Longitudinal changes in anterior chamber depth and axial length in Asian subjects after trabeculectomy surgery.

Background/aims: To investigate longitudinal changes in anterior chamber depth (ACD) and axial length (AXL) over 5 years after trabeculectomy surgery in Asian patients with primary glaucoma, and to identify factors associated with these changes.

Methods: In this prospective cohort study, phakic subjects with primary glaucoma who underwent trabeculectomy had ACD and AXL measured over 5 years. The effect of intraocular pressure (IOP) on ACD and AXL was determined.

The Singapore 5-fluorouracil trial: intraocular pressure outcomes at 8 years.

Objective: To report the 8-year outcomes of Asian subjects who underwent trabeculectomy augmented by intraoperative 5-fluorouracil (5-FU) or placebo.

Design: Retrospective review of a randomized controlled trial.

Participants: Subjects with primary open-angle or angle-closure glaucoma.

Genome-wide association analyses identify three new susceptibility loci for primary angle closure glaucoma.

Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study including 1,854 PACG cases and 9,608 controls across 5 sample collections in Asia. Replication experiments were conducted in 1,917 PACG cases and 8,943 controls collected from a further 6 sample collections.

Initial management of acute primary angle closure: a randomized trial comparing phacoemulsification with laser peripheral iridotomy.

Purpose: To compare the 2-year efficacy of phacoemulsification and intraocular lens implant (phaco/IOL) with laser peripheral iridotomy (LPI) in the early management of acute primary angle closure (APAC) and coexisting cataract.

Design: Randomized, controlled trial.

Participants: We included 37 subjects presenting with APAC who had responded to medical treatment such that intraocular pressure (IOP) was ≤30 mmHg within 24 hours, and had cataract with visual acuity of ≤6/15.

Cataract surgery after trabeculectomy: the effect on trabeculectomy function.

Objective: To determine whether the timing of cataract surgery after trabeculectomy has an effect on trabeculectomy function in terms of intraocular pressure control.

Methods: This was a cohort study nested within a randomized clinical trial. There were 235 participants with glaucoma who had a single previous trabeculectomy augmented with either intraoperative 5-fluorouracil or placebo.

Glaucoma management in patients with osteo-odonto-keratoprosthesis (OOKP): the Singapore OOKP Study.

Purpose: To report diagnostic modalities and treatment options for glaucoma in eyes with osteo-odonto keratoprosthesis (OOKP).

Methods: Eyes that underwent OOKP were evaluated for glaucoma at the time of the first postoperative visit, then at 1 and 3 months after the procedure, and thereafter every 6 months. All eyes underwent stereo-biomicroscopic optic nerve head (ONH) assessment, kinetic (Goldmann perimetry) and automated static visual field testing, ONH photography, Heidelberg retina tomograph, scanning laser polarimetery (GDx), and optical coherence tomography.

A randomised crossover study comparing bimatoprost and latanoprost in subjects with primary angle closure glaucoma.

Background/aims: To compare the intraocular pressure (IOP) lowering efficacy and side effects of latanoprost 0.005% and bimatoprost 0.03% in subjects with chronic primary angle closure glaucoma (PACG).

The singapore 5-Fluorouracil trabeculectomy study: effects on intraocular pressure control and disease progression at 3 years.

Purpose: To report 3-year results of a randomized, controlled trial comparing the use of a single application of 5-fluorouracil (5-FU) with placebo in trabeculectomy surgery.

Design: Prospective, randomized, double-blinded treatment trial.

Participants: Two hundred forty-three Asian patients with primary open-angle or primary angle-closure glaucoma undergoing primary trabeculectomy.

Confirmation of the presence of uveal effusion in Asian eyes with primary angle closure glaucoma: an ultrasound biomicroscopy study.

Objective: To confirm the presence of uveal effusion in the eyes of Asian patients with primary angle closure glaucoma (PACG) using ultrasound biomicroscopy (UBM).

Methods: In this observational case series, 70 patients with PACG (28 untreated patients with newly diagnosed PACG and 42 patients who had undergone previous laser iridotomy and were being monitored) and 12 patients with acute primary angle closure (APAC) were recruited. Eyes of patients with newly diagnosed PACG and APAC underwent UBM before and after laser iridotomy, whereas eyes of patients with treated PACG underwent UBM at enrollment.

National survey of ophthalmologists in Singapore for the assessment and management of asymptomatic angle closure.

Purpose: Approximately 10% of Chinese people older than 50 years in Singapore have asymptomatic narrow angles [also termed primary angle closure suspects (PACS)]. The aim of this study was to determine the attitudes and practices of ophthalmologists in Singapore regarding the management of these patients.

Methods: A nation wide questionnaire-based survey was conducted on all registered, practicing ophthalmologists in Singapore by electronic mail and post.

Efficacy and safety of a systematic switch from latanoprost to travoprost in patients with glaucoma.

Purpose: To assess the efficacy and safety of systematically switching a large number of hospital-based glaucoma patients from latanoprost to travoprost therapy.

Materials And Methods: In this prospective observational study, patients on latanoprost were systematically switched to travoprost without washout and followed-up for 12 weeks. The main outcome measures were control of intraocular pressure (IOP), rate of switching back, and tolerability.

[Effects of lens opacity on AccuMap multifocal objective perimetry in glaucoma].

Objective: To investigate the effect of lens opacity on the performance of the multi-focal visual evoked potential (mfVEP) test in patients with glaucoma and its relationship with the Humphrey's automated static perimetry.

Methods: This is a prospective, non-randomized study. Twenty-two patients were enrolled with moderate cataract and primary glaucoma scheduled for cataract surgery with or without glaucoma surgery.

