Current trends in cataract surgery in Thailand--2004 survey.

OBJECTIVES: To survey and investigate the current trend of cataract surgery in Thai ophthalmologists in 2004. MATERIAL AND METHOD: Questionnaires were sent to 600 ophthalmologists who were the members of the Ophthalmological Society and Royal Colleges of Ophthalmologists of Thailand. Data received from 248 (41.3%) of the recipients were analyzed and compared with those from the previous survey. RESULTS: The majority of respondents were male (63.3%) while 36.7% were female. In cataract surgery, 99.2% were still doing cataract surgery, the average number of cataract surgery procedures per surgeon per month was 25.6, 89.8% preferred phacoemulsification, and 42.5% preferred acrylic lens. The posterior capsular tear was the most common complication. CONCLUSION: There are trends toward more cataract surgical procedures performed by a surgeon, increasing preference of topical anesthesia, small incision wound and foldable acrylic lenses which reflected the popularity of phacoemulsification.

Comparison of anterior chamber depth in healthy myopic Thai eye using Orbscan and ultrasound.

OBJECTIVES: To compare the anterior chamber depth (ACD) using ultrasonic and optical measurements. MATERIAL AND METHOD: In this prospective study, ultrasound and optical (Orbscan) devices were employed to measure ACD in 42 eyes of 21 myopic volunteers. ACD values were compared using the paired-sample Student t test. The correlation of ACD values obtained from two groups was assessed by linear regression analysis. RESULTS: The difference of mean ACD values between the ultrasound (3.02 +/- 0.37 mm) and Orbscan (3.56 +/- 0.42 mm) method was statistically significant difference (p < 0.0001). CONCLUSION: The optical measurement of ACD in healthy myopic Thai eyes is, on average, 0.54 mm greater than ultrasonic measurement; however, both methods posses a significant linear correlation.

Penetrating keratoplasty following scleral patch graft procedure.

PURPOSE: To present the benefit of preserved sclera for immediately repairing perforated corneal ulcer and report the clinical outcome of patients undergoing penetrating keratoplasty after scleral patch graft. PATIENTS AND METHOD: The results of perforated corneal ulcer patients, who underwent penetrating keratoplasty after scleral patch graft between January 1996 and December 2002, were reviewed retrospectively. The causes of the corneal ulcer were also included. RESULTS: Penetrating keratoplasty was performed after scleral patch graft for perforated corneal ulcer on four patients, three males and one female. The culture results from corneal scraping showed Fusarium spp in two cases and Streptococus pneumoniae in one. One patient had a presumed bacterial corneal ulcer. The post-penetrating keratoplasty visual acuity ranged from hand motions to 20/40. CONCLUSION: The scleral patch graft procedure for perforated corneal ulcer may benefit in circumstances of unavailable corneal donors. The results of penetrating keratoplasty after scleral patch graft were favorable.

Epidemiology of the ocular complications of HIV infection in Chiang Mai.

OBJECTIVE: To identify the magnitude of ocular complications in HIV infection in Chiang Mai, and determine the signs or symptoms that indicate the risk factors for developing ocular complications in HIV-positive patients METHOD: A prospective study was carried out in newly diagnosed HIV-positive patients seen in the Ocular Infectious Disease Clinic of Maharaj Nakorn Chiang Mai Hospital from March 1, 2000 through February 28, 2001. A complete ophthalmic examination was performed on each patient together with a systemic evaluation of present illness and current medications. RESULTS: Three-hundred and ninety-five HIV-positive patients were seen for ophthalmic evaluation. Of these, 90 were in stage A (asymptomatic), 84 were in stage B (symptomatic), and 221 were in stage C (AIDS). Ocular complications were found in 44.6 per cent of the patients. Cytomegalovirus (CMV) retinitis was the most common ophthalmic complication (33%). Other ocular complications included cotton wool spot (8%), uveitis (4%), optic neuropathy (3%), and keratoconjunctivitis sicca (2%). The clinical presenting symptoms, which were the indicators for ocular complications and CMV retinitis, included chronic cough, oral thrush, chronic diarrhea, weight loss, wasting, and skin disorders. Ocular symptoms, which indicated a high risk of developing CMV retinitis, included flashing, floaters, and scotoma. CONCLUSIONS: Ocular complications are common in HIV-positive patients. CMV retinitis, which is a major vision-threatening problem, represented the most common finding. It is recommended that HIV-positive patients should have their eyes examined regularly, particularly when they have the clinical presenting symptoms previously mentioned. The patients should also notice early symptoms of CMV retinitis, which includes flashing, floaters, and scotoma.

