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Koo S.C.Y.,Tung Wah Eastern Hospital | Chan C.W.N.,Tung Wah Eastern Hospital
International Ophthalmology | Year: 2011

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the developed world. Although effective treatment modalities such as anti-VEGF treatment have been developed for neovascular AMD, there is still no effective treatment for geographical atrophy, and therefore the most cost-effective management of AMD is to start with prevention. This review looks at current evidence on preventive measures targeted at AMD. Modalities reviewed include (1) nutritional supplements such as the Age-Related Eye Disease Study (AREDS) formula, lutein and zeaxanthin, omega-3 fatty acid, and berry extracts, (2) lifestyle modifications, including smoking and body-mass-index, and (3) filtering sunlight, i.e. sunglasses and blue-blocking intraocular lenses. In summary, the only proven effective preventive measures are stopping smoking and the AREDS formula. © 2010 The Author(s).

Ho J.C.-H.,Tung Wah Eastern Hospital | Chan C.W.-N.,Tung Wah Eastern Hospital
Journal of Cataract and Refractive Surgery | Year: 2012

We report a case of progressive capsule membrane growth 4 months after neodymium:YAG capsulotomy for posterior capsule opacification. The clinical picture closely resembled epithelial ingrowth, but histology proved otherwise. Multiple operations were required to control glaucoma and capsule proliferation. However, the patient's visual potential was limited by corneal decompensation and glaucomatous damage. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2012 ASCRS and ESCRS.

Yam J.C.,Tung Wah Eastern Hospital
Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus | Year: 2012

To compare postoperative drift after bilateral lateral rectus recession for infantile exotropia (XT) and for intermittent XT and to compare initial postoperative alignment with long-term motor outcome. Medical records of all patients with infantile exotropia or intermittent exotropia who had undergone bilateral lateral rectus muscle recession surgery with a follow-up longer than 3 years were reviewed. The pre- and postoperative angles of deviation at distance and at near and postoperative drift at distance were compared. Surgical outcome was categorized as "success" (esotropia <6(Δ) or exotropia <11(Δ)), "recurrence" (>10(Δ) exotropia), or "overcorrection" (>5(Δ) of esotropia). The overall mean postoperative exotropic drift at 3 years was 10.4(Δ) in the infantile XT group and 7.2(Δ) in the intermittent XT group (P = 0.05). Both groups had a low success rate at 3 years: 41% in the infantile XT group and 51% in the intermittent XT group (P = 0.270). For patients with an initial esotropia of 0(Δ) to 10(Δ), the success rate at 3 years was 86% in the infantile XT group (12 of 14) and 65% in the intermittent XT group (28 of 43). Postoperative exotropic drift is clinically similar in patients with intermittent versus infantile exotropia. Esotropia of 0(Δ) to 10(Δ) during the early postoperative period may be associated with the best long-term ocular alignment. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Ng D.S.,Tung Wah Eastern Hospital
Korean journal of ophthalmology : KJO | Year: 2013

Here, we report a large, overhanging cystic bleb that compromised vision and induced a foreign body sensation in a patient who underwent a trabeculectomy surgery with anti-metabolite therapy 4 years prior. Ultrasound biomicroscopy revealed multiple loculations with thin septa inside the bleb and a high risk of damage to the bleb was anticipated with a straight forward surgical excision. We injected autologous blood and placed a compression suture 6 weeks prior to surgical excision of the overhanging portion of the bleb. The operation was successful in preserving excellent bleb function, restoring visual acuity, and alleviating symptoms in our patient with up to 9 months of follow-up.

Ip T.P.,Tung Wah Eastern Hospital | Ip T.P.,University of Hong Kong | Leung J.,Ruttonjee Hospital | Kung A.W.C.,University of Hong Kong
Osteoporosis International | Year: 2010

Hip fracture is associated with high morbidity, mortality, and economic burden worldwide. It is also a major risk factor for a subsequent fracture. A literature search on the management of osteoporosis in patients with hip fracture was performed on the Medline database. Only one clinical drug trial was conducted in patients with a recent hip fracture. Further studies that specifically address post-fracture management of hip fracture are needed. The efficacy of anti-osteoporosis medication in older individuals and those at high risk of fall is reviewed in this paper. Adequate nutrition is vital for bone health and to prevent falls, especially in malnourished patients. Protein, calcium, and vitamin D supplementation is associated with increased hip BMD and a reduction in falls. Fall prevention, exercise, and balance training incorporated in a comprehensive rehabilitation program are essential to improve functional disability and survival. Exclusion of secondary causes of osteoporosis and treatment of coexistent medical conditions are also vital. Such a multidisciplinary team approach to the management of hip fracture patients is associated with a better clinical outcome. Although hip fracture is the most serious of all fractures, osteoporosis management should be prioritized to prevent deterioration of health and occurrence of further fracture. © 2010 The Author(s).

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