Displaying all 11 publications

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  1. Mohd Razali K
    Med J Malaysia, 2013 Apr;68(2):173-4.
    PMID: 23629570 MyJurnal
    This case report is about a rare disease with unusual presentation. Failure to recognise atypical presentation may lead to error in managing the patient and cause disastrous complications. Here we highlight a case of Terrien Marginal Degeneration in both eyes with atypical presentation; namely pseudopterygium. A 22 year old man was referred to our centre for iatrogenic right eye corneal perforation after having an atypical pterygium removed at another hospital. On arrival, his vision was 1/60 in both eyes with bilateral cornea Terrien Marginal Degeneration. His right eye anterior chamber was deep with a conjunctival flap covering the perforation site which was located from the 2.30 - 3.30 clock position nasally with no aqueous leak. However after a day his right eye anterior chamber became flat and there was fast aqueous leak from the perforation site. An emergency C shaped peripheral corneal lamellar keratoplasty was performed to seal the perforation. Post operatively his right eye improved to 6/24.
    Matched MeSH terms: Cornea/surgery
  2. Lam CK, Sundaraj K, Sulaiman MN
    Medicina (Kaunas), 2013;49(1):1-8.
    PMID: 23652710
    The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with commercialized surgical training products, such as EYESI® and PhacoVision®. The review covers the simulation of the main cataract surgery procedures, i.e., corneal incision, capsulorrhexis, phacosculpting, and intraocular lens implantation in various virtual reality surgery simulators. Haptics realism and visual realism of the procedures are the main elements in imitating the actual surgical environment. The involvement of ophthalmology in research on virtual reality since the early 1990s has made a great impact on the development of surgical simulators. Most of the latest cataract surgery training systems are able to offer high fidelity in visual feedback and haptics feedback, but visual realism, such as the rotational movements of an eyeball with response to the force applied by surgical instruments, is still lacking in some of them. The assessment of the surgical tasks carried out on the simulators showed a significant difference in the performance before and after the training.
    Matched MeSH terms: Cornea/surgery
  3. Mohidin N, Mat Yacob A, Norazman FN
    Med J Malaysia, 2020 09;75(5):538-542.
    PMID: 32918423
    BACKGROUND: Menicon Z night orthokeratology (OK) lenses was introduced in Malaysia in 2015 and to date there is no report on its effects on the cornea. The objective of this study was to examine short term changes in corneal thickness and morphology of endothelial cells in young Malay adults after wearing Menicon Z night OK lenses.

    METHODS: Corneal thickness was measured at the central and mid-peripheral locations of 20 participants aged 22.45±1.19 years using Tomey SP-3000 A-scan ultrasonography. Endothelial images of the central and peripheral locations captured using Tomey EM-3000 specular microscope were noted. Corneal thickness, endothelial cell density (ECD), coefficient of variation in cell size (CV), and hexagonality (HEX) at baseline, 24 hours, three months and six months after treatment were noted and analysed using repeated measure analysis of variance.

    RESULTS: Central corneal thickness decreased significantly over a three-month period (p=0.001) and stabilised thereafter. There were no significant changes in thickness in all peripheral areas measured (p>0.05), and in ECD, CV and HEX after the six-month period (p>0.05).

    CONCLUSIONS: The current study showed that significant thinning of central cornea and none at the mid-periphery. OK lens wear with Menicon Z night lenses had no effects on corneal morphology over the six month period.

