PURPOSE: To investigate the relationships between preoperative factors and intraocular pressure (IOP) reduction after phacoemulsification in normal, open-angle glaucoma (OAG) and angle-closure glaucoma (ACG) patients. METHODS: IOP was measured before and 3 months after cataract surgery in 30 normal, 24 OAG and 31 ACG patients. The relationship between IOP reduction after cataract surgery and preoperative parameters including anterior chamber depth (ACD), axial length (AL), preoperative IOP/ACD ratio (PD ratio), preoperative IOP/AL ratio (PL ratio) were investigated in the 3 groups. RESULTS: Significant IOP reduction was observed in all 3 groups after surgery (paired sample t-test; p < 0.05), and IOP reduction was correlated with preoperative IOP level in all 3 groups (Pearson's correlation; p < 0.05). Other preoperative parameters such as ACD and AL were not correlated with IOP reduction, and PD ratio was significantly correlated with IOP reduction only in the OAG group (Pearson's correlation; p < 0.001). PL ratio was significantly correlated with IOP reduction in all 3 groups (Pearson's correlation; p < 0.05) and showed the best sensitivity and specificity to predict significant reduction in IOP after cataract surgery among parameters including preoperative IOP, PD ratio and PL ratio. CONCLUSIONS: PL ratio was significantly correlated with IOP reduction after cataract surgery in all 3 groups and showed a higher predictive value for IOP reduction in the OAG group than in the other groups.
Anterior Chamber ; Biometry ; Cataract ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Growth Hormone ; Humans ; Intraocular Pressure ; Peptide Fragments ; Phacoemulsification ; Sensitivity and Specificity

PURPOSE: This study analyzes the factors influencing anatomical failure of the primary operation for simple rhegmatogenous retinal detachment. METHODS: The patients in this study were diagnosed with simple rhegmatogenous retinal detachment and operated on by a single physician. The success group comprised 251 eyes and the failure group comprised 29 eyes. The factors analyzed between the two groups were the type of primary procedure, the type of retinal defect; the numbers of retinal defects; the extent of retinal detachment; the duration of retinal detachment; the existence of peripheral degeneration; carrying out of subretinal fluid drainage; the type of tamponade material used and the position of retinal defects. RESULTS: The anatomical success rate of the primary operation for simple rhegmatogenous retinal detachment was 89.64%. Patient sex, the type of tamponade material used and the position of the retinal defect showed significant differences between the success and failure groups. There was a higher percentage of male patients in the failure group than in success group (p=0.034). Silicone oil used as the tamponade material resulted in a greater chance of failure than success (p=0.017). Analysis of the position of the retinal defect showed that, defects distributed in the inferior retina or through multiple area led to a greater likelihood of anatomical failure (p=0.036). CONCLUSIONS: Due ti the greater possibility of anatomical failure of the primary operation when retinal defects are distributed in the inferior retina or through multiple area, clinicians should consider intensive treatment for such cases.
Drainage ; Humans ; Male ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Subretinal Fluid

PURPOSE: To study the effect of the corrective lens for anisometropia on aniseikonia and binocular function. METHODS: The study subjects were 30 patients without strabismus and amblyopia, who had anisometropia of more than 1.00D between the spherical equivalent of each correction lens. The amount of aniseikonia was measured by Awaya's New Aniseikonia Test. The degree of stereopsis and fusion were determined with Titmus Stereo Test and fusion card of major amblyoscope, respectively. RESULTS: The amount of aniseikonia increased significantly with increasing level of anisometropia (p=0.000). There was a statistically significant correlation between the amount of anisometropia and fusion (p=0.046). With increased aniseikonia, the stereopsis declined consequently, but the decline was not statistically significant. Aniseikonia was induced when there was more than 2.00D of anisometropia. With anisometropia increased by 1.00D, the odds ratio of induced aniseikonia was 7.197 (p=0.047). CONCLUSIONS: Anisometropia is an important factor for aniseikonia and can disturb binocular function.

