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Biomedical subjects

Donald Tan

Publications and source records attributed to Donald Tan.

At least 19 recordsLinked to original sources
PubMed2006

Atropine for the treatment of childhood myopia.

PURPOSE: To evaluate the efficacy and safety of topical atropine, a nonselective muscarinic antagonist, in slowing the progression of myopia and ocular axial elongation in Asian children. DESIGN: Parallel-group, placebo-controlled, randomized, double-masked study. PARTICIPANTS: Four hundred children aged 6 to 12 years with refractive error of spherical equivalent -1.00 to -6.00 diopters (D) and astigmatism of -1.50 D or less. INTERVENTION: Participants were assigned with equal probability to receive either 1% atropine or vehicle eye drops once nightly for 2 years. Only 1 eye of each subject was chosen through randomization for treatment. MAIN OUTCOME MEASURES: The main efficacy outcome measures were change in spherical equivalent refraction as measured by cycloplegic autorefraction and change in ocular axial length as measured by ultrasonography. The primary safety outcome measure was the occurrence of adverse events. RESULTS: Three hundred forty-six (86.5%) children completed the 2-year study. After 2 years, the mean progression of myopia and of axial elongation in the placebo-treated control eyes was -1.20+/-0.69 D and 0.38+/-0.38 mm, respectively. In the atropine-treated eyes, myopia progression was only -0.28+/-0.92 D, whereas the axial length remained essentially unchanged compared with baseline (-0.02+/-0.35 mm). The differences in myopia progression and axial elongation between the 2 groups were -0.92 D (95% confidence interval, -1.10 to -0.77 D; P<0.001) and 0.40 mm (95% confidence interval, 0.35-0.45 mm; P<0.001), respectively. No serious adverse events related to atropine were reported. CONCLUSIONS: Topical atropine was well tolerated and effective in slowing the progression of low and moderate myopia and ocular axial elongation in Asian children.

Administration, Topical↗
PubMed2006

Longitudinal study of anisometropia in Singaporean school children.

PURPOSE: The purpose of this study was to document the incidence rates of anisometropia, year-by-year prevalences, changes in the intereye difference in spherical equivalent (SE), and its association with myopia progression and axial length changes in a cohort of Singaporean school children. METHODS: This is a prospective cohort study of Singaporean school children (n = 1979) aged 7 to 9 years who were examined annually with cycloplegic refraction and ultrasonography over a 3-year period. RESULTS: In the 1908 children without anisometropia at commencement, the 3-year cumulative incidence rate of anisometropia (difference in SE at least 1.0 D) was 144 (7.55%; 95% CI: 6.42-8.85). The mean intereye difference in SE in all children at baseline was 0.29 +/- 0.46 D (SD: 0.46) and increased to 0.44 D (0.59) on the last examination. On the initial examination, 3.6% (95% CI: 2.8-4.4) or 71 children had anisometropia. Of the 59 of 71 children who completed all examinations, only 3 (5.1%) had an increase in the intereye difference in SE by at least 0.5 D, whereas 2 (3.4%) had a decrease of at least 0.5D. The mean intereye difference in SE was stable between visits. The change in intereye difference in SE correlated with the change in intereye axial length (r = 0.43). Compared with the isometropic children, each eye of the anisometropic children had a higher rate of progression of myopia. CONCLUSIONS: The 3-year incidence of anisometropia was 7.55% in these young Singaporean children. Although the frequency of anisometropia increased with time, the difference in SE between eyes tended to remain stable.

Anisometropia↗
PubMed2006

Defensins HNP1 and HBD2 stimulation of wound-associated responses in human conjunctival fibroblasts.

PURPOSE: To study the responses of human conjunctival fibroblasts (HCFs) to stimulation by human neutrophil defensin 1 (HNP1) and beta defensin2 (HBD2). METHODS: Defensin-stimulated gene expression in primary cultures of HCFs was analyzed by real-time PCR after exposure to various concentrations of HNP1 or HBD2. Gene and protein expression for selected collagens, matrix metalloproteinases, and tissue inhibitors of metalloproteinases were determined by real-time PCR and ELISA analysis. Activation of p42/44 mitogen-activated protein (MAP) and Akt was analyzed by Western blot. RESULTS: HCFs did not express significant levels of the genes for HNP1 or HBD1-3. However, HNP1 and HBD2 stimulated HCF proliferation, the activation of p42/44 MAP kinase, and Akt kinase in a dose-dependent manner. HNP1 and HBD2 were not found to be chemotoxic for HCFs. It was demonstrated with the use of U0126 and wortmannin that the activation of p42/44 MAP kinase and Akt was responsible for the increased HCF proliferation observed under HNP1 and HBD2 stimulation. HNP1 stimulated the expression of the genes for collagen I, III, VI, and VIII. In addition, it reduced the secretion of collagen I protein but increased its intracellular retention. HNP1 and HBD2 upregulated the transcription and translation of MMP1. Small increases were observed in MMP14 gene expression after HNP1 stimulation and MMP2 gene expression after HBD2 stimulation. CONCLUSIONS: The results of this study suggest that HNP1 and HBD2 have a potential role in the biosynthetic and tissue remodeling responses of conjunctival fibroblasts.

