Universal Eye Center

Taoyuan, Taiwan

Universal Eye Center

Taoyuan, Taiwan
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Lin H.-Y.,Universal Eye Center | Lin H.-Y.,Central Taiwan University of Science and Technology | Lin H.-Y.,Fu Jian Medical University | Fang Y.-T.,Universal Eye Center | And 6 more authors.
Clinical Ophthalmology | Year: 2017

During toric intraocular lens (IOL) implantation, surgeons must take particular care to ensure that inaccurate preoperative measurement and intraoperative misalignment do not cause unexpected postoperative residual astigmatism. This retrospective, comparative case series study aimed to analyze the rotational deviation, or cyclotorsion, of three corneal marking methods: VERION digital marker (VDM; reference), horizontal slit beam marking (HSBM), and subjective direct visual marking (SDVM) on the table (using a bevel knife tip). Subjects included 81 eyes of 61 patients (mean age: 65.70±13.14 years; range: 32–91 years) undergoing scheduled cataract surgery. A preoperative reference image was taken of each eye. Subsequently, a slit lamp with the light beam turned to the horizontal meridian was used to align the seated patient’s head, and two reference marks were placed at the 3- and 9-o’clock positions of the corneal limbus using a 27-gauge needle and marking pen (HSBM). Upon transfer to the surgical table, the VDM was used to display a real-time dial scale on the patient’s eye, with the entrance of the temporal clear corneal incision (CCI) at 0° (horizontal meridian). Simultaneously, a bevel knife tip was used to create a marker based on the surgeon’s visual determination of the temporal 0° point (SDVM). We used the VDM to quantitatively evaluate the accuracy of axis alignment via deviation from the horizontal reference meridian. Compared with the reference meridian, the SDVM (-3.46°±7.32°, range: -18° to 13°) exhibited greater average relative cyclotorsion versus the HSBM (0.41°±4.92°, range: -10° to 10°). Furthermore, the mean average misalignment was significantly less in the HSBM group versus the SDVM group (t=4.179, P<0.001). The VDM is likely a reliable marking method, similar to the HSBM. In contrast, the SDVM is not entirely reliable. The VDM usage may prevent inaccurate preoperative manual marking during toric IOL implantation. © 2017 Lin et al.

Lin H.-Y.,Universal Eye Center | Chen H.-Y.,Universal Eye Center | Chen H.-Y.,Ningbo First Hospital | Fam H.B.,Tan Tock Seng Hospital | And 3 more authors.
Clinical Ophthalmology | Year: 2017

Purpose: To assess the corneal keratometric values obtained using the VERION image-guided surgery system and other devices. Methods: This study evaluated the right eyes of 115 cataract patients before intraocular lens (IOL) implantation through consecutive tests using 5 devices: VERION Reference Unit, Placido-based corneal topography (OPD-Scan III), monochromatic light-emitting diodes (LenStar LS900 and AL-Scan), and rotary prism technology (auto kerato-refractometer KR-8800). Analyzed parameters were corneal steep and flat keratometric values (Ks and Kf) and corneal astigmatism and axis. These parameters were evaluated using the one-sample two-tailed t-test and the 95% limits of agreement (95% LOAs) between the devices. Results: The mean corneal cylinder value measurements were −0.97±0.63 D, −0.88± 0.60 D, −0.90±0.69 D, −0.90±0.67 D, and −0.83±0.60 D with VERION, LenStar, AL-Scan (2.4 mm), OPD III, and KR-8800, respectively. Only KR-8800 showed a significant difference from VERION in the corneal cylinder value (P<0.05). The mean differences in the Kf and Ks of VERION compared to those of OPD III were 0.18±0.45 D and 0.17±0.38 D (P<0.05), respectively. The 95% LOAs of Bland–Altman analysis for the corneal astigmatism axis of the VERION with LenStar, AL-Scan (2.4 mm), OPD III, and KR-8800 were −26.25° to 58.71°, −20.61° to 47.44°, −25.03° to 58.98°, and −27.85° to 65.17°, respectively. Conclusion: None of the VERION parameters were significantly different from those of AL-Scan and LenStar. AL-Scan (2.4 mm zone) was especially similar to VERION. Wide LOAs are potential contributors to axis error in patients with toric IOL implants. © 2017 Lin et al.

