4 years of follow-up). However, because a small proportion of fellow eyes did experience a rise in IOP within the first year, despite the presence of a patent LPI, close monitoring is still advised in the follow-up of fellow eyes of patients with APAC.

Acute Disease↗
PubMed2000

Long-term clinical course of primary angle-closure glaucoma in an Asian population.

PURPOSE: To study the long-term clinical course of patients with primary angle-closure glaucoma (PACG). DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Sixty-five consecutive patients who were diagnosed with PACG at one Singapore hospital from January 1990 through December 1994. METHODS: Primary angle-closure glaucoma was defined as the presence of glaucomatous optic neuropathy and compatible visual field loss associated with a closed angle in the same eye. All study eyes underwent laser peripheral iridotomy (LPI). There were two groups of patients studied. Group A consisted of those with a past documented history of an episode of acute angle closure (that had resolved after LPI). Group B consisted of those with no previous acute episode. The presenting features, management, and subsequent long-term intraocular pressure (IOP) outcome were analyzed. MAIN OUTCOME MEASURES: Intraocular pressure and the need for further glaucoma treatment. RESULTS: The follow-up period was 63 +/- 29 months (mean +/- standard deviation). The mean presenting IOP was 40 +/- 16 mmHg, and the presenting vertical cup-to-disc ratio was 0.6 +/- 0.2. Of the 83 eyes, only five eyes (6%) did not require any treatment after LPI in the long term. In group A (35 eyes), all eyes required further treatment with antiglaucoma medications. Twenty-two eyes (62. 9%) eventually underwent filtering surgery at a mean of 7.3 months after the commencement of treatment. In group B (48 eyes), 43 eyes (89.6%) underwent further medical therapy, of which 22 eyes (45.8%) eventually underwent filtering surgery at a mean of 18.4 months after the commencement of treatment. CONCLUSIONS: Despite the presence of a patent LPI, most eyes with established PACG require further treatment to control IOP. Medical therapy fails in most cases, necessitating filtering surgery. Patients risk experiencing further glaucomatous visual damage if this trend is not detected.

Adult↗
PubMed2000

Endogenous Klebsiella endophthalmitis.

PURPOSE: To report 4 cases of endogenous Klebsiella endophthalmitis. This disease is a rare but devastating complication of Klebsiella sepsis. Familiarity with its varied clinical presentations would aid in early diagnosis and institution of appropriate therapy. METHODS: We report 5 eyes of 4 patients with endogenous Klebsiella endophthalmitis from December 1995 to September 1996 and review the literature regarding previously successfully treated cases. RESULTS: The mean age of the patients was 67.5 years (range 37-85 years). One patient had bilateral involvement. At presentation, 3 eyes had a visual acuity of no perception of light (NPL) and the 1 patient with bilateral involvement had an acuity of counting fingers in one eye and 20/40 in the other. The primary source of sepsis was the pulmonary system in 2 patients, the hepatobiliary system in 1 patient and the urinary tract in 1 patient. One patient had coexisting diabetes mellitus. Two patients had a pupillary hypopyon. Local and systemic treatment with an aminoglycoside and cephalosporin was initiated. Despite treatment, 2 eyes remained NPL. One eye developed a globe perforation and was eviscerated. The patient with bilateral involvement was treated within 8 h and recovered fully with a final visual acuity of 20/20 in both eyes. CONCLUSION: It is important to have a high index of suspicion in patients with septicaemia presenting with intraocular inflammation, especially in diabetics with suppurative liver disease, urinary tract infection or pulmonary infection. As the visual prognosis for patients with Klebsiella endophthalmitis is generally poor, early diagnosis and treatment with intravenous and intravitreal antibiotics may improve the visual outcome.

Adult↗
PubMed2000

Bilateral choroidal infarction in a patient with antiphospholipid syndrome: a case report.

PURPOSE: To report a case of bilateral choroidal infarction occurring as a complication of primary antiphospholipid syndrome. METHODS: The case notes of the patient were reviewed. RESULTS: A 25-year-old man with primary antiphospholipid syndrome and a previous history of deep vein thrombosis and pulmonary embolism, developed episcleritis and bilateral choroidal infarction, with deterioration of vision to 6/12 OD and counting fingers at 5 feet OS. Anticoagulation therapy with warfarin was administered and the patient's vision gradually improved to 6/6 OD and 6/9 OS. CONCLUSION: Primary antiphospholipid syndrome is associated with thrombotic phenomena, which may affect the ocular arterial and venous vasculature. Therefore, a detailed ophthalmological examination is warranted in those patients who present with ocular symptoms and deteriorating vision. Retinal fluorescein angiography is valuable in confirming the diagnosis when in doubt, and in determining the extent of vessel occlusion.