Adult↗
PubMed2006

Human limbal progenitor cell characteristics are maintained in tissue culture.

INTRODUCTION: To determine the differentiation of human limbal epithelial cells in tissue culture. MATERIALS AND METHODS: Epithelial cells from the human limbus (n = 29) were isolated and cultured in supplemental hormonal epithelial medium (SHEM) in the presence of mitomycin C-treated 3T3 feeder layer. Confluent cells were airlifted to form multiple layers. The expression of cytokeratin 3 (K3), cytokeratin 12 (K12), involucrin, connexin 43 (Cx43), proliferation cell nuclear antigen (PCNA) and p63 was studied in normal and airlifted cells by immunohistochemistry. Expression levels of K3 and K12 mRNA were examined by real-time polymerase chain reaction (PCR). RESULTS: The colony-forming efficiency of primary cultured (P0) cells was about 19.35 +/- 6.46% (mean +/- SD, n = 7). Real-time PCR analysis showed that the transcription level of K3 and K12 in cultured cells was lower than in freshly isolated limbal cells or cells from central cornea (P <0.01). Few cells were positive for K3 in P0 or P1 cells [(1.99 +/- 1.27)% (n = 7, P0) and (3.96 +/- 1.35)% (n = 4, P1), P = 0.046]. More cells at all levels were found to stain positive for PCNA and p63 as compared to K3, K12 and involucrin. After air-lifting, cell sheets of 3 to 5 epithelial cell layers formed. Involucrin showed positive staining in suprabasal layers of the cell sheets while connexin 43 was only observed in the basal layer. Staining of K3 remained sparse. CONCLUSIONS: Human limbal cells isolated from cadaveric tissues were able to proliferate in vitro and exhibited a phenotype with characteristics similar to that of the limbal stem or progenitor cells.

Cell Differentiation↗
PubMed2005

Comparisons of the handheld autorefractor, table-mounted autorefractor, and subjective refraction in Singapore adults.

PURPOSE: The purpose of this article was to compare the Retinomax with the table-mounted autorefractor and subjective refraction in Singapore adults. METHODS: Adults (n = 100) attending a tertiary eye hospital clinic were examined by an optometrist. First, subjective refraction testing was performed using a trial lens set, followed by handheld autorefractor tests using the Nikon Retinomax and the table-mounted autorefractor (Topcon RM8000B). Spherical equivalent and vector components of astigmatism were analyzed: J0 (Cartesian astigmatism) and J45 (oblique astigmatism). RESULTS: The Retinomax autorefractor readings (mean = -4.69 D) were more minus compared with the table-mounted autorefractor (mean = -4.05 D) and subjective refraction (mean = -3.90 D). There were significant differences in J0 and J45 for comparisons between subjective refraction and Retinomax autorefraction, and table-mounted autorefraction and Retinomax autorefraction. CONCLUSION: The Retinomax autorefractor measures were more minus compared with the table-mounted autorefractor and subjective refraction. The Retinomax autorefractor is not recommended for research purposes, unless in remote inaccessible areas where a portable instrument is necessary and cycloplegia is not possible.

Adult↗
PubMed2004

Predilection of the macular region to high incidence of choroidal neovascularization after intense laser photocoagulation in the monkey.