Wu C.-Y.,National Yang Ming University | Wu C.-Y.,Taipei Medical University Hospital | Hu H.-Y.,National Yang Ming University | Hu H.-Y.,Taipei Medical University Hospital | And 7 more authors.
PLoS ONE | Year: 2014

Objectives: The aim of the study was to investigate determinants of long-term care use and to clarify the differing characteristics of home/community-based and institution-based services users. Design: Cross-sectional, population-based study. Setting: Utilizing data from the 2005 National Health Interview Survey conducted in Taiwan. Participants: A national sample of 2,608 people (1,312 men, 1,296 women) aged 65 and older. Measurements: The utilization of long-term care services (both home/community- and institution-based services) was measured. A χ2 analysis tested differences in baseline characteristics between home/community-based and institution-based long-term care users. The multiple-logistic model was adopted with a hierarchical approach adding the Andersen model's predisposing, enabling, and need factors sequentially. Multiple logistic models further stratified data by gender and age. Results: Compared with users of home/community-based care, those using institution-based care had less education (p = 0.019), greater likelihood of being single (p = 0.001), fewer family members (p = 0.002), higher prevalence of stool incontinence (p = 0.011) and dementia (P = .025), and greater disability (p = 0.016). After adjustment, age (compared with 65-69 years; 75-79 years, odds ratio [OR] = 2.08, p = 0.044; age ≥80, OR = 3.30, p = 0.002), being single (OR = 2.16, p = 0.006), urban living (OR = 1.68, p = 0.037), stroke (OR = 2.08, p = 0.015), dementia (OR = 2.32, p = 0.007), 1-3 items of activities of daily living (ADL) disability (OR = 5.56, p<0.001), and 4-6 items of ADL disability (OR = 21.57, p<0.001) were significantly associated with long-term care use. Conclusion: Age, single marital status, stroke, dementia, and ADL disability are predictive factors for long-term care use. The utilization was directly proportional to the level of disability. © 2014 Wu et al.

Yang K.-J.,Chang Gung Memorial Hospital | Yang K.-J.,Chang Gung University | Yang K.-J.,Universal Eye Center | Sun C.-C.,Chang Gung Memorial Hospital | And 9 more authors.
Optometry and Vision Science | Year: 2012

Purpose.: To determine the correlation between axial length and diabetic retinopathy (DR) in patients with diabetes mellitus for 10 years or more. Methods.: This study was a prospective, observational, cross-sectional study. Patients with diabetes for 10 years or more were included. We excluded eyes with any other significant ocular disease or any prior intraocular surgery, except uncomplicated cataract surgery. Only one eye of each patient was included as the study eye. The severity of DR was graded as no DR, non-proliferative DR (NPDR), or proliferative DR (PDR). Axial length was measured by A-scan ultrasound (10 MHz Transducer, AL-2000 Biometer/Pachymeter; Tomey, Phoenix, AZ). Univariate logistic regression models were used to evaluate the relationship between the dependent variables (any DR, PDR) and all potential risk factors. Axial length and other factors with p value <0.1 were included in multivariate logistic regression models. Backward selection based on the likelihood ratio statistic was used to select the final models. Results.: We included 166 eyes from 166 patients (93 female and 73 male; mean age, 68.8 years). The mean diabetes duration was 15.4 years. Fifty-four (32.5%) eyes had no DR, 72 (43.4%) eyes had NPDR, and 40 (24.1%) eyes had PDR. In univariate analysis, hypertension (p = 0.009), renal impairment (p = 0.079), and insulin use (p = 0.009) were associated with developing any DR. Hypertension (p = 0.042), renal impairment (p = 0.014), insulin use (p = 0.040), pseudophakia (p = 0.019), and axial length (p = 0.076) were associated with developing PDR. In multivariate analysis, hypertension (p = 0.005) and insulin use (p = 0.010) were associated with developing any DR. Hypertension (p = 0.020), renal impairment (p = 0.025), pseudophakia (p = 0.006), and axial length (p = 0.024) were associated with developing PDR. Conclusions.: This observational study suggests an inverse relationship between axial length and the development of PDR in patients with diabetes for 10 years or more. No relationship was found between axial length and the development of any DR. © 2012 American Academy of Optometry.