    Matched MeSH terms: Cornea/surgery*
  4. Wong HS, Then KY, Ramli R
    Med J Malaysia, 2011 Oct;66(4):369-70.
    PMID: 22299563 MyJurnal
    We report the first case of Osteo-odonto-keratoprosthesis (OOKP) who successfully underwent surgery in Malaysia following a grade 4 (severe) chemical injury in both eyes in 2006. The patient's left eye was eviscerated and his right eye underwent penetrating keratoplasty. However, the corneal graft failed and became opaque. His right eye could only perceive light. The OOKP was offered to him hoping to recover some functional vision. He underwent a 2-stage surgery to implant the OOKP into his right eye. However, 2 months post-operation, he developed vitreous haemorrhage. A successful pars plana vitrectomy (PPV) was performed via the limited view through the lens. He attained a final visual acuity of 6/60 (N36). He was able to mobilize more independently, feed, dress himself and read large print.
    Matched MeSH terms: Cornea/surgery*
  5. Deva JP
    J Refract Surg, 1998 Apr;14(2 Suppl):S215-7.
    PMID: 9571558
    PURPOSE: To investigate the accuracy of preoperative optical assessment and other factors that influenced the final visual outcome after photorefractive keratectomy (PRK).

    METHODS: The records of 126 eyes from 54 male and 72 female eyes were studied retrospectively, ranging from 6 months to 3 years post-PRK. Refractive errors ranged from low to high myopia and astigmatism, and proper and careful preoperative selection of patients was made. A single standard ablation zone (AZ) of 6.00 mm and transition zone (TZ) of 7.00 mm was made in all cases.

    RESULTS: The study population showed a high degree of accuracy in visual outcome. In simple myopia, 92.3% of female eyes and 84.1% of male eyes had a visual acuity of more than 6/9 or better. In myopia with astigmatism, 83.05% of female and 65.9% of male eyes had a visual acuity of 6/9 (20/40) or better. However, despite the residual myopia, whether with or induced astigmatism, post PRK visual acuity seemed to be less influenced by it, than as in the pre-PRK status.

    CONCLUSION: This study showed an accuracy in visual outcome of > 90% for females and > 80% for males. The Nidek EC-500 was satisfactory for its purpose.

    Matched MeSH terms: Cornea/surgery*
  6. Lim KL, Fam HB
    J Refract Surg, 2006 Apr;22(4):406-8.
    PMID: 16629076
    PURPOSE: To evaluate a novel non-surgical method for improving vision in a refractive surgery patient.

    METHODS: A 45-year-old man who had undergone LASIK 5 years previously presented with blurred distance vision. Unaided vision in the right eye was 20/329-2) and 20/20 in the left eye. He enrolled for NeuroVision treatment (NeuroVision Pte Ltd, Singapore), a computer-based interface in which a repetitive set of visual excerises is performed for 10 to 12 weeks.

    RESULTS: After 35 sessions, unaided visual acuity in the right eye was 20/16(-3) and 20/20(-1) in the left eye, representing 2.8 lines of improvement in the right eye and 1.6 lines in the left eye.

    CONCLUSIONS: NeuroVision, a noninvasive treatment based on the concept of perceptual learning, is a benefit in cases in which surgical enhancement is not recommended.

    Matched MeSH terms: Cornea/surgery
  7. Ho FL, Salowi MA, Bastion MC
    Asia Pac J Ophthalmol (Phila), 2017;6(5):429-434.
    PMID: 28379650 DOI: 10.22608/APO.2016198
    PURPOSE: To investigate the effects of postoperative eye patching on clear corneal incision architecture in phacoemulsification.

    DESIGN: A single-center, randomized controlled trial.

    METHODS: A total of 132 patients with uncomplicated phacoemulsification were randomly allocated to the intervention or control group. The intervention group received postoperative eye patching for approximately 18 hours, whereas the control group received eye shield. The clear corneal incision architecture was examined postoperatively at 2 hours, 1 day, and 7 days after surgery using optical coherence tomography.

    RESULTS: Epithelial gaping was significantly reduced on postoperative day 1 in the intervention group (52.4%) compared with control (74.2%) (P = 0.01). No differences were found for other architectural defects. Descemet membrane detachment was associated with lower intraocular pressure on postoperative day 7 (P = 0.02). Presence of underlying diabetes mellitus did not seem to influence architectural defects.

