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Biomedical subjects

T Aung

Publications and source records attributed to T Aung.

At least 19 recordsLinked to original sources
PubMed2000

Comparison of the intraocular pressure-lowering effect of latanoprost and timolol in patients with chronic angle closure glaucoma: a preliminary study.

OBJECTIVE: To compare the intraocular pressure (IOP)-reducing effect and side effects of 0.005% latanoprost once daily to 0.5% timolol twice daily in patients with primary chronic angle closure glaucoma (CACG). DESIGN: Randomized, double-masked two-center clinical trial. PARTICIPANTS: Thirty-two Asian patients with CACG, defined as glaucomatous optic neuropathy with a compatible visual field defect and at least 6 clock hours of synechial angle closure on gonioscopy were recruited. All patients had previous peripheral iridotomy (PI) with IOP >21 mmHg after PI and were thereafter controlled (IOP <22 mmHg) with one or two pressure-reducing drugs. INTERVENTION: After a washout period, the patients were randomized to a 2-week treatment period with either placebo in the morning and 0.005% latanoprost in the evening or 0.5% timolol twice daily. MAIN OUTCOME MEASURES: The short-term IOP reduction of latanoprost and timolol in patients with CACG. IOP was measured at baseline, and after 2, 7, and 14 days of treatment. In addition, the short-term ocular and systemic adverse events of the two drugs were evaluated. RESULTS: Thirty patients completed the study. Two patients in the timolol group were withdrawn because of inadequate IOP control. Compared with baseline, the IOP after 2 weeks of treatment was statistically significantly reduced by 8.8 +/- 1.1 mmHg (mean +/- SEM, P < 0.001) in the latanoprost group, and by 5.7 +/- 0.9 mmHg (P < 0.001) in the timolol group. The difference in IOP reduction between the two treatment groups was 3.1 +/- 1.5 mm Hg in favor of latanoprost (P = 0.04). The main ocular adverse events reported in both treatment groups were conjunctival hyperemia and discomfort. CONCLUSIONS: In this preliminary study, a significantly greater IOP reduction was achieved with 0.005% latanoprost once daily compared with 0.5% timolol twice daily in patients with CACG. The results suggest that latanoprost may be a therapeutic choice for the medical treatment of primary CACG.

Adrenergic beta-Antagonists↗
PubMed2000

Trabeculectomy for acute primary angle closure.

OBJECTIVE: To analyze the results of trabeculectomy performed for all cases of acute primary angle closure (APAC). DESIGN: Retrospective, noncomparative case series PARTICIPANTS: Fifty-six consecutive patients who underwent trabeculectomy for APAC at two Singapore centers from 1993 through 1995. METHODS: The conventional treatment for APAC is to lower intraocular pressure (IOP) medically, after which laser peripheral iridotomy (PI) is performed. However, in Asian eyes, the acute attack is often refractory to standard treatment. Trabeculectomy is occasionally performed on eyes that do not respond to medical therapy, as well as eyes with APAC that respond to medical therapy but are assessed as having underlying chronic angle-closure glaucoma. In such cases, laser PI is not performed before trabeculectomy. MAIN OUTCOME MEASURES: The surgical outcome was assessed in terms of final IOP and the incidence of complications. Success was defined as final IOP less than 21 mmHg without medication, and qualified success was defined as final IOP less than 21 mmHg with medication. Patients whose IOP was more than 21 mmHg, required further glaucoma surgery, lost light perception, or whose eye became phthisical were classified as failures. RESULTS: The mean follow up was 22 months (range, 6-42 months). In group A, the medical failure group (n = 32), success in IOP control was obtained in 18 patients (56.2%), qualified success was achieved in 3 patients (9.4%), and failure resulted in 11 patients (34.4%). Ten patients (31.3%) encountered early postoperative complications such as shallow anterior chamber. In group B, the medical success group (n = 24), success in IOP control was achieved in 21 patients (87.5%), qualified success was achieved in 3 patients (12.5%), and there were no cases of failure. The incidence of postoperative complications was low (4 eyes [16.7%]). In terms of IOP outcome, trabeculectomy outcome was significantly worse in group A (P<0.001, Fisher's exact test). CONCLUSIONS: Because there is a high risk of surgical failure and complications, trabeculectomy may not be the procedure of choice in medically unresponsive cases of APAC.

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

Subjective visual experience during phacoemulsification and intraocular lens implantation under topical anesthesia.

