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Biomedical subjects

P S Tseng

Publications and source records attributed to P S Tseng.

12 recordsLinked to original sources
PubMed1997

Patient-controlled sedation using propofol during interventional neuroradiologic procedures.

Patient-controlled sedation (PCS) using propofol has been reported to provide safe and effective sedation during a variety of procedures performed under regional or local anesthesia. In a prospective, randomized fashion, this study evaluated propofol PCS compared to anesthesiologist-administered midazolam-fentanyl sedation during interventional neuroradiologic (INR) procedures. Nineteen patients undergoing 24 INR procedures received propofol PCS (PCS dose, 0.5 mg/kg; lockout interval, 3 min) or anesthesiologist-administered midazolam-fentanyl sedation. Study parameters included discomfort, sedation and anxiety visual analogue scores (VAS), cognitive function, patient satisfaction, and complications. No difference was found between the two sedation techniques with respect to the levels of sedation and anxiolysis. Cognitive function was well preserved in both groups. Patient satisfaction was similarly high in both groups. Complications were similar between groups. These included ventilatory depression (two patients in each group) and excessive sedation (two patients in each group). Three patients in the propofol group became excessively restless, resulting in brief interruptions during the respective procedures. Propofol PCS offers a safe sedation technique during INR procedures with a sedation and anxiolysis profile that was not distinguishable from anesthesiologist-administered midazolam-fentanyl sedation.

Adolescent↗
PubMed1997

Idiopathic intracranial hypertension, empty sella turcica and polycystic ovary syndrome--a case report.

Permanent visual loss is a well established major sequela of idiopathic intracranial hypertension (IIH). It is often insidious and frequently unnoticed by patients with IIH. It is vital to monitor these patients with serial perimetric and visual acuity tests because visual loss can be halted and occasionally reversed if treatment is begun early. We report a case of IIH with an empty sella turcica and polycystic ovary syndrome who developed visual field loss over ten years. This report illustrates the importance of close ophthalmic monitoring and detailed neurological and endocrinological evaluation to prevent complications in such patients.

Adult↗
PubMed1996

Analysis of photorefractive keratectomy patients who have not had PRK in their second eye.

BACKGROUND AND OBJECTIVE: Excimer laser photorefractive keratectomy (PRK) is performed at the Singapore National Eye Centre (SNEC) with a minimum period of 3 months between first and second eye treatment. During this period, iatrogenic anisometropia may occur, which can lead to significant visual disability. We analyzed the reasons why some patients delayed or did not receive PRK treatment to their second eye. The reasons for originally electing PRK, and the expectations these patients had, were also studied. PATIENTS AND METHODS: Between January 1992 and September 1993, 341 patients underwent PRK at SNEC. Of these, 86 (25.2%) did not receive PRK to their fellow eye within 1 year of follow-up and were recruited into the study. Data were collected retrospectively using a standardized questionnaire, and objective clinical data were obtained from the case records. Sixty-eight patients (79%) responded. RESULTS: Fifty-one patients (14.9%) had not undergone PRK at the conclusion of the study (mean follow-up = 31 months). Of these, 36 were due to dissatisfaction with the results of the procedure. Symptoms relating to hypermetropia (15 patients) and symptoms of glare and halos were the main reasons which discouraged patients from receiving PRK in their fellow eye. Seventeen of the 51 patients (33.3%) who did not have PRK performed in the second eye were overcorrected to hypermetropia, as opposed to 9 out of 255 patients (3.5%) who had PRK in the second eye (P < 0.001, chi-square test). Seventy-five percent of the patients who did not undergo PRK in the second eye expected postlaser unaided vision to be equal to prelaser best corrected vision; however, only 23% of these patients achieved this. CONCLUSION: Hypermetropia, glare and halos are significant causes of patient dissatisfaction after PRK. Patients who request PRK should be advised against harboring unrealistically high expectations for the procedure.

Adult↗
PubMed1996

Fusarium keratitis following the use of topical antibiotic-corticosteroid therapy in traumatised eyes.

Keratomycosis is a rare sight-threatening infection of the cornea. Important predisposing factors in its pathogenesis include corneal trauma and use of topical corticosteroid or antibiotic-corticosteroid therapy. Some family physicians are unaware of the dangers of unmonitored topical corticosteroid therapy for traumatised eyes. Three cases of Fusarium keratitis following the use of topical antibiotic-corticosteroid therapy in traumatised eyes are reported. Despite aggressive anti-fungal therapy, one eye required a therapeutic penetrating keratoplasty for impending corneal perforation, another eye progressed to corneal perforation and required evisceration while the third eye developed endophthalmitis which also required evisceration. The potential danger of fungal infections of the cornea following the unmonitored use of topical antibiotic-corticosteroids in traumatised eyes is highlighted.

Adrenal Cortex Hormones↗
PubMed1995

Scleral necrosis and infection 15 years following pterygium excision.