OBJECTIVE: To determine the key factors for creating a high incidence model of choroidal neovascularization (CNV) in the monkey. METHODS: Intense laser photocoagulation was performed in 8 eyes of 4 monkeys using krypton red and green-yellow and Alcon frequency-doubled diode ophthalmic lasers. Eight to 13 lesions were delivered to an area between the temporal vascular arcades in each eye. Development of CNV was monitored by fluorescein angiography at 2 and 4 weeks after laser treatment, and the results were correlated with histological analysis. RESULTS: A much higher incidence of CNV occurred in the macular region, which refers to an anatomic area equivalent to a mean +/- SD 2.5 +/- 0.4 times the horizontal diameter of the optic disc in the fundus. Regardless of the type of ophthalmic laser used, 72% of lesions developed fluorescein leakage within the macula, compared with 12% outside the macula (P<.001). By histological analysis, 89% of lesions developed microscopic CNV within the macula vs 22% outside the macula (P<.001). CONCLUSION: The macular region is predisposed to creation of laser-induced CNV in the monkey.Clinical Relevance The predilection of the macular region to a high incidence of laser-induced CNV may account for the high recurrence rate of subfoveal CNV after laser treatment in humans.

Animals↗
PubMed2004

Anisometropia in Singapore school children.

PURPOSE: To report the prevalence rates of anisometropia in a school population and determine the relative contribution of refractive power and axial length to the measured anisometropia. DESIGN: Population-based cross-sectional study. METHODS: Autorefraction, keratometry, and ultrasonography studies were made. SETTING: Three schools, located on the eastern, northern, and western part of Singapore. STUDY POPULATION: In all, 1,979 children aged 7 to 9 years were recruited for this study. The study sample included Chinese (n = 1,481), Malay (n = 324), and Asian Indian (n = 174) children; 720 subjects have myopia (spherical equivalent <= -0.5 diopters) in at least one eye. MAIN OUTCOME MEASURE: Anisometropia. RESULTS: The prevalence rates of anisometropia, in terms of spherical equivalent (SE) difference of at least 1.5 diopters and 2.0 diopters were 1.57% (95% confidence interval [CI]: 1.1, 2.2) and 1.01% (95% CI: 0.6, 1.6), respectively. The prevalence rate of anisometropia (at least 2.0 diopters) among the children with at least one myopic eye was 2.4% (95% CI: 1.4, 3.8), whereas in those without any myopic eyes, the prevalence rate was only 0.2% (95% CI: 0.06, 0.8). The spherical equivalent difference between the right and left eyes was positively correlated with the difference in axial lengths (P <.001). The difference in corneal refractive power is not statistically different between the anisometropic and the nonanisometropic children. CONCLUSIONS: The anisometropia prevalence rate in a childhood population with a relatively high prevalence of myopia was reported. The origin of the anisometropia is axial, and these results suggest that the differential rate of elongation between the two eyes of nonmyopic subjects results in anisometropia.

Anisometropia↗
PubMed2004

Optic disk and retinal characteristics in myopic children.

PURPOSE: To examine the baseline retina and optic disk characteristics in children. DESIGN: Cross-sectional study. METHODS: Subjects included 679 subjects with myopia and 100 with emmetropia, aged 8 to 13 years. Digital retina imaging and cycloplegic autorefraction were conducted to look for signs of retinal degeneration. Other outcome measures were vertical and horizontal cup-to-disk (CD) ratios, CD area ratio, parapapillary atrophy (PPA)-to-disk area ratio, and disk rotational angle. RESULTS: The prevalence of lattice degeneration was 0.15% (95% confidence interval: 0.008-1.00). No other retinal abnormalities were detected. Increased PPA-to-disk area ratio was associated with increased axial length, increased myopia severity, and increasing age. Cup-to-disk ratios were smaller in subjects with myopia compared with those with emmetropia, but this did not correlate with severity of myopia. In subjects with severe myopia, the upper pole of the disk was rotated away from the fovea but to lesser extent than in those with emmetropia or milder myopia. CONCLUSIONS: Apart from PPA, degenerative features were not commonly found in this study.

Adolescent↗
PubMed2004

Performance of the Hansatome microsuction ring for laser in situ keratomileusis in eyes with narrow palpebral apertures.

PURPOSE: To evaluate the performance of a new microsuction ring during laser in situ keratomileusis (LASIK) in eyes with narrow palpebral apertures. SETTING: Singapore National Eye Centre, Singapore, Republic of Singapore. METHODS: Laser in situ keratomileusis was performed sequentially in both eyes of 33 Chinese patients. A randomization table was used to determine the control and test eyes. A standard suction ring (20.3 mm diameter) was used in control eyes, and a microsuction ring (19.0 mm diameter) was used in test eyes. Corneal flaps were created using the Hansatome microkeratome (Baush & Lomb). The following ring performance parameters were evaluated: flap diameter deviation (actual minus nominal flap diameter), ease of suction ring application, adequacy of suction, and overall microkeratome performance. Parameters 2 to 4 were rated by the surgeons using a subjective 1 to 100 scale. RESULTS: The mean flap diameter deviation was 0.45 mm in the control eyes and 0.22 mm in the study eyes; the mean difference was 0.23 mm (95% confidence interval, 0.39-0.07) (P<.001). For ease of application, the mean score of the microsuction ring was 100 and of the standard suction ring, 89.9. For adequacy of suction, the mean score of the microsuction ring was 99.7 and of the standard suction ring score, 98.2 (P = .13). The mean overall microkeratome performance score using the microsuction ring was 99.4 and using the standard suction ring, 94.6 (P = .011). CONCLUSION: The Hansatome microsuction ring was easy to apply during LASIK in eyes with narrow palpebral apertures, and there appeared to be no compromise of ring performance and safety.

