1.Review Of Ocular Injuries In Malaysia
Thanigasalam Thevi ; Sagili Chandrasekhara Reddy
Malaysian Journal of Public Health Medicine 2017;17(1):69-77
Ocular injuries or trauma to the eye can be caused by variety of objects resulting in a spectrum of lesions in the eye.
We did a Pubmed/Google/Science Direct search to review the spectrum of ocular injuries in Malaysia. In our review,
we included 28 papers providing information on ocular injuries which were published from Malaysia during the period
1991-2016 in different medical journals. Prevalence was more among males with an average age of 35 years. Among
adults they were more common in the workplace but in children it occurred at home. Few wore protective glasses at
work. The mode of injury was due to sharp objects hitting the eye, motor vehicle and domestic accidents,
firecrackers, chemicals and rarer causes like superglue and durian fruit. Prognostic factors for outcome were the
initial visual acuity, length of the wound, associated factors like hyphaema, intraocular foreign body and vitreous
prolapse. Missing the diagnosis of perforation of the eyeball is possible without eliciting a proper history. Protective
devices must be worn to prevent injuries. Display of health education charts showing the effect of injuries in the eye
and their preventive measures in health centres, private hospitals, schools, factories and sports centres will increase
the awareness of public about the ocular injuries. It is important to diagnose the tissues involved in ocular trauma by
the general practitioners and primary care physicians and refer the patients to the Ophthalmologist urgently for
treatment to salvage vision. Compensation mechanisms should then be put forth in terms of rehabilitation and for
monetary loss.
2.The temerloh hospital cataract complications study:factors associated with, types and outcomes of cataract surgery complications
Thevi THANIGASALAM ; Sagili Chandrasekhara REDDY ; Karuthan CHINNA
International Eye Science 2014;(8):1367-1372
AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.
RESULTS:Complications occurred in 11. 1% of the total 1007 patients operated. Posterior capsule rupture (3. 6%) was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction ( ICCE ) and phacoemulsification converted to extracapsular cataract extraction ( ECCE ) were significantly associated with more complications ( P < 0. 001 ). The visual outcome was significantly poor in patients with complications (P<0. 001).
CONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.
3.Visual outcome following posterior capsule rupture during phacoemulsification in a tertiary care hospital in Malaysia
Thanigasalam Thevi, MS ; Soumendra Sahoo, MS
The Medical Journal of Malaysia 2016;71(2):45-46
Purpose: To analyse the visual outcomes of cases with
posterior capsule rupture (PCR) compared to those without
PCR following phacoemulsification. The occurrence of
posterior capsule rupture during phacoemulsification
surgery for cataract can have serious implications in the
visual recovery. However, recognition of PCR and proper
management can yield a successful visual outcome. This
study analysed the visual outcomes of cases with PCR
compared to those without PCR.
Methods: This is a case-control study. All patients who
underwent cataract surgery from 2011 to 2012 in Hospital
Melaka were traced from the National Eye Database (NED) of
Malaysia. The visual outcomes were classified as good,
borderline and poor as per WHO guidelines. The data was
analysed with SPSS version 12 IBM.
Results: Out of 80.4% (2519) of eyes that had undergone
phacoemulsification (PHACO) type of surgery, 3.06% (77
cases) had posterior capsule rupture complication. There
was no significant difference in the visual outcome of
borderline between cases with PCR and cases without PCR
(Odds Ratio (OR) 0.989; 95% Confidence Interval (CI) 0.382-
2.560). However, cases with PCR were significantly less
likely to have good vision compared to those without PCR
(OR 0.335; 95% CI 0.157-0.714).
Conclusion: The study reveals that a significant number of
patients without PCR had good vision, whereas those with
PCR did not get good vision. We would like to suggest
meticulous care during phacoemulsification surgery to
avoid PCR in order to obtain good visual outcomes.
Phacoemulsification
4.Posterior Capsule Rupture during Phacoemulsification among Patients with Pseudoexfoliation–Is There A Correlation?
Thevi Thanigasalam ; Soumendra Sahoo ; Htoo Htoo Kyaw Soe
Malaysian Journal of Medical Sciences 2014;21(4):51-53
This study was done to correlate the occurrence of posterior capsule rupture among patients with pseudoexfoliation during phacoemulsification. This was a retrospective audit of patients who underwent phacoemulsification type cataract surgery from January 2011 to December 2012 in a tertiary hospital in Malaysia. Data was obtained from the National Eye Database (NED) of Malaysia. The data was analysed using SPSS version 21.0. By using logistic regression analysis, it was found that there was no significant increase in the occurrence of posterior capsule rupture among patients with pseudoexfoliation. Hence, we concluded that there was no correlation between the occurrence of posterior capsule rupture and the presence of pesudoexfoliation among patients who underwent phacoemulsification.
5.Association of Well-Being Index and Cognitive Impairment with Primary Open Angle Glaucoma Patients of Malaysia: A Case-Control Study
Soumendra SAHOO ; Thanigasalam THEVI ; Htoo Htoo Kyaw Soe
Malaysian Journal of Medical Sciences 2018;25(1):96-100
The purpose of this study was to determine the association of well-being and cognitive impairment with primary open angle glaucoma (POAG) patients attending a tertiary care hospital in Malaysia. Fifty-four individuals were recruited for study as cases were matched with 60 individuals as the control subjects, and data were collected using the WHO well-being index and the validated 6-item cognitive impairment test dementia test. The results showed that there was no significant association between gender, ethnicity, socioeconomic status and POAG. Patients with POAG had significantly lower well-being index scores (mean 67.93) than the control group (mean 81.60) with P-value < 0.001. Similarly, patients with POAG had a significantly higher score of cognitive impairment (CIT test) (mean 6.15) compared to the control group (mean 0.40) with P-value < 0.001. Consequently, POAG is likely to be associated with higher cognitive impairment and lower well-being index.