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Dennis S C Lam - One of the best experts on this subject based on the ideXlab platform.
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Phacoemulsification versus trabeculectomy in medically uncontrolled chronic angle closure glaucoma without cataract
Ophthalmology, 2013Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Dennis S C Lam, Nafees BaigAbstract:Objective To compare Phacoemulsification versus trabeculectomy with adjunctive mitomycin C in medically uncontrolled chronic angle-closure glaucoma (CACG) without cataract. Design Prospective, randomized clinical trial. Participants Fifty medically uncontrolled CACG eyes without cataract of 50 patients. Intervention Patients were randomized into undergoing either Phacoemulsification or trabeculectomy with adjunctive mitomycin C. After surgery, patients were followed up every 3 months for 2 years. Main Outcome Measures Intraocular pressure (IOP) and requirement for glaucoma drugs. Results Twenty-six CACG eyes were randomized to receive Phacoemulsification, and 24 eyes underwent trabeculectomy with mitomycin C. Phacoemulsification and trabeculectomy resulted in significant and comparable IOP reduction at 24 months after surgery (reduction of 8.4 mmHg or 34% for Phacoemulsification vs. 8.9 mmHg or 36% for trabeculectomy; P = 0.76). Over first 24 months, trabeculectomy-treated eyes required on average 1.1 fewer drugs than Phacoemulsification-treated eyes ( P P = 0.001). Eight (33%) of 24 trabeculectomy eyes demonstrated cataract during follow-up. Conclusions Both Phacoemulsification and trabeculectomy are effective in reducing IOP in medically uncontrolled CACG eyes without cataract. Trabeculectomy is more effective than Phacoemulsification in reducing dependence on glaucoma drugs, but is associated with more complications. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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effects of Phacoemulsification versus combined phaco trabeculectomy on drainage angle status in primary angle closure glaucoma pacg
Journal of Glaucoma, 2010Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Jimmy S M Lai, Dennis S C LamAbstract:PURPOSE To document anatomic effects of Phacoemulsification versus combined phaco-trabeculectomy on drainage angle in primary angle closure glaucoma (PACG). METHODS Indentation gonioscopy and ultrasound biomicroscopy were performed preoperatively, and then at 1 year after Phacoemulsification alone or combined phaco-trabeculectomy in PACG patients. RESULTS Seventy-two PACG eyes of 72 patients were included in this study. Thirty-eight eyes were randomized into receiving Phacoemulsification alone, whereas 34 eyes had combined phaco-trabeculectomy. The mean extent of synechial angle closure was significantly reduced from 266.4 degrees to 198.9 degrees (P<0.001) by Phacoemulsification alone, and from 266.0 degrees to 227.2 degrees (P=0.03) by combined surgery. The mean angle opening distance (AOD 500) measured by ultrasound biomicroscopy was significantly increased from 208.0 to 468.0 microm (P<0.001) by Phacoemulsification, and from 214.6 to 344.4 microm (P<0.001) by combined surgery. The mean trabecular-ciliary process distance was significantly increased from 824.6 to 1043.6 microm (P<0.001) by Phacoemulsification, and from 800.9 to 951.5 microm (P=0.01) by combined surgery. The mean anterior chamber depth was significantly increased from 1798.6 to 3528.4 microm (P<0.001) by Phacoemulsification alone, and from 1781.6 to 3297.8 microm (P<0.001) by combined surgery. Phacoemulsification alone resulted in significantly greater postoperative angle opening distance 500 (P<0.001) and anterior chamber depth (P<0.001) than phaco-trabeculectomy. CONCLUSIONS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes. SYNOPSIS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes.
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Surgically induced astigmatism in Phacoemulsification, pars plana vitrectomy, and combined Phacoemulsification and vitrectomy: a comparative study.
Eye (London England), 2008Co-Authors: C. Y. F. Yuen, B. T. O. Cheung, Chi Wai Tsang, R. F. Lam, N. B. Baig, Dennis S C LamAbstract:Surgically induced astigmatism in Phacoemulsification, pars plana vitrectomy, and combined Phacoemulsification and vitrectomy: a comparative study
Clement C Y Tham - One of the best experts on this subject based on the ideXlab platform.
