PubMed Health⌕ Search

Biomedical subjects

D S Lam

Publications and source records attributed to D S Lam.

At least 127 records · Page 7Linked to original sources
PubMed1999

Combined surgery for severe eye trauma with extensive iridodialysis, posterior lens dislocation, and intractable glaucoma.

A 44-year-old woman sustained a severe left eye contusion from the explosion of a plastic bottle containing fermented orange juice. This resulted in extensive iridodialysis, posterior crystalline lens dislocation, and intractable glaucoma. Eleven days after the injury, combined surgery of trabeculectomy with mitomycin-C, pars plana vitrectomy, lens removal, iridodialysis repair, and scleral-fixated intraocular lens implantation under general anesthesia was performed. Intraocular pressure (IOP) was under control until 5 weeks postoperatively; glaucoma implant surgery was then performed. At the last follow-up 15 months after the combined surgery, best corrected visual acuity was 20/50 and IOP was 15 mm Hg without medication. Combined surgery can be considered a safe, effective option in the management of severe eye trauma in selected cases.

Adult↗
PubMed1999

Limited argon laser peripheral iridoplasty as immediate treatment for an acute attack of primary angle closure glaucoma: a preliminary study.

PURPOSE: To study the efficacy and safety of limited (180 degrees) argon laser peripheral iridoplasty (ALPI) as a first-line treatment for acute primary angle closure glaucoma (PACG) without the use of systemic anti-glaucomatous medications. METHODS: Ten consecutive patients with PACG were recruited into the study. Each patient received topical pilocarpine (4%) and timolol (0.5%), and immediate limited ALPI as primary treatment. The intraocular pressures at 15, 30 and 60 min after ALPI were documented by Goldmann applanation tonometry. RESULTS: The mean intraocular pressure (IOP) of this group of patients was reduced from 57.9 +/- 10.6 mmHg to 39.0 +/- 10.9 mmHg at 15 min, 28.3 +/- 9.1 mmHg at 30 min and 20.4 +/- 9.0 mmHg at 60 min after ALPI. No complications were encountered. In 8 of the 10 patients the corneal oedema cleared 1 h after ALPI. In the remaining 2 patients the corneal oedema cleared 2 h after ALPI. CONCLUSION: Immediate limited ALPI, without adjunctive systemic anti-glaucomatous medications, appeared to be effective and safe in controlling the IOP in treating acute PACG with a duration of attack < or = 48 h. It may be as effective as 360 degrees ALPI, and therefore has a role in those patients in whom 360 degrees treatment is not possible.

Acute Disease↗
PubMed1999

Primary orbital Ewing's sarcoma: report of a case and review of the literature.

Primary orbital Ewing's sarcoma is a very rare condition. Since the first case was reported in 1950, only 7 other cases have been reported in the English literature. Herein we describe the ninth, the only bilateral and the youngest case of primary orbital Ewing's sarcoma occurring in a 2-year-old boy, who presented to us with bilateral painless proptosis. Tissue biopsy of the tumour was obtained through the nasal sinus. Immunohistological studies of the biopsy tissue confirmed the diagnosis of Ewing's sarcoma. No distant site of the tumour was found so this was considered a primary orbital tumour. Combined chemotherapy and radiotherapy without surgical resection achieved an encouraging result in that the patient has remained in remission for 30 months after completion of treatment. The successful use of combined chemotherapy and radiotherapy, without surgery, adds further support to evidence that surgical excision may be avoided in selected cases of primary orbital Ewing's sarcoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

Sub-Tenon's anesthesia in vitreoretinal surgery: a needleless technique.

PURPOSE: To evaluate the safety and efficacy of "needleless" regional anesthesia via the sub-Tenon's route without adjunct facial nerve or subconjunctival block for vitreoretinal surgery. METHODS: Forty-eight consecutive patients were included and studied prospectively. The number, time, and volume of anesthetic solutions given were recorded. Any complications such as severe intraocular pressure rise or orbital hemorrhage were noted. Within 24 hours after surgery, the patients were asked to grade their level of pain during the procedure using a standard 10-point visual analog scale. The use of postoperative analgesic agents was recorded from the nurses' notes. Patient demography, number of previous vitreoretinal operations, preoperative diagnosis, and operative procedures performed were recorded. RESULTS: Thirty-seven (77%) patients needed only one or two infiltrations of anesthetic solution (range 1-5, mean 2.1). Ninety-two percent of patients reported a pain score of 0-2 on the visual analog scale (range 0-5, mean 1.17). Ninety percent of patients required no analgesic or just acetaminophen for the control of postoperative pain. The other patients received a single dose or multiple doses of codeine. All patients had adequate akinesia and anesthesia. No complications were encountered. CONCLUSION: Needleless regional anesthesia appears to be safe and effective and can thus be considered as an alternative method of anesthesia in suitable vitreoretinal cases.

Adolescent↗
PubMed1999

Trabeculectomy using a sutureless scleral tunnel technique: a preliminary study.

PURPOSE: This study was conducted to evaluate prospectively the surgical outcome in terms of intraocular pressure (IOP) control and safety of trabeculectomy using a sutureless scleral tunnel technique in patients with uncomplicated primary open-angle glaucoma (POAG). METHODS: Patients with POAG whose IOP was more than 21 mmHg with administration of maximally tolerated medications were recruited for this study. All patients underwent the sutureless scleral tunnel trabeculectomy under retrobulbar anesthesia. Intraoperative complications and postoperative visual acuity, IOP, bleb status, and complications were evaluated for a follow-up period of 1 year. RESULTS: Surgery was performed in 18 patients (20 eyes); 17 of the patients (19 eyes) completed the study (one patient was excluded because of defaulted follow-up). Mean IOP was 26.6 +/- 3.6 mmHg before surgery and 15.3 +/- 3.0 mmHg 1 year after surgery. No intraoperative complications were encountered. Mild hyphema (10.5%) and shallow anterior chamber (15.8%) were noted in the immediate postoperative period, but both were managed successfully with conservative treatment. The absolute success rate was 79.0%. CONCLUSION: The preliminary results of this study are encouraging. It appears that sutureless scleral tunnel trabeculectomy is a safe and effective drainage procedure for treating uncomplicated POAG. A larger-scale study with a longer follow-up period seems warranted.

Aged↗