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Biomedical subjects

D S Lam

Publications and source records attributed to D S Lam.

At least 109 records · Page 6Linked to original sources
PubMed2000

The association between cigarette smoking and ocular diseases.

OBJECTIVE: To review the effect of smoking on common ocular disorders. DATA SOURCES: Medline literature search, 1966 to 1999. STUDY SELECTION: The following key words were used: smoking; Graves' disease, age-related macular degeneration; glaucoma; cataract. DATA EXTRACTION: Epidemiological and experimental studies were reviewed. DATA SYNTHESIS: Cigarette smoking is an important risk factor for cardiovascular, respiratory, and malignant diseases. There is also a strong association between smoking and a number of common eye diseases, which include Graves' ophthalmopathy, age-related macular degeneration, glaucoma, and cataract. Despite the multifactorial aetiology of these ocular syndromes, smoking is an independent risk factor that has dose-response effects. It causes morphological and functional changes to the lens and retina due to its atherosclerotic and thrombotic effects on the ocular capillaries. Smoking also enhances the generation of free radicals and decreases the levels of antioxidants in the blood circulation, aqueous humour, and ocular tissue. Thus, the eyes are more at risk of having free-radical and oxidation attacks in smokers. CONCLUSION: Smoking, if continued, may perpetuate further ocular damage and lead to permanent blindness. Cessation of smoking and avoidance of passive smoking is advised to minimise the harmful effects of smoking on the eyes.

Cataract↗
PubMed2000

Inferior limbal-conjunctival autograft transplantation for recurrent pterygium.

PURPOSE: To study the safety and efficacy of inferior limbal-conjunctival autograft (LCAT) transplantation in the surgical management of recurrent pterygium. METHODS: Prospective non-comparative case series. Inferior limbal-conjunctival autografting was performed on 11 patients (11 eyes) with recurrent pterygium. Pterygium recurrence was considered a surgical failure. RESULTS: Recurrence of pterygium was noted in two (18.2%) eyes, after a mean follow up of 16.2 +/- 0.9 months (range: 10-19 months). Neither recurrence required further surgical treatment. Nonprogressive pseudopterygium formation was noted at the donor site in five (45.5%) eyes. CONCLUSION: Inferior LCAT appears to be a safe and effective option in the management of recurrent pterygium. In patients with suspected or proven glaucoma, this may be the procedure of choice, if mitomycin C is contraindicated.

Adult↗
PubMed1999

Modified sutureless sclerotomies in pars plana vitrectomy.

PURPOSE: To study the effectiveness and safety of a modified sutureless sclerotomy technique in pars plana vitrectomy. METHODS: We rotated the scleral tunnels of the original sutureless sclerotomy technique through 90 degrees, thus rendering them parallel to the corneoscleral limbus. This modified technique was applied to 25 consecutive eyes (25 patients) that had pars plana vitrectomy during a 2-month period. RESULTS: Twenty (80%) of 25 eyes (25 patients) did not require suturing of the sclerotomy sites associated with pars plana vitrectomy. Eight (11%) of 75 sclerotomy sites required suturing to ensure watertight closure. No clinically significant complications were encountered. CONCLUSION: The modified sutureless sclerotomy technique was found to be safe, more convenient, and easier to perform, especially in eyes with small interpalpebral space.

Humans↗
PubMed1999

Isolated pedunculated congenital corneal dermoid.

PURPOSE: To investigate a case of isolated pedunculated congenital corneal dermoid. METHODS: Case report. RESULTS: In a 14-day-old infant, the pedunculated portion of the dermoid was removed and confirmed by histopathologic examination. No surgical complication or recurrence was encountered, and the patient is waiting for a rotational autokeratoplasty. CONCLUSIONS: Prompt treatment of such an unusual tumor is important to allow for visual rehabilitation and development.

Corneal Diseases↗
PubMed1999

Retinal breaks.

Explore the source record for details and available documents.

Humans↗
PubMed1999

Ocular complications of pediatric bone marrow transplantation.

OBJECTIVE: To investigate the ocular complications in pediatric bone marrow transplantation (BMT) patients. DESIGN: Cross-sectional study. PARTICIPANTS: A total of 29 pediatric BMT patients were studied. TESTING: Comprehensive ophthalmic check-up, including best-corrected visual acuity, intraocular pressure (IOP), Schirmer's test, tear breakup time, and slit-lamp and fundus examinations, was performed. MAIN OUTCOME MEASURES: Tear film instability and its related complications, IOP, cataract, and fundus lesions were measured. RESULTS: The mean age of patients was 9.1 years (range, 1.5-15 years). The mean post-BMT duration was 20.2 months (range, 3-54 months). Fifteen patients (51.7%) had tear abnormalities. Subconjunctival fibrosis was detected in two patients (6.9%). Dry and scaly skin of the eyelids was seen in one patient (3.4%). Lens opacities were found in 2 (33.3%) of 6 irradiated patients and 2 (8.7%) of 23 nonirradiated patients. Two patients (6.9%) had fundus changes, one with unilateral epiretinal membrane and the other with bilateral multiple discrete chorioretinal hypopigmented lesions in the middle to peripheral part of the retina. The overall complication rates for the anterior and posterior segments were 75.8% and 6.9%, respectively. CONCLUSION: Ocular manifestations of BMT in children are not uncommon. The most common anterior segment problem is tear dysfunction. Posterior segment complications are less common but do exist. High rate of cataract formation is reported, and this probably is the most important long-term "amblyogenic" problem in these immature eyes. Awareness and management of these problems with routine eye examination and early intervention are recommended.