OBJECTIVE: The aim of this study was to investigate the subjective visual experience of patients during phacoemulsification and intraocular lens (IOL) implantation under topical anesthesia. DESIGN: Postoperative questionnaire survey. PARTICIPANTS: The study cohort consisted of 52 patients with cataracts. There were 18 male (34.6%) and 34 female (65.4%) patients. Their mean (+/- SD) age was 67.5 (+/-10.8) years. INTERVENTION: The patients underwent routine phacoemulsification and IOL implantation under topical anesthesia. MAIN OUTCOME MEASURES: The patients were interviewed on the same day after their operation regarding their visual experience in the operated eye during surgery. RESULTS: All patients (100%) reported that they could see at least some light during the surgery. Some patients reported they could also see one or more colors (50 patients, 96.2%), movements (32 patients, 61.5%), flashes (24 patients, 46.2%), the surgeon's fingers/hands (13 patients, 25%), instruments (12 patients, 23.1%), and/or the surgeon (4 patients, 7.7%). The colors seen included red (24 patients, 46.2%), yellow (23 patients, 44.2%), blue (12 patients, 23.1%), green (7 patients, 13.5%), and orange (6 patients, 11.5%). Eight patients (15.4%) saw the spectrum of colors similar to that of the rainbow. Twenty-four patients (46.2%) reported that the brightness of light changed during the course of the operation. Eight patients (15.4%) found their visual experience frightening. There was no statistically significant association between those who found the visual experience frightening and the sex or age of the patient, a history of cataract operation in the fellow eye, the type of visual sensation experienced, or the presence of coexisting ocular pathology. CONCLUSION: All patients undergoing phacoemulsification under topical anesthesia experience a variety of visual sensations that may be frightening in a small proportion of patients.

Aged↗
PubMed2000

Ocular decompression retinopathy after resolution of acute primary angle closure glaucoma.

A patient presented with acute primary angle closure glaucoma with markedly elevated intraocular pressure. Two weeks after laser peripheral iridotomy and resolution of the acute attack, the patient was noted to have developed scattered retinal haemorrhages. The haemorrhages resolved over time with no visual sequelae. This is the first reported case of ocular decompression retinopathy after resolution of acute primary angle closure glaucoma.

Acute Disease↗
PubMed1999

Clinical application of a blood pressure autoregulation system during hypotensive anesthesia.

A blood pressure autoregulation system based on the state-predictive control method was developed to minimize intraoperative blood loss and hence avoid blood transfusion. In this report, the system is further improved by incorporating fuzzy logic with a fail-safe function and an individual parameter-identifying function. The safety and stability of this system had been confirmed by preclinical experiments with dogs. Thereafter clinical application with 17 patients was conducted to maintain their mean arterial pressure at around 60 mmHg during major surgery. The use of this system resulted in decreased blood loss and more speedy and accurate surgery due to a clearer surgical field. Unwanted effects of hypotension were not observed clinically or in laboratory tests. This system is therefore safe, stable, and effective in reducing the blood loss during major surgery that otherwise might cause substantial blood loss.

Anesthesia↗
PubMed1999

Correlation of tensile strength with bursting pressure in the evaluation of intestinal anastomosis.

BACKGROUND: Although bursting pressure and tensile strength have long been measured to evaluate anastomotic techniques, it has yet to be clarified whether or not they are correlated, what implications they have, and which should be used as a gold standard. MATERIAL AND METHODS: Using an experimental model to estimate pressure and tension in the same colonic anastomosis, the following variables were measured in 48 rats between days 0 and 14: bursting pressure (BP); minimal tensile strength (MITS) necessary to break a part of the anastomosis, and maximal tensile strength (MATS) needed to disrupt the whole anastomosis. Also, circulatory wall tension (CWT) was derived from BP and the anastomotic circumference (AC), and longitudinal wall tension (LWT) from MITS and AC. These variables were compared using correlation and regression analysis. RESULTS: During the lag phase (days < or = 4) there was poor correlation between pressure-related and tension-related variables whereas highly significant correlations were noted in the subsequent fibroplastic phase (day > or = 5). It was shown by regression lines that positive MITS and MATS were expected when BP was zero. CONCLUSION: Contrary to the previous assumption, no correlation was found between BP and tensile strength in the critical postoperative period. Based on our present and previous studies, measurement of MITS is recommended to evaluate the healing of colonic anastomosis.

Anastomosis, Surgical↗
PubMed1998

Glaucoma drainage implants in Asian eyes.