Wu C.-Y.,National Yang Ming University | Wu C.-Y.,Taipei Medical University Hospital | Hu H.-Y.,National Yang Ming University | Hu H.-Y.,Taipei Medical University Hospital | And 7 more authors.
Archives of Gerontology and Geriatrics | Year: 2013

Disability is associated with increased long-term care use among the elderly, but its association with utilization of acute care is not well understood. The aim of this study is to investigate the association between functional disability and acute medical care utilization among the elderly. This nationwide, population-based cohort study was based on data from the 2005 National Health Interview Survey (NHIS), linking to the 2004-2007 National Health Insurance (NHI) claims data. A total of 1521 elderly subjects aged 65 years or above were observed from the year 2004 to 2006; this sample was considered to be a national representative sample. The utilization of acute medical care (including outpatient services, emergency services, and inpatient services) and medical expenditure were measured. Functional disability was measured by determining limitations on activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility. After adjusting for age, comorbidity, and sociodemographic characteristics, functional disability that affected IADLs or mobility was a significant factor contributing to the increased use of care. A clear proportional relationship existed between disability and utilization, and this pattern persisted across different types of acute care services. Disability affecting IADLs or mobility, rather than ADLs, was a more sensitive predictor of acute medical care utilization. Compared to elderly persons with no limitations, the medical expenditure of those with moderate-to-severe limitations was 2-3 times higher for outpatient, emergency, and inpatient services. In conclusion, functional disability among the elderly is a significant factor contributing to the increased use of acute care services. © 2013 Elsevier Ireland Ltd.

Huang S.-F.,Chang Gung University | Lee T.-J.,Chang Gung University | Lee Y.-S.,Chang Gung University | Lee Y.-S.,Ming Chuan University | And 3 more authors.
Annals of Otology, Rhinology and Laryngology | Year: 2011

Objectives: Periorbital infection frequently originates from acute rhinosinusitis in children. We tried to find the characteristics of pediatric patients who are likely to develop subperiosteal orbital abscesses and to need emergency surgery for acute orbital swelling. Methods: In an observational retrospective cohort study, we reviewed 64 children less than 18 years of age who visited emergency rooms for periorbital swelling and were hospitalized with a diagnosis of periorbital cellulitis and subperiosteal orbital abscess between 1996 and 2007 at Chang Gung Memorial Hospital. The presence of periorbital abscess was diagnosed radiographically, and all of the patients had concomitant sinusitis that was proved by computed tomographic scan. Results: The mean age of the patients was 6.95 years, and 42 (65.63%) were male (male-to-female ratio, 1.91). Thirty patients (46.88%) had surgical drainage, and 34 (53.13%) received antibiotic therapy only. The factors associated on bivariate analysis with abscess formation were age of 6 years or less (p = 0.023), proptosis (p = 0.012), fever (p < 0.001), and a white blood cell count of more than 11,100 cells per microliter (p = 0.004). On multivariate analysis, fever and proptosis were independent factors that predicted abscess formation. In patients who underwent surgical drainage, the most frequently cultured microbes were Staphylococcus aureus, Streptococcus viridans, and coagulase-negative staphylococci, and 29% of our patients had polymicrobial pus cultures. Conclusions: The most important factor in predicting the failure of antibiotic treatment of sinusitis-related periorbital infections is abscess formation. Patients with fever and proptosis are prone to develop subperiosteal orbital abscesses. © 2011 Annals Publishing Company. All rights reserved.

Fang Y.-T.,National Yang Ming University | Fang Y.-T.,Universal Eye Center | Chou Y.-J.,National Yang Ming University | Pu C.,National Yang Ming University | And 6 more authors.
Eye (Basingstoke) | Year: 2013

PurposeThis study was conducted to examine the atropine eye drop prescription trend for children diagnosed with myopia, and to determine the factors associated with the prescription of atropine eye drops.DesignThis was a population-based cross-sectional study.MethodsThis study was conducted using a national representative sample from the National Health Insurance (NHI) claims data. All school children between 4 and 18 years of age who had visited an ophthalmologist and were diagnosed with myopia between 2000 and 2007 were included herein. The main outcome measure was the proportion of subjects who were prescribed atropine eye drops in each year. Logistic regression was used to identify the factors associated with atropine eye drops being prescribed.ResultsThe prescription of atropine eye drops for children diagnosed with myopia increased significantly from the school years 2000 (36.9%) to 2007 (49.5%). There was also a shift from prescribing high concentrations (0.5 and 1%) of atropine eye drops to lower concentration ones (0.3, 0.25, and 0.1%) within this period. Atropine eye drops were more frequently prescribed to 9-12-year-old children (OR=1.26-1.42, compared with those 7-8 years old), and to children from families with a high socioeconomic status (OR=1.19-1.25); however, they were less prescribed to those living in mid to low urbanized areas (OR=0.65-0.84).ConclusionsThis study revealed an increasing trend of atropine eye drop prescription for children with myopia in Taiwan. Our study provides eye-care professionals worldwide a reference for the potential integration of atropine eye drops into their clinical practice toward children with myopia. © 2013 Macmillan Publishers Limited All rights reserved.