Adolescent↗
PubMed1999

Retinal complications after cataract extraction in patients with high myopia.

OBJECTIVE: To assess risk factors and incidence of retinal complications after cataract extraction in patients with high myopia. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: One hundred eighteen patients with highly myopic eyes who had an axial length of 26 mm or more (mean axial length, 30.13 +/- 2.08 mm) and who underwent cataract surgery over a period of 6 years were studied. INTERVENTION: Patients underwent cataract extraction either by extracapsular cataract extraction (ECCE) or phacoemulsification. Prophylactic argon laser photocoagulation was performed in 13 eyes for retinal tears recognized before surgery and in 13 eyes after surgery; neodymium:YAG (Nd:YAG) laser capsulotomy was performed for patients with posterior capsule opacification (PCO) that affected the vision. MAIN OUTCOME MEASURES: Incidence of retinal detachment and PCO and percentage of prophylactic argon laser or of Nd:YAG laser treatments. RESULTS: Of the 118 eyes, 73 (61.9%) underwent ECCE and 45 (38.1%) underwent phacoemulsification. Posterior capsule opacification was the most common complication and was found in 30 eyes (25.4%). Thirteen patients (11%) received prophylactic laser treatment for retinal tears before cataract operation, and 13 more patients (11%) had postoperative retinal tears requiring laser treatments. None of these patients developed retinal detachment. Two patients (1.69%) developed retinal detachment within 6 months after their operations. There were no intraoperative complications, and postoperative Nd:YAG capsulotomy was not performed in these two patients. CONCLUSIONS: Active searching and prophylactic laser treatments for retinal tears developed before and after cataract extraction in patients with high myopia are recommended. This may lower the incidence of postoperative retinal detachment.

Adult↗
PubMed1999

Culture-negative ulcerative keratitis after laser in situ keratomileusis.

A 40-year old man, highly myopic in both eyes, had laser in situ keratomileusis (LASIK) in the left eye in November 1996. Corneal melting and ulceration and fine striae-like interface infiltrates were noticed 1 day postoperatively. There was no response to intensive topical antibiotics in the form of hourly ofloxacin 3% (Tarivid), and satellite lesions developed on day 4. Corneal scrapings for gram stain and culture were done twice. No bacterial or fungal organisms were identified. Intensive topical fortified vancomycin (50 mg/mL) was added, and the lesions resolved gradually over the ensuing 2 weeks. Eighteen months after LASIK, refraction was -1.50 - 0.75 x 105 in the left eye, and uncorrected visual acuity was 20/70, correctable to 20/25 with spectacles.

Adult↗
PubMed1999

Management of severe flap wrinkling or dislodgment after laser in situ keratomileusis.

PURPOSE: To review the management and results of cases with severe flap wrinkling or dislodgment after laser in situ keratomileusis (LASIK). SETTING: University Eye Center, Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, The Chinese University of Hong Kong. METHODS: Four patients with severe flap wrinkling or dislodgment after LASIK are described. Surgical repositioning of the flap was performed in all cases. Flap status, refractive changes, and final uncorrected and best corrected visual acuities were used to evaluate the outcome of flap repositioning. RESULTS: Flap repositioning required suturing in 2 patients, 1 of whom developed severe epithelial ingrowth with melting of the corneal flap and stromal bed and eventually required flap removal. The stromal inflammation resolved, and the corneal surface re-epithelialized after flap excision. In 2 other patients, wedge-shaped tissue excision (1.0 x 1.5 mm) from the superior portion of the corneal flap was necessary to allow better flap realignment. In 1 of these patients, the corneal flap was eventually converted to a free cap to correct residual wrinkling. At a mean follow-up of 15 months, the postoperative uncorrected visual acuity ranged from 20/20 to 20/60, and the best spectacle-corrected visual acuity (BSCVA) was 20/30 or better in all patients. In 1 patient, BSCVA decreased by 1 line. CONCLUSIONS: Flap dislodgment and wrinkling are serious postoperative complications of LASIK. Early recognition of these complications and prompt surgical management are crucial to achieve a successful surgical and visual outcome.

Adult↗