Adult↗
PubMed2004

Screening for myopia and refractive errors using LogMAR visual acuity by optometrists and a simplified visual acuity chart by nurses.

PURPOSE: To compare the sensitivity and specificity of a widespread method of screening for refractive errors in Singapore schoolchildren using a simplified acuity screening chart with a more rigorous method using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. A secondary aim is to estimate the best cutoff values for the detection of refractive errors using these two methods. METHODS: This is a population-based study, involving 1779 schoolchildren from three schools in Singapore. Logarithm of the minimum angle of resolution (logMAR) visual acuity was recorded using a modified Bailey-Lovie chart by trained optometrists, and visual acuity measurement was also undertaken using a simplified 7-line visual acuity screening chart by school health nurses. The main outcome measures were the receiver-operating characteristics (ROC's) of logMAR and the simplified screening visual acuity to detect myopia or any refractive errors. The difference between measurements, simplified screening visual acuity--logMAR visual acuity, was calculated. RESULTS: The optimal threshold using the simplified screening visual acuity chart for the detection of myopia or any refractive error was 6/12 or worse. Using logMAR visual acuity, the most efficient threshold for the detection of myopia was 0.26, but this was 0.18 for the detection of any refractive error. The area under the ROC curves was significantly greater in the case of the logMAR visual acuity measurement compared with the simplified screening visual acuity measurement for the detection of myopia or any refractive errors. The 95% limits of agreement for the two methods (simplified screening--logMAR acuity) was -0.219 to +0.339. CONCLUSIONS: Bearing in mind that the visual acuity measurements were performed by two different groups of professionals, visual acuity screening using the ETDRS method appears to be more accurate than the simplified charts for the detection of myopia or any refractive errors in children.

Child↗
PubMed2004

Corneal thickness determination and correlates in Singaporean schoolchildren.

PURPOSE: To determine the central cornea thickness (CCT) in Singaporean children and to examine the possible relationship between intraocular pressure (IOP) and other biometric factors and CCT. METHODS: This was a cross-sectional study. The subjects (N=652) were obtained from the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). The subjects' ages ranged from 9 to 11 years. There were 485 Chinese, 92 Malayan, and 75 Asian Indian children. Measurement procedures included air-puff tonometry, noncontact slit lamp optical pachymetry, cycloplegic autorefraction, and autokeratometry. RESULTS: The mean CCT was 543.6 +/- 32.0 microm. Chinese children had thicker corneas than Malayan or Indian children (P=0.002). The boys had thicker corneas than girls (P=0.011), but the mean difference was only 6.4 microm. There was high correlation of CCT (r=0.98) and IOP (r=0.88) between right and left eyes. IOP was correlated with CCT (r=0.45, P <0.001). In a multiple linear regression model, each millimeter of mercury of IOP was associated with a CCT difference of 5.90 microm (95% confidence interval [CI], 4.98-6.82). The radius of corneal curvature correlated with CCT (r=0.19, P <0.001). The following parameters were not significantly (P >0.05) associated with CCT: age, family income, father's education, axial length, and spherical equivalent. CONCLUSIONS: The mean CCT in Singaporean children aged 9 to 11 years was 543.6 microm and showed ethnic and gender variation. CCT affected measured IOP and correlated weakly with corneal curvature. Compared with data in adults, a change in CCT was associated with a greater difference in measured IOP.

Anthropometry↗
PubMed2004

Incidence and progression of astigmatism in Singaporean children.