    CONCLUSIONS: Postoperative eye patching facilitated epithelial healing and reduced the occurrence of epithelial gaping on postoperative day 1. It may play a role in protecting and improving corneal wounds during the critical immediate postoperative period.

    Matched MeSH terms: Cornea/surgery*
  8. Koay AC, Yew YH, Ngo CT, Loo VP, Intan G, Chua CN
    Med J Malaysia, 2008 Dec;63(5):421-2.
    PMID: 19803308 MyJurnal
    Corneal perforation is an ocular emergency that requires early intervention to avoid permanent visual loss from endophthalmitis or irreversible structural changes. Although tectonic keratoplasty is the best choice for patching a large perforation, a donor cornea is not always immediately available. Consequently, an alternative material is required while awaiting a donor cornea. We report the use of preserved bovine pericardium as a temporizing graft to maintain the ocular integrity in two patients with corneal perforation.
    Matched MeSH terms: Cornea/surgery*
  9. Tan AK, Pall S
    Med J Malaysia, 2011 Oct;66(4):284-5.
    PMID: 22299542 MyJurnal
    Matched MeSH terms: Cornea/surgery*
  10. Khanna RK, Mokhtar E
    Indian J Ophthalmol, 2008 8 20;56(5):429-30.
    PMID: 18711278
    To describe use of a locally processed bovine pericardium (BP) to cover a large central corneal perforation following alkali injury and discuss postoperative outcome. A 27-year-old Malay male patient presented two weeks after alkali splashed in his left eye while working. A clinical diagnosis of left central corneal ulcer with limbal ischemia following alkali injury with secondary infection was made. After failed medical therapy, we performed a Gunderson conjunctival flap under local anesthesia that retracted after one week and resulted in a large central corneal perforation with surrounding stromal thinning. The perforation was covered with a locally processed BP xenograft (Lyolemb) supplied by the National Tissue Bank, University Sains Malaysia. Nine months follow-up showed a well-taken graft without any exposure/dehiscence and minimal inflammation. Amniotic membrane transplantation when used as a patch graft needs an urgent tectonic graft to promote corneal stability in patients with severe corneal thinning. The use of processed BP can be a viable option in treating such cases.
    Matched MeSH terms: Cornea/surgery
  11. Chitamparam S, Lim TH, Tai E, Ibrahim M
    Turk J Ophthalmol, 2020 12 29;50(6):332-338.
    PMID: 33389932 DOI: 10.4274/tjo.galenos.2020.57609
    Objectives: To identify the clinical profile, etiology, and outcome of culture-positive mycotic keratitis in a tertiary referral centre in the Northeastern part of Malaysia.

    Materials and Methods: A retrospective review of all patients with culture-positive mycotic keratitis in Hospital Universiti Sains Malaysia over a 3-year period, from January 2015 to December 2017.

    Results: This study included 27 eyes of 27 patients treated for mycotic keratitis based on a positive fungal culture. The most common predisposing factor was ocular trauma, in 22 patients (81.5%). Eleven patients (40.7%) had a presenting visual acuity worse than 6/60, due to central ulcer involvement. Approximately half of these (6 patients) experienced visual improvement post-treatment. Fusarium spp. was the most common fungus isolated (37%), followed by non-sporulating fungi and Curvularia spp. Three patients (7.4%) had corneal microperforations, which healed after gluing and bandage contact lens application. One patient (3.7%) required tectonic penetrating keratoplasty and 1 patient (3.7%) underwent evisceration. The final visual acuity was 6/18 or better in approximately half (14 patients) of our cohort and worse than 3/60 in approximately 20% (5 patients).

    Conclusion: Mycotic keratitis occurred mainly in males and secondary to ocular trauma. The most common organism isolated was Fusarium spp. Although treatment may improve vision, the visual outcome is guarded.

    Matched MeSH terms: Cornea/surgery*
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