Scleral necrosis and infection are serious late complications of pterygium treatment and are difficult to manage. We describe a 70-year-old Chinese male who presented with scleral necrosis and Pseudomonas aeruginosa infection 15 years after the excision of a pterygium. The infection was treated early and aggressively with intensive topical and intravenous antibiotics and the thin necrotic sclera was reinforced with a donor scleral patch graft when the scleral infection was clinically controlled. The integrity of the globe was maintained by a thin layer of sclera anterior to the graft after the graft gradually shrunk in size and retracted posteriorly. The eye was saved from possible scleral perforation and endophthalmitis. This case is reported to highlight the importance of early aggressive treatment of infection and the value of prophylactic repair of scleral necrosis in the management of these late complications of pterygium treatment.

Administration, Topical↗
PubMed1994

Anaesthetic management of idiopathic long QT syndrome--a case report.

This report describes the management of a patient with Idiopathic Long QT Syndrome (LQTS). The patient had life-threatening ventricular arrhythmias which did not respond to drug therapy with propranolol and phenytoin. A series of left stellate ganglion blocks were performed to control the arrhythmias. After stabilisation a high left thoracic sympathectomy was performed for a more permanent control of arrhythmias. Perioperative anaesthetic management is described and the usefulness of stellate ganglion block is demonstrated.

Adult↗
PubMed1993

Decentered ablation zones resulting from photorefractive keratectomy with an erodible mask.

Four patients underwent photorefractive keratectomy for compound myopic astigmatism using the erodible mask. All achieved improvements in unaided visual acuities despite manifesting varying levels of decentration of the ablated zones. However, one patient had significant monocular diplopia because of the severity of the decentration. The problems with the present system include the use of a NON coaxial microscope; difficulty with obtaining and maintaining proper alignment of the excimer laser beam to the erodible mask and the central corneal zone; the inability to interrupt and restart the procedure due to the ablation of the reference marks on the mask; and patient discomfort. We suggest installation of the PMMA mask at the laser aperture in order to alleviate the above difficulties. In the meantime, use of a coaxial microscope, a limbal suction device for fixation, permanent reference marks on the mask and peribulbar anaesthesia may be helpful.

Adult↗
PubMed1993

Major blinding complications of intraocular implantation.

Modern implant surgery for cataract by trained ophthalmologists gives excellent results in the vast majority of patients. All eye surgeons have a grave responsibility to ensure that blinding complications are avoided. The major blinding postoperative complications include endophthalmitis, problems with lens implants, corneal decompensation, uveitis and glaucoma, retinal complications and inadequate microsurgical training. The most disastrous of these is postoperative endophthalmitis which is preventable and can result in total blindness.

Aged↗
PubMed1993

Excimer laser photorefractive keratectomy in Singapore--a new treatment modality for myopia.

BACKGROUND: Myopia is a national epidemic in Singapore. Photorefractive Keratectomy (PRK) for the treatment of myopia using the Argon Fluoride Excimer Laser commenced in January 1992 at the Singapore National Eye Centre. METHODS: An open, prospective, non randomised clinical trial to assess the efficacy, predictability, stability, and safety of PRK for the correction of myopia between -2.0 to -6.0 dioptres. RESULTS: One hundred and fifty-five eyes of one hundred and thirty-five patients underwent PRK between January and September 1992, of which thirty-one had completed at least six months of follow-up. Twenty-nine of the thirty-one patients (93.5%) achieved an unaided visual acuity of at least 6/12. Twenty-six patients (83.9%) were within 1 dioptre of emmetropia. There was an initial over-correction in all patients which regressed to a plateau at around three or four months. Corneal haze did not pose a significant problem. Three patients had ocular hypertension, and another developed a mild allergic reaction to the antibiotic-steroid ointment. CONCLUSIONS: Excimer Laser Photorefractive Keratectomy is a very effective, fairly predictable, stable and safe surgical method for the treatment of myopia.

Adult↗
PubMed1991

Singapore General Hospital's experience in corneal grafting.

This is a retrospective study of 56 corneal grafts that was done in the Singapore General Hospital (SGH) between 1980 and 1989. These cases were analysed and it was found that there was a male predominance of about 2:1. There was a rather even spread among the various age groups except for a slightly higher incidence in the 20-29 year age group. There was a drastic drop in the number of grafts done after the year 1987 and this was attributed to the reluctance to accept donor corneas from Sri Lanka as there was the danger of the AIDS transmission through the donor material. The most number of grafts were done for patients with infection as a cause for corneal opacities, followed closely by keratoconus. There was a high incidence of graft rejection as almost 20 out of the 56 developed rejection. However, the visual results proved to be good with 27 obtaining at least 6/12 vision post operatively. This article outlines the need for more stringent pre-operative evaluation of both the donor material as well as the host patient in order to reduce the incidence of graft rejection and, hence, increase the overall success rate.

Age Factors↗