PURPOSE: This study investigated the incidence and progression, as well as factors associated with changes in astigmatism in school children. METHODS: This was a prospective cohort study. Children 7 to 9 years of age, of Chinese, Malay, and Asian Indian ethnicity, were examined annually over a 4-year period. Cycloplegic autorefraction was performed. A questionnaire was used to evaluate risk factors for incidence and progression of astigmatism. RESULTS: The cumulative 3-year incidence rate of astigmatism was 33.6% (cylinder power of 0.5 D or worse) or 11.5% (cylinder power of 1.0 D or worse). Myopic children had a higher incidence rate of astigmatism than nonmyopes (P <0.001). The mean J0 change per year was 0.012 D (95% CI: 0.007-0.018), whereas J45 did not show a significant change each year (mean, 0.001 D per year). Chinese children had greater worsening of J0 per year (P <0.001). Girls also had significantly greater progression of J0 than did boys (P <0.001). Similarly, myopia at baseline (P <0.001) and the hours of computer use (P=0.049) were associated with a greater progression rate of J0. J0 tended to improve in children with compound hyperopic astigmatism, worsen in children with compound myopic astigmatism, and remain stable in mixed astigmatics. CONCLUSIONS: Although there was minimal progression of astigmatism in school age children (0.44-0.53 D) over this period of follow-up, incident cases of astigmatism (>1.0 D) were not uncommon. The progression rate of astigmatism was affected by the ethnicity, presence of myopia, axis, and subtype of astigmatism.

Astigmatism↗
PubMed2003

Analysis of rabbit tear proteins by high-pressure liquid chromatography/electrospray ionization mass spectrometry.

The aim of this study was to develop a fast and reliable analytical procedure for the display of the protein components of tears that can be used to differentiate the status of the ocular surface. Using this new procedure, we analyzed the tear protein components following a corneal wound in the rabbit. Calibrated 10-microL glass, fire-polished capillary micropipettes were used to collect tears from New Zealand White rabbits prior to and daily for 9 days following a unilateral 6-mm diameter centrally placed anterior keratectomy. Tear proteins were eluted by a reversed-phase high-performance liquid chromatography (RP-HPLC) column and the tear protein profile was monitored by electrospray ionization (ESI) mass spectrometry positive total ion current (TIC) chromatography. Tear proteins were reliably separated into 17 peaks, each of which contained one or a number of protein components. The molecular weight of each protein component was determined by on-line ESI. Major tear protein components, lactoferrin, lysozyme (minimally detectable in rabbit tears), albumin, lipocalin, lipophilin and beta2-microglobulin, were tentatively identified by this method. Based on the mass spectrometric data, beta2-microglobulin was found to be glycosylated with N-acetylhexosamine. ESI-positive TIC chromatograms and mass spectra revealed comparative differences in the tear protein spectra after corneal wounding. One day after wounding, rabbit lysozyme with a molecular weight of 14,717 Da was found to be 8-fold higher in the tears of wounded eyes when compared with tears from unwounded eyes. It dropped back to normal 3 days after wounding. The expression of an unidentified tear protein with the molecular weight of 16,060 Da was also elevated after corneal wounding and returned to normal level by day 5. In this study, LC/ESI-MS was developed as a fast, reproducible and simple method for the identification and analysis of many of the protein components of the tears. Importantly, this technique also allows quantification of each component resolved in the chromatogram. This method is very suitable for mapping peptides and proteins (<80 kDa) in tears.

Animals↗
PubMed2003

Pharmacokinetic and toxicity study of an intraocular cyclosporine DDS in the anterior segment of rabbit eyes.

PURPOSE: To establish the safety and pharmacokinetic efficacy of an Oculex Drug Delivery System (DDS; Oculex Pharmaceuticals, Inc., Sunnyvale, CA) containing cyclosporin A (CsA) in the anterior segment of the rabbit eye. METHODS: The Oculex DDS is an intraocular, sustained-release, drug delivery system comprising a biodegradable lactic acid-glycolic acid copolymer. A controlled prospective study was performed that involved implanting a DDS containing 0.5 mg of CsA into the anterior chamber (AC) of the right eyes of 16 New Zealand White rabbits. A placebo DDS was implanted into the left eyes of these same rabbits as the control. Slit lamp examinations and AC taps were performed serially, and the rabbits were killed and the globes removed at 2, 4, 8, and 12 weeks for histology and determination of CsA drug levels. Analysis of CsA levels was performed with high-performance liquid chromatography-mass spectrometry. RESULTS: High concentrations of CsA were detectable in all layers of the cornea (epithelium, corneal stroma and endothelium) throughout the 3-month period. Low CsA levels were detected in the aqueous, whereas no CsA was detectable in the blood. There were no adverse reactions observed. CONCLUSIONS: The Oculex DDS CsA device is effective in delivering long-term levels of CsA to corneal tissues, without adverse effects. Further studies in an animal model of corneal transplant rejection should be performed to determine the potential of this device in the prophylaxis and treatment of corneal transplant rejection in humans.