Adult↗
PubMed2000

Abdominal pregnancy: a case report and literature review.

We report a rare and unusual case of an Abdominal pregnancy that was delivered successfully at term. It is the first documented case in the local literature in almost 30 years. What makes it even more exceptional is that despite the high mortality associated with the condition, both mother and baby survived the ordeal. She subsequently delivered another child, 2 years later by an elective lower segment caesarean section and had a tubal ligation performed concomitantly. A review of the topic and its management is also presented.

Adult↗
PubMed1997

Iris varix.

Varix of the iris as a solitary primary lesion is rare. We report a 31-year-old Indian man with an iris varix who developed recurrent haemorrhages into the anterior chamber which led to secondary glaucoma. An iridectomy was performed and the diagnosis was confirmed histologically. There has been no recurrence of the lesion 3 years after surgery.

Adult↗
PubMed1997

Endoscopic injection of collagen for the treatment of female urinary stress incontinence.

BACKGROUND: The objective of our study was to assess the efficacy and safety of glutaraldehyde cross-linked collagen injection in the treatment of female urinary stress incontinence. METHODS: We conducted a retrospective analysis of the records of 105 women who underwent collagen injection for urinary stress incontinence between March 1991 and April 1995. Preoperative assessment included uroflowmetry, residual urine determination, and urodynamic studies. RESULTS: Of the 105 women in our series, 95 patients (90.5%) had initial successful results at 3 months (61.0% cured, 29.5% significantly improved) while 4 patients (3.8%) had slight improvement and 6 (5.7%) failed surgical correction. One year after the procedure, the success rate dropped to 81.9% (86 patients) with 46.7% cured and 35.2% significantly improved. Nine patients (8.6%) had slight improvement and 10 patients (9.5%) failed surgical correction. Eight patients (7.6%) with initial unsatisfactory results underwent additional sessions of collagen injection and were subsequently either cured or had significant improvement. Twenty-three patients (21.9%) suffered a relapse. The mean time to relapse was 13.3 months, and 6 of those who relapsed underwent repeated injections with favorable results. Complications were minimal; 6 patients had temporary retention of urine, and 2 patients had urinary tract infections. CONCLUSIONS: We conclude that glutaraldehyde cross-linked collagen injection is a simple and safe method of treatment for urinary stress incontinence. A longer follow-up period is necessary to assess the long-term efficacy of this treatment.

Adult↗
PubMed1997

Penile revascularisation for vascular impotence.

OBJECTIVE: Many methods of microscopic penile revascularisation procedures have been employed over the past 2 decades for the treatment of vasculogenic impotence, with varying success rates. The aim of our study was to evaluate the effectiveness and complications of deep dorsal vein arterialisation in the treatment of selected patients with arteriogenic and mixed arteriogenic/venogenic impotence. METHODS: This involved a retrospective analysis of 6 patients with vasculogenic impotence who presented to Toa Payoh Hospital from December 1991 to November 1994 and had penile revascularisation surgery performed. All patients underwent an extensive preoperative assessment, including dynamic infusion cavernosometry and cavernosography and selective pudendal arteriography. RESULTS: The 6 patients were aged between 27 and 51 years (mean 44 years). 2 (33%) patients had pure arteriogenic impotence, while 4 (66%) had mixed arteriogenic and venogenic impotence. Two patients (33%) had excellent surgical outcomes and 2 patients (33%) were considered improved. The mean follow-up period was 19.8 months (range 8 to 37). Complications were minimal. CONCLUSIONS: We conclude that although the results of penile revascularisation are promising in carefully selected patients, further studies with longer follow-up and more objective postoperative tests of hemodynamic and erectile function are needed to assess the true value of this mode of treatment.

Adult↗
PubMedDate not supplied

A case of episcleral neurofibroma.

PURPOSE: To report a rare case of episcleral neurofibroma and discuss the possible differential diagnoses. METHODS: Case report of a 36-year-old man who presented with a painless epibulbar mass of the left eye. We describe the clinical and histopathologic features of the tumour and compare it with other tumours which may have a similar clinical presentation. RESULTS: An excisional biopsy of the tumour was performed. Histopathologic examination revealed the tumour to be an isolated episcleral neurofibroma. CONCLUSION: It is often difficult to clinically differentiate this tumour from other conditions. Because of the slow growth of neurofibromas and its slow risk of malignant transformation, these lesions may be observed periodically for progression. Surgical excision may be performed if the lesion is found to be progressively enlarging in size.

Adult↗