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Phacoemulsification versus trabeculectomy in medically uncontrolled chronic angle closure glaucoma without cataract
Ophthalmology, 2013Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Dennis S C Lam, Nafees BaigAbstract:Objective To compare Phacoemulsification versus trabeculectomy with adjunctive mitomycin C in medically uncontrolled chronic angle-closure glaucoma (CACG) without cataract. Design Prospective, randomized clinical trial. Participants Fifty medically uncontrolled CACG eyes without cataract of 50 patients. Intervention Patients were randomized into undergoing either Phacoemulsification or trabeculectomy with adjunctive mitomycin C. After surgery, patients were followed up every 3 months for 2 years. Main Outcome Measures Intraocular pressure (IOP) and requirement for glaucoma drugs. Results Twenty-six CACG eyes were randomized to receive Phacoemulsification, and 24 eyes underwent trabeculectomy with mitomycin C. Phacoemulsification and trabeculectomy resulted in significant and comparable IOP reduction at 24 months after surgery (reduction of 8.4 mmHg or 34% for Phacoemulsification vs. 8.9 mmHg or 36% for trabeculectomy; P = 0.76). Over first 24 months, trabeculectomy-treated eyes required on average 1.1 fewer drugs than Phacoemulsification-treated eyes ( P P = 0.001). Eight (33%) of 24 trabeculectomy eyes demonstrated cataract during follow-up. Conclusions Both Phacoemulsification and trabeculectomy are effective in reducing IOP in medically uncontrolled CACG eyes without cataract. Trabeculectomy is more effective than Phacoemulsification in reducing dependence on glaucoma drugs, but is associated with more complications. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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effects of Phacoemulsification versus combined phaco trabeculectomy on drainage angle status in primary angle closure glaucoma pacg
Journal of Glaucoma, 2010Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Jimmy S M Lai, Dennis S C LamAbstract:PURPOSE To document anatomic effects of Phacoemulsification versus combined phaco-trabeculectomy on drainage angle in primary angle closure glaucoma (PACG). METHODS Indentation gonioscopy and ultrasound biomicroscopy were performed preoperatively, and then at 1 year after Phacoemulsification alone or combined phaco-trabeculectomy in PACG patients. RESULTS Seventy-two PACG eyes of 72 patients were included in this study. Thirty-eight eyes were randomized into receiving Phacoemulsification alone, whereas 34 eyes had combined phaco-trabeculectomy. The mean extent of synechial angle closure was significantly reduced from 266.4 degrees to 198.9 degrees (P<0.001) by Phacoemulsification alone, and from 266.0 degrees to 227.2 degrees (P=0.03) by combined surgery. The mean angle opening distance (AOD 500) measured by ultrasound biomicroscopy was significantly increased from 208.0 to 468.0 microm (P<0.001) by Phacoemulsification, and from 214.6 to 344.4 microm (P<0.001) by combined surgery. The mean trabecular-ciliary process distance was significantly increased from 824.6 to 1043.6 microm (P<0.001) by Phacoemulsification, and from 800.9 to 951.5 microm (P=0.01) by combined surgery. The mean anterior chamber depth was significantly increased from 1798.6 to 3528.4 microm (P<0.001) by Phacoemulsification alone, and from 1781.6 to 3297.8 microm (P<0.001) by combined surgery. Phacoemulsification alone resulted in significantly greater postoperative angle opening distance 500 (P<0.001) and anterior chamber depth (P<0.001) than phaco-trabeculectomy. CONCLUSIONS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes. SYNOPSIS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes.
Dexter Y L Leung - One of the best experts on this subject based on the ideXlab platform.