PURPOSE: To study the effect of spherical lens induced aniseikonia on stereopsis and fusion. METHODS: One hundred subjects, with normal binocular function without any ophthalmic disease or surgery history, were examined. The aniseikonia was induced with spherical lenses in 1 diopter (D) stepwise manner from -2 D to +2 D. The amount of aniseikonia was measured by Awaya's New Aniseikonia Test. Stereopsis and fusion were determined with Titmus Stereo Test and fusion card of major amblyoscope respectively. RESULTS: As the amount of aniseikonia was increased, the stereopsis and fusion were decreased. The change was statistically significant (ANOVA, p<0.001). Aniseikonia was more correlated to fusion than stereopsis. A significant decline in the stereopsis was detected when the size of aniseikonia changed from 1% to 2%. A significant decline in fusion was noticed when aniseikonia changed from 2% to 3% (Independent t-test, p<0.01). CONCLUSIONS: Our study suggests that binocular function can be disturbed by experimentally induced aniseikonia in normal subjects and that stereoacuities and fusional amplitude can be decreased as the degree of aniseikonia becomes larger.
Aniseikonia* ; Depth Perception ; Telescopes*

The rising prevalence of obesity in Singapore is a harbinger for a corresponding increase in obesity-related complications such as type 2 diabetes mellitus (T2DM) and coronary heart disease. Obesity is a complex disease driven by multiple factors, and hence, treatment cannot follow a 'one-size-fits-all' approach. Lifestyle modifications involving dietary interventions, physical activity and behavioural changes remain the cornerstone of obesity management. However, similar to other chronic diseases such as T2DM and hypertension, lifestyle modifications are often insufficient on their own, hence the importance of other treatment modalities including pharmacotherapy, endoscopic bariatric therapy and metabolic-bariatric surgery. Weight loss medications currently approved in Singapore include phentermine, orlistat, liraglutide and naltrexone-bupropion. In recent years, endoscopic bariatric therapies have evolved as an effective, minimally invasive and durable therapeutic option for obesity. Metabolic-bariatric surgery remains the most effective and durable treatment for patients with severe obesity, with an average weight loss of 25%-30% after one year.
Humans ; Singapore ; Diabetes Mellitus, Type 2 ; Obesity ; Obesity, Morbid ; Bariatric Surgery

Background/Aims: Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is preferred for sampling of lymph nodes (LNs) adjacent to the gastrointestinal wall; however, fine-needle biopsy (FNB) may provide improved diagnostic outcomes. This study aimed to evaluate the comparative efficacy and safety of FNA versus FNB for LN sampling. Methods: This was a multicenter retrospective study of prospectively collected data to evaluate outcomes of EUS-FNA and EUS-FNB for LN sampling. Characteristics analyzed included sensitivity, specificity, accuracy, the number of needle passes, diagnostic adequacy of rapid on-site evaluation (ROSE), cell-block analysis, and adverse events. Results: A total of 209 patients underwent EUS-guided LN sampling. The mean lesion size was 16.22±8.03 mm, with similar sensitivity and accuracy between FNA and FNB ([67.21% vs. 75.00%, respectively, p=0.216] and [78.80% vs. 83.17%, respectively, p=0.423]). The specificity of FNB was better than that of FNA (100.00% vs. 93.62%, p=0.01). The number of passes required for diagnosis was not different. Abdominal and peri-hepatic LN location demonstrated FNB to have a higher sensitivity (81.08% vs. 64.71%, p=0.031 and 80.95% vs. 58.33%, p=0.023) and accuracy (88.14% vs. 75.29%, p=0.053 and 88.89% vs. 70.49%, p=0.038), respectively. ROSE was a significant predictor for accuracy (odds ratio, 5.16; 95% confidence interval, 1.15–23.08; p=0.032). No adverse events were reported in either cohort. Conclusions Both EUS-FNA and EUS-FNB are safe for the diagnosis of LNs. EUS-FNB is preferred for abdominal LN sampling. EUSFNA+ ROSE was similar to EUS-FNB alone, showing better diagnosis for EUS-FNB than traditional FNA. While ROSE remained a significant predictor for accuracy, due to its poor availability in most centers, its use may be limited to cases with previous inconclusive diagnoses.

Asian People ; Humans ; Prevalence ; Stereotyping