OBJECTIVE: Previous studies have suggested that there are racial differences in the outcome of conventional filtration surgery. This study aims to evaluate the outcome of glaucoma drainage implants in Asian eyes with complicated glaucoma and to determine whether there are racial differences in the results of such implant surgery compared to previous reports in non-Asian patients. DESIGN: The study design was a retrospective review of all patients with more than 6-months' follow-up after glaucoma implant surgery at the Singapore National Eye Centre between January 1993 and August 1996. PARTICIPANTS: A total of 83 Asian patients with uncontrolled complicated glaucoma participated. INTERVENTION: A total of 29 patients received Molteno implants and 54 received Baerveldt implants. MAIN OUTCOME MEASURES: The surgical outcome was assessed in terms of final intraocular pressure (IOP), visual acuity outcome, and incidence of complications. Success was defined as final IOP less than 22 mmHg with no medications and qualified success as an IOP less than 22 mmHg with medication. RESULTS: With mean follow-up of 13.41 months, success in IOP control was achieved in 73.5% of patients and qualified success in 12%. Visual acuity remained stable or improved in 85.5%. There were no patients who encountered intraoperative complications, and the incidence of serious postoperative complications was low. The most frequently observed short- and long-term postoperative complication was hyphema in 14 eyes (16.9%) and bullous keratopathy in 7 eyes (8.4%), respectively. CONCLUSIONS: Glaucoma drainage implants have good outcome and visual stabilization in Asian eyes with success rates for IOP control comparable to those reported in previous studies in non-Asian eyes.

Adolescent↗
PubMed1998

Nosocomial Klebsiella pneumoniae conjunctivitis resulting in infectious keratitis and bilateral corneal perforation.

PURPOSE: Klebsiella pneumoniae is a known cause of metastatic endophthalmitis. However, the organism has never been described to cause severe infectious keratoconjunctivitis. We report a fulminant case of nosocomial K. pneumoniae conjunctivitis complicated by infectious keratitis and corneal perforation in both eyes. METHODS: An 83-year-old previously healthy Chinese woman, blind in the right eye from rubeotic glaucoma and with bilateral dense cataracts, was admitted for observation after a head injury. While in hospital, she developed purulent bilateral conjunctivitis. Repeated cultures grew K. pneumoniae. This rapidly progressed to severe infectious keratitis and corneal perforation in both eyes, despite intensive antibiotics to which the organism was susceptible. The patient was otherwise well, and investigations did not reveal any source of endogenous sepsis. RESULTS: The patient lost complete vision in both eyes. The left eye turned phthisical, and the right eye was eviscerated for uncontrolled endophthalmitis. CONCLUSION: Although not previously reported, K. pneumoniae can cause devastating keratoconjunctivitis resulting in corneal melt, perforation, and uncontrolled endophthalmitis.

Aged↗
PubMed1998

Frontal sinus mucoceles causing proptosis--two case reports.

Paranasal sinus mucoceles can present with a multitude of different symptoms including ophthalmic disturbances. We describe two patients with frontal sinus mucoceles presenting with non-axial proptosis, and give details of their presentation, investigations and treatment. Possible ocular manifestations of mucoceles and the diagnostic imaging techniques used are discussed. The treatment of mucoceles is reviewed. It is stressed that a team approach involving the ophthalmologist, otolaryngologist and radiologist is essential for accurate diagnosis and management.

Adult↗
PubMed1997

Penetrating cardiac injury without tamponade.

A case of unsuspected penetrating cardiac injury is presented. It was recognised by the presence of bleeding into peritoneal cavity even after the source of bleeding from intra-abdominal organs had been stopped. It highlights the importance of high index of suspicion of associated cardiac injury in high epigastric penetrating injury.

Adult↗
PubMed1996

Orbital colour Doppler imaging in carotid-cavernous sinus fistula.

BACKGROUND: Colour Doppler imaging (CDI) is a recent advance in ultrasonography that allows for colour-encoded blood flow data of a vascular structure to be displayed simultaneously on a conventional real-time gray-scale B mode image. Real time A and B mode ultrasonography have been used for diagnostic evaluation of ophthalmic disorders since the early 1960s. The haemodynamic characteristics of the ophthalmic circulation have recently been studied by the use of CDI. METHOD: We present three cases of carotid-cavernous sinus fistulas with different presentations. In each case, orbital CDI was used in evaluating the patient's condition. RESULTS: Orbital CDI was successful in confirming the diagnosis in all three cases. CDI was capable of showing the haemodynamic changes in the orbital vasculature which resulted from carotid-cavernous sinus fistula. CONCLUSION: This non-invasive technique presents as an excellent alternative to invasive vascular studies such as angiography for the diagnosis and evaluation of carotid-cavernous sinus fistulas.

Aged↗
PubMed1996

Oedipism.

BACKGROUND: Oedipism or self-enucleation is a rare form of self-mutilation, and most often described in acutely psychotic patients, who have religious or sexual delusions. CLINICAL RECORD: A 47-year-old Chinese man with a history of chronic schizophrenia enucleated his own left eye and mutilated his right eye. The reason for his behaviour was unknown. The history and legends surrounding autoenucleation and the medical literature are reviewed. RESULTS: The patient was managed jointly with the psychiatrist. He suffered extensive injury to his right eye, resulting in loss of vision. CONCLUSION: The management of Oedipism requires close cooperation between ophthalmologists and psychiatrists. Precautions must be taken to prevent repeated attempts or other self-mutilatory behaviour.

Eye Enucleation↗