PubMed | Fujian Medical University and Universal Eye Center
Type: Journal Article | Journal: International journal of ophthalmology | Year: 2016

To evaluate blood pressure (BP) changes during phacoemulsification (PC) and femtosecond laser (FSL)-assisted cataract surgery.A retrospective chart review was performed for all patients who received traditional phacoemulsification surgery (PC group) and FSL-assisted cataract surgery (FS group) from July 2013 to December 2014. Totally 206 eyes from 133 patients receiving the two types of procedures were included. Patient characteristics (age, gender, and hypertension history), pre- and post-operative BPs were collected.The pro-operative systolic and diastolic BPs (mm Hg) were 124.8920.48 BP increases but at a limited level after FSL-assisted cataract surgery compared to traditional phacoemulsification.

Pu C.,National Yang Ming University | Tang G.-J.,National Yang Ming University | Fang Y.-T.,National Yang Ming University | Fang Y.-T.,Universal Eye Center | Chou Y.-J.,National Yang Ming University
Journal of Epidemiology | Year: 2012

Background: We attempted to identify the domain of self-rated health (SRH) that bestpredicts medical care utilization among Taiwanese adults. In addition, we examined the association between SRH and different measure of medical care utilization.Methods: We analyzed data on 11 987 community-dwelling adults aged 18 to 64 years from the 2005 Taiwan National Health Interview Survey (NHIS). NHIS data were linked to the 2006 National Health Insurance (NHI)administrative database. Then, medical care utilization in 2006, including all outpatient visits, hospitalizations, and mental health outpatient visits, was identified. Domain-specific health ratings were measured by using the Short Form-36 (SF-36) health survey questionnaire. Negative binominal models were used to estimate the contributionof the health domains to medical care utilization. Incidence rate ratios (IRRs) are presented.Results: The IRR for the physical component scale showed that those with the highestscores had 77% of the outpatient visits of those with the lowest scores. The importance of mental health domains was markedly higher in estimating mental health outpatient visits. Those with mental health scores above the median had only 61% of mental health outpatient visits of those with scores below the median.Conclusions: A person's medical care utilization is reflected in the different domains of general health. Domainspecific measures of subjective health are not interchangeable with global general health ratings, because different domains have independent effects on medical care utilization. Our results are potentially important for medical resource allocation because they identify different health domain experiences that require improvement.© 2012 by the Japan Epidemiological Association.

Horng S.-S.,National Yang Ming University | Chou Y.-J.,National Yang Ming University | Huang N.,National Yang Ming University | Fang Y.-T.,Universal Eye Center | Chou P.,National Yang Ming University
Neurourology and Urodynamics | Year: 2014

Aims This study assesses the prevalence, comorbidity, and risk factors of fecal incontinence (FI), and explores help seeking patterns among older FI people. Methods The data were obtained from the 2005 National Health Interview Survey, in which 1,345 men and 1,370 women aged above 65 years responded to questions concerning FI occurrence, and 218 FI-affected elderly people responded to the question about FI help seeking. The chi-square test, Student's t-test, and multiple logistic regression were used. Results The weighted FI prevalence of older Taiwanese people was 6.9% for men and 9.3% for women. Urinary incontinence, diabetes mellitus, dementia, and asthma significantly increased the risk of FI among old men, but being overweight appeared to be FI-protective (OR 0.37, 95% CI=0.17-0.80). In women, urinary incontinence, stroke, transit ischemia attack, dementia, chronic hepatitis, being underweight (BMI<18.5), and greater parity were significant FI risk factors. Of those with FI, 49.1% had sought medical help. Using Andersen's model, data analysis showed that living in an urban area (OR 2.36, CI=1.19-4.68), mucous stool incontinence (OR 3.56, 95% CI=1.35-8.32), and one or more of the following FI-related problems, namely, anxiety, families interaction, social life, work life, and sexual life, significantly predicted FI sufferers seeking medical attention. Conclusion Self-reported FI is a prevalent condition with various etiologies among older people in Taiwan. Understanding the epidemiology and comorbidity of FI, and investigating the factors associated with help seeking, is beneficial in devising and implementing prevention and management strategies. © 2013 Wiley Periodicals, Inc.

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