Absorbable Implants↗
PubMed2002

Interventions to retard myopia progression in children: an evidence-based update.

TOPIC: To evaluate the efficacy of interventions such as eyedrops, bifocal lenses, or contact lenses in retarding the progression of myopia in myopic children. CLINICAL RELEVANCE: Myopia is a common ocular disorder, and high myopia (myopia at least -6.0 diopters) is associated with potentially blinding conditions. At present, there are no general guidelines on interventions that may decrease myopia progression in children, but some interventions such as contact lenses are offered on an ad hoc basis. METHODS OR LITERATURE REVIEWED: English and non-English language articles published from 1968 to 2000 were retrieved using a keyword search of MEDLINE, Embase, Cochrane Library, and Science Citation Index databases. Randomized controlled trials with comparisons of the effectiveness of interventions to decrease myopia progression in myopic children were reviewed. RESULTS: Ten clinical trials of different interventions to retard myopia progression were reviewed, including three trials that evaluated atropine and one trial that evaluated soft contact lenses. Atropine eye drops of 0.5% concentration were effective in clinical trials, but no significant effect was found for tropicamide or timolol eyedrops. Five of the six trials on bifocal spectacle lenses with various additions failed to show significant retardation, and results of the remaining trial were barely significant (P = 0.047). A trial of soft contact lenses failed to show significant effects. CONCLUSIONS: The latest evidence from randomized clinical trials does not provide sufficient information to support interventions to prevent the progression of myopia. Long-term large-scale double-masked randomized clinical trials, including cycloplegic refraction, are needed before any recommendations about interventions in clinical practice to prevent high myopia in myopic children are considered.

Atropine↗
PubMed2002

The Chirila Keratoprosthesis: phase I human clinical trial.

OBJECTIVE: To undertake a preliminary safety and performance evaluation of an artificial cornea, the Chirila Keratoprosthesis, in human patients. DESIGN: A prospective, interventional case series. PARTICIPANTS: Fourteen consecutive patients with blindness of corneal origin not treatable by repeated standard penetrating keratoplasty. METHODS: Keratoprostheses were manufactured and implanted. The patients, all with preoperative visual acuity of light perception to count fingers (CF), were followed clinically in adherence to a protocol. MAIN OUTCOME MEASURES: Safety (keratoprosthesis retention, incidence of serious complications) and performance (visual acuity, comfort, appearance). RESULTS: Ninety-three percent of keratoprostheses were retained to the date of reporting, up to 2.5 years. One keratoprosthesis (7%) was removed in a manner that restored the patient's preoperative condition. All but one patient maintained their preoperative level of visual acuity or improved on it, with most achieving their estimated full potential visual acuity, (range, count fingers - 20/20). CONCLUSIONS: This keratoprosthesis is acceptably safe and has demonstrated an ability to restore vision in cases in which alternative management would have had a poor prognosis. More extensive trials are warranted.

Cornea↗
PubMed2002

Visual function and outcomes after cataract surgery in a Singapore population.

PURPOSE: To identify the predictors of visual outcomes (visual acuity and visual function) in cataract surgery patients in Singapore and compare the visual outcomes of phacoemulsification and extracapsular cataract extraction (ECCE). SETTING: Singapore National Eye Center, Singapore, Republic of Singapore. METHODS: The visual function was measured by the VF-14 and visual acuity in the operated and the better eye in 460 systematically sampled cataract surgery patients preoperatively and 3 months after surgery. Several patient- and surgery-related predictive factors were recorded. RESULTS: After cataract surgery, 85.1% of patients reported improved visual acuity in the operated eye and 77.6% reported improved visual function. Patients with poorer visual acuity and visual function at baseline reported greater improvements in visual acuity and visual function. Patients who had phacoemulsification had better final visual function (P =.006) and better final visual acuity (P <.001) scores. In multiple linear regression models, final visual function was better in patients without preexisting eye disease and with better baseline visual function, and final visual acuity in the operated eye was better in patients who were younger, were better educated, had no preexisting conditions or postoperative complications, and had a better baseline visual acuity. CONCLUSIONS: Patients with poorer baseline visual acuity or who had no preexisting eye disease reported more improvement in visual acuity in the operated eye. Several factors including no preexisting eye disease were associated with better final visual acuity and visual function scores.

Aged↗