Comparison of the scanning peripheral anterior chamber depth analyzer and the modified van Herick grading system in the assessment of angle closure.

Purpose: To compare the performance of the scanning peripheral anterior chamber depth analyzer (SPAC) and the modified van Herick grading system in the assessment of angle closure, using gonioscopy as the reference standard.

Design: Prospective comparative study.

Participants: One hundred twenty phakic subjects (53 with primary angle closure and 67 with open angles) with no history of laser or intraocular surgery.

Effect of trabeculectomy on lens opacities in an East Asian population.

Objective: To examine the progression of lens opacity in Asian people after trabeculectomy and determine associated risk factors.

Methods: This was an observational case series of 243 people aged 36 to 82 years. Trabeculectomy was performed on 1 eye of each subject.

Visual acuity after acute primary angle closure and considerations for primary lens extraction.

Background/aim: Primary lens extraction has been advocated for acute primary angle closure (APAC), but it is not known if this is warranted in all cases. The aim of this study was to investigate the visual acuity (VA) of APAC eyes shortly after resolution of the acute episode in order to assess the appropriateness of performing such surgery in this condition.

Methods: This was a prospective observational case series.

Utility values in Singapore Chinese adults with primary open-angle and primary angle-closure glaucoma.

Purpose: To evaluate utility values in Chinese glaucoma patients.

Patient And Methods: Singapore Chinese residents (n = 213) with primary open-angle glaucoma or primary angle-closure glaucoma were recruited from a single tertiary ophthalmic center. Standard face-to-face interviews were conducted to ask about utility values (time trade-off and standard gamble for both death and blindness).

Iris ischaemic changes and visual outcome after acute primary angle closure.

Background: Ischaemic changes in the iris occur frequently after an episode of acute primary angle closure (APAC). The aim of this study was to investigate the significance of such changes with regards to visual outcome.

Methods: Acute primary angle closure cases were treated with medical therapy followed by laser peripheral iridotomy after resolution of the acute episode.

Use of surodex in phacotrabeculectomy surgery.

Purpose: To evaluate the use of Surodex (Oculex Pharmaceuticals, Sunnyvale, California) a drug delivery system incorporating 60 micrograms of dexamethasone in a pellet, in phacotrabeculectomy surgery.

Design: Nonrandomized, prospective, interventional case series.

Methods: Phacotrabeculectomy was performed on 37 Asian subjects with primary open-angle glaucoma (POAG) using a standardized technique.

[The long-term effect of phacoemulsification combined with trabeculectomy and intraoperative 5-fluorouracil in glaucoma patients].

Objective: This study was designed to evaluate the long-term effect of phacoemulsification, lens implantation combined with trabeculectomy augmented with 5-Fluorouracil (phaco-trab-5-Fu) in Asian glaucoma patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG).

Methods: This retrospective study included 71 consecutive patients who underwent phaco-trab-5-Fu in Singapore National Eye Center between January 1996 and December 1998. Patients with follow-up time less than 6 months were excluded from the study.

Interocular asymmetry of visual field defects in primary open angle glaucoma and primary angle-closure glaucoma.

Aim: To compare the interocular asymmetry in visual field loss of patients with primary open-angle (POAG) and primary angle-closure glaucoma (PACG).

Methods: Subjects entering a prospective, randomised, controlled trial of intraoperative 5-fluorouracil in glaucoma surgery in Singapore were included. Preoperative visual field testing was performed using automated white-on-white perimetry (24-2 test pattern, threshold program, Mk II, Model 750, Zeiss-Humphrey, San Leandro, CA, USA).

Effect of cataract extraction and intraocular lens implantation on nerve fibre layer thickness measurements by scanning laser polarimeter (GDx) in glaucoma patients.

Purpose: To assess the influence of visually significant cataract on the measurement of nerve fibre layer thickness by scanning laser polarimetry (GDx) in glaucoma patients undergoing phacoemulsification cataract extraction.

Method And Subjects: All subjects with primary glaucoma participating in a prospective trial of glaucoma surgery who subsequently underwent cataract extraction were eligible. A single trained observer using the GDx nerve fibre layer analyser (LDT) performed pre- and post-operative measurements of nerve fibre layer thickness (NFLT).

Randomised controlled trial comparing the effect of brimonidine and timolol on visual field loss after acute primary angle closure.

Aim: To compare the effect of brimonidine and timolol in reducing visual field loss in patients with acute primary angle closure (APAC).

Methods: In addition to standard acute medical treatment, patients presenting with APAC were randomised to either brimonidine 0.2% or timolol 0.

Combined phacoemulsification, intraocular lens implantation and trabeculectomy for chronic angle closure glaucoma.

Purpose: To investigate the results of combined phacoemulsification, intraocular lens implantation and trabeculectomy in Asian patients with chronic angle closure glaucoma (CACG).

Methods: This was a retrospective non-comparative case series of 55 consecutive patients (57 eyes) who underwent phacoemulsification, posterior chamber intraocular lens implantation and trabeculectomy for CACG at the Singapore National Eye Centre between 1997-1998. The surgical outcome was assessed in terms of intraocular pressure (IOP), the incidence of complications and the visual acuity at last follow-up.

Optic disc hemorrhage in Asian glaucoma patients.

Purpose: To assess the prevalence of optic disc hemorrhage in Asian patients with established glaucoma using a recently described, highly sensitive detection method.

Materials And Methods: Patients entering a trial of glaucoma filtering surgery in Southeast Asia (The Singapore 5FU Study) were assessed for the presence or absence of optic disc hemorrhage using stereo flicker chronoscopy of stereophotograph pairs.

Results: A total of 167 patients (117 males and 50 females) were assessed, of whom 128 were Chinese.