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Phacoemulsification versus trabeculectomy in medically uncontrolled chronic angle closure glaucoma without cataract
Ophthalmology, 2013Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Dennis S C Lam, Nafees BaigAbstract:Objective To compare Phacoemulsification versus trabeculectomy with adjunctive mitomycin C in medically uncontrolled chronic angle-closure glaucoma (CACG) without cataract. Design Prospective, randomized clinical trial. Participants Fifty medically uncontrolled CACG eyes without cataract of 50 patients. Intervention Patients were randomized into undergoing either Phacoemulsification or trabeculectomy with adjunctive mitomycin C. After surgery, patients were followed up every 3 months for 2 years. Main Outcome Measures Intraocular pressure (IOP) and requirement for glaucoma drugs. Results Twenty-six CACG eyes were randomized to receive Phacoemulsification, and 24 eyes underwent trabeculectomy with mitomycin C. Phacoemulsification and trabeculectomy resulted in significant and comparable IOP reduction at 24 months after surgery (reduction of 8.4 mmHg or 34% for Phacoemulsification vs. 8.9 mmHg or 36% for trabeculectomy; P = 0.76). Over first 24 months, trabeculectomy-treated eyes required on average 1.1 fewer drugs than Phacoemulsification-treated eyes ( P P = 0.001). Eight (33%) of 24 trabeculectomy eyes demonstrated cataract during follow-up. Conclusions Both Phacoemulsification and trabeculectomy are effective in reducing IOP in medically uncontrolled CACG eyes without cataract. Trabeculectomy is more effective than Phacoemulsification in reducing dependence on glaucoma drugs, but is associated with more complications. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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effects of Phacoemulsification versus combined phaco trabeculectomy on drainage angle status in primary angle closure glaucoma pacg
Journal of Glaucoma, 2010Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Jimmy S M Lai, Dennis S C LamAbstract:PURPOSE To document anatomic effects of Phacoemulsification versus combined phaco-trabeculectomy on drainage angle in primary angle closure glaucoma (PACG). METHODS Indentation gonioscopy and ultrasound biomicroscopy were performed preoperatively, and then at 1 year after Phacoemulsification alone or combined phaco-trabeculectomy in PACG patients. RESULTS Seventy-two PACG eyes of 72 patients were included in this study. Thirty-eight eyes were randomized into receiving Phacoemulsification alone, whereas 34 eyes had combined phaco-trabeculectomy. The mean extent of synechial angle closure was significantly reduced from 266.4 degrees to 198.9 degrees (P<0.001) by Phacoemulsification alone, and from 266.0 degrees to 227.2 degrees (P=0.03) by combined surgery. The mean angle opening distance (AOD 500) measured by ultrasound biomicroscopy was significantly increased from 208.0 to 468.0 microm (P<0.001) by Phacoemulsification, and from 214.6 to 344.4 microm (P<0.001) by combined surgery. The mean trabecular-ciliary process distance was significantly increased from 824.6 to 1043.6 microm (P<0.001) by Phacoemulsification, and from 800.9 to 951.5 microm (P=0.01) by combined surgery. The mean anterior chamber depth was significantly increased from 1798.6 to 3528.4 microm (P<0.001) by Phacoemulsification alone, and from 1781.6 to 3297.8 microm (P<0.001) by combined surgery. Phacoemulsification alone resulted in significantly greater postoperative angle opening distance 500 (P<0.001) and anterior chamber depth (P<0.001) than phaco-trabeculectomy. CONCLUSIONS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes. SYNOPSIS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes.
Yolanda Y Y Kwong - One of the best experts on this subject based on the ideXlab platform.
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Phacoemulsification versus trabeculectomy in medically uncontrolled chronic angle closure glaucoma without cataract
Ophthalmology, 2013Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Dennis S C Lam, Nafees BaigAbstract:Objective To compare Phacoemulsification versus trabeculectomy with adjunctive mitomycin C in medically uncontrolled chronic angle-closure glaucoma (CACG) without cataract. Design Prospective, randomized clinical trial. Participants Fifty medically uncontrolled CACG eyes without cataract of 50 patients. Intervention Patients were randomized into undergoing either Phacoemulsification or trabeculectomy with adjunctive mitomycin C. After surgery, patients were followed up every 3 months for 2 years. Main Outcome Measures Intraocular pressure (IOP) and requirement for glaucoma drugs. Results Twenty-six CACG eyes were randomized to receive Phacoemulsification, and 24 eyes underwent trabeculectomy with mitomycin C. Phacoemulsification and trabeculectomy resulted in significant and comparable IOP reduction at 24 months after surgery (reduction of 8.4 mmHg or 34% for Phacoemulsification vs. 8.9 mmHg or 36% for trabeculectomy; P = 0.76). Over first 24 months, trabeculectomy-treated eyes required on average 1.1 fewer drugs than Phacoemulsification-treated eyes ( P P = 0.001). Eight (33%) of 24 trabeculectomy eyes demonstrated cataract during follow-up. Conclusions Both Phacoemulsification and trabeculectomy are effective in reducing IOP in medically uncontrolled CACG eyes without cataract. Trabeculectomy is more effective than Phacoemulsification in reducing dependence on glaucoma drugs, but is associated with more complications. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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effects of Phacoemulsification versus combined phaco trabeculectomy on drainage angle status in primary angle closure glaucoma pacg
Journal of Glaucoma, 2010Co-Authors: Clement C Y Tham, Dexter Y L Leung, Yolanda Y Y Kwong, Jimmy S M Lai, Dennis S C LamAbstract:PURPOSE To document anatomic effects of Phacoemulsification versus combined phaco-trabeculectomy on drainage angle in primary angle closure glaucoma (PACG). METHODS Indentation gonioscopy and ultrasound biomicroscopy were performed preoperatively, and then at 1 year after Phacoemulsification alone or combined phaco-trabeculectomy in PACG patients. RESULTS Seventy-two PACG eyes of 72 patients were included in this study. Thirty-eight eyes were randomized into receiving Phacoemulsification alone, whereas 34 eyes had combined phaco-trabeculectomy. The mean extent of synechial angle closure was significantly reduced from 266.4 degrees to 198.9 degrees (P<0.001) by Phacoemulsification alone, and from 266.0 degrees to 227.2 degrees (P=0.03) by combined surgery. The mean angle opening distance (AOD 500) measured by ultrasound biomicroscopy was significantly increased from 208.0 to 468.0 microm (P<0.001) by Phacoemulsification, and from 214.6 to 344.4 microm (P<0.001) by combined surgery. The mean trabecular-ciliary process distance was significantly increased from 824.6 to 1043.6 microm (P<0.001) by Phacoemulsification, and from 800.9 to 951.5 microm (P=0.01) by combined surgery. The mean anterior chamber depth was significantly increased from 1798.6 to 3528.4 microm (P<0.001) by Phacoemulsification alone, and from 1781.6 to 3297.8 microm (P<0.001) by combined surgery. Phacoemulsification alone resulted in significantly greater postoperative angle opening distance 500 (P<0.001) and anterior chamber depth (P<0.001) than phaco-trabeculectomy. CONCLUSIONS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes. SYNOPSIS Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes.
Arie L Marcovich - One of the best experts on this subject based on the ideXlab platform.
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topical tetracaine versus topical tetracaine plus intracameral lidocaine for cataract surgery
Journal of Cataract and Refractive Surgery, 1998Co-Authors: Noel S Carino, Allan R Slomovic, Frances Chung, Arie L MarcovichAbstract:Abstract Purpose: To compare topical tetracaine 0.5% alone and with intracameral lidocaine 1% as a local anesthetic agent in Phacoemulsification with intraocular lens (IOL) implantation. Setting: The Toronto Hospital—Western Division; Toronto, Canada. Methods: Fifty-trine consecutive patients (60 eyes) having Phacoemulsification with implantation of a foldable acrylic IOL (AcrySot) were randomized into 1 of 2 groups: The-intracameral balanced salt solution (BSS) group received topical tetracaine 0.5% plus intracameral BSS;-the intracameral lidocaine group received topical tetracaine 0.5.% with preservabve-free intracameral lidocaine 1%. The patients' subjective experience of pain ,vvas measured at 4 points during surgery using a 4-point pain scale. Patient and surgeon satisfaction with the anesthesia used was measured using a 5-point satisfaction scale. Central endothelial cell counts were obtained preoperatively and 1 month postoperatively. Best corrected visual acuity (BCVA) was measured pfeoperatively and 1 hour, i day, 1 week, and 1 month postoperatively. Results: The mean pain score after phaccemulsfication was significantly higher in the intracameral BSS group than in the intracameral lidocaine group (0.63 ± 0.7 [SD] and 0.23 ± 0.4, respectively,- P P P Conclusion: Topical tetracaine 0.5% with intracameral lidocaine was safe and effective in patients having phacoemulsifcation with IOL implantation. The advantage of using intracameral lidocaine 1% over a placebo was a significant decrease in the patients' subjective experience of pain and in the surgeon's satisfaction with the anesthesia used. None of the other parameters measured in this study differed significantly between the 2 groups.