The comparison of corneal thickness measurement: ultrasound versus optical methods.

PURPOSE: To compare the measurement of central corneal thickness between ultrasonic and optical techniques in normal Thai myopic eyes. METHOD: In this prospective study, the ultrasonic and optical pachymeter were employed to measure the central corneal thickness in 100 eyes of normal myopic volunteers. Corneal thickness was compared using the paired Student t-test. The correlation of central corneal thickness between the two groups was assessed by linear regression analysis. RESULTS: The difference of mean central corneal thickness between ultrasound (554.4 +/- 27.50 microm) and optical (581.1 +/- 22.62 microm) pachymetry was statistically significant in the normal myopic eyes (p = 0.001). Both methods possessed a highly significant linear correlation (r = 0.90, p = 0.001). CONCLUSIONS: The optical measurement of central corneal thickness in normal myopic eyes is, on average, 27 microm greater than ultrasonic pachymeter measurement.

Basic tear secretion measurement in pterygium.

PURPOSE: To evaluate the correlation between dry eye and pterygium. MATERIAL AND METHOD: A prospective study of basic tear secretion in 30 patients who had unilateral pterygium was performed. Schirmer's test with anesthesia was assessed in both eyes of patients with unilateral pterygium. RESULTS: Mean Schirmer's test value in the eye with pterygium was 11.6 +/- 0.4 mm and 12.4 + 0.4 mm, without pterygium. The Schirmer's test value was decreased significantly in the eye with pterygium. CONCLUSION: This study revealed that the Schirmer's test value with anesthesia was decreased significantly in the eye with unilateral pterygium when compared with a healthy eye.

Clinical indications for penetrating keratoplasty in Maharaj Nakorn Chiang Mai Hospital, 1996-1999.

PURPOSE: To determine the leading indication for penetrating keratoplasty. MATERIAL AND METHOD: The authors retrospectively performed a chart review of the hospital records of all patients who underwent penetrating keratoplasty at Maharaj Nakorn Chiang Mai Hospital between January 1996 and December 1999. RESULTS: A total of 45 corneal transplants were performed. The leading indications for penetrating keratoplasty, in order of decreasing frequency, were bullous keratopathy (28.9%), corneal scar (22.2%), corneal dystrophy and degeneration (20.0%), corneal ulcer (17.8%), regraft (8.9%), and trauma (2.2%). CONCLUSION: Bullous keratopathy was the leading indication for penetrating keratoplasty at Maharaj Nakorn Chiang Mai Hospital from 1996 to 1999, followed by corneal scar. The major cause of bullous keratopathy was associated with posterior chamber intraocular lens implantation.

Conjunctival autograft transplantation for primary pterygium.

PURPOSE: To evaluate the success rate of conjunctival autograft transplantation for primary pterygium. MATERIAL AND METHOD: The results of 56 patients with primary pterygia who underwent conjunctival autograft transplantation were retrospectively reviewed. The success rate was evaluated in terms of recurrence percentage of pterygia onto the cornea. RESULTS: Of the 56 patients, 20 were men and 36 women. The mean follow-up was 16.3 +/- 8.2 months. Three (5%) eyes had recurrent pterygium within 1 year. No serious sight-threatening complications were associated with this study. CONCLUSION: Conjunctival autograft transplantation can achieve very low recurrence rates for primary pterygium and may be considered a safe procedure.