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A 5-year analysis of endothelial vs penetrating keratoplasty graft survival in Chinese patients

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International Journal of Ophthalmology(English edition) 2020年第9期13卷 1374-1377页

作者： Anita Lai Wah Li Rachel Pui Wai Kwok Ka Wai Kam alvin lerrmann young Department of Ophthalmology and Visual Sciences Prince of Wales Hospital&Alice Ho Miu Ling Nethersole HospitalNew Territories East ClusterHospital Authoritythe Chinese University of Hong KongHong Kong SARChina

AIM:To determine if there is any difference in longterm graft survival between Descemet’s stripping endothelial keratoplasty(DSEK)and penetrating keratoplasty(PK).METHODS:A retrospective 5-year cases analysis of bullous keratopathy secondary to Fuchs’endothelial dystrophy or pseudophakic bullous keratopathy,receiving either DSEK or PK.A total of 42 DSEK cases and 25 PK cases were included in the ***:In the 5-year analysis,graft survival rates were very similar in the two groups(DSEK 77.1%vs PK76.0%.P=0.918.95%CI:-6.3 to 33.4).Sub-analyses at 1y(DSEK 81%vs PK 95%.P=0.085.95%CI:-29 to 3.6)and 2y(DSEK 81%vs PK 88%.P=0.381.95%CI:-25.9 to 11.8)show a trend towards lower survival rates of DSEK vs PK,but the results were not statistically ***:Longterm 5-year graft survival is similar between the DSEK and PK methods of corneal transplant in Chinese patients with bullous keratopathy.

关键词： cornea endothelial keratoplasty corneal graft

Clinical features and treatment outcomes of endogenous Klebsiella endophthalmitis:a 12-year review

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International Journal of Ophthalmology(English edition) 2020年第12期13卷 1933-1940页

作者： Chun Yue Mak Mary Ho Lawrence Pui-leung Iu Helena Pui-yee Sin Li Jia Chen Grace Lui Marten Erik Brelen alvin lerrmann young Department of Ophthalmology and Visual Sciences Prince of Wales HospitalNew TerritoriesHong KongChina Department of Ophthalmology and Visual Sciences the Chinese University of Hong KongNew TerritoriesHong KongChina Division of Infectious Diseases Department of Medicine and Therapeuticsthe Chinese University of Hong KongNew TerritoriesHong KongChina

AIM:To identify the clinical features and treatment outcomes of endogenous Klebsiella pneumoniae endophthalmitis and investigate prognostic factors of poor visual ***:The clinical records of all patients diagnosed with endogenous Klebsiella endophthalmitis between January 2007 to December 2018 in Prince of Wales Hospital,Hong Kong,China were retrospectively *** ophthalmological examination findings were recorded in the case note,including visual acuity testing,slit-lamp examination,indirect ophthalmoscopy and B-scan ultrasonography if media opacity precluded fundus ***:A total of 18 eyes in 14 patients were *** involvement was noted in 4 patients(28.6%).Hepatobiliary sepsis was the source in 9 patients(64.3%).Culture of intraocular fluid was positive in 5 out of 18 eyes(27.8%).Mortality was noted in 2 patients(14.3%).Mean final visual acuity was 20/*** out of 16 eyes had total loss of sight(37.5%)and 3 eyes required evisceration(18.8%).Multivariate linear regression revealed poor presenting visual acuity(P=0.031)and lack of fundus view due to vitritis(P=0.02)as prognostic factors of poor visual ***:Visual outcome of endogenous Klebsiella endophthalmitis is *** presenting visual acuity and lack of fundus view predict poor visual *** index of suspicion for endophthalmitis is important in Klebsiella sepsis patients with complaints of ocular *** screening is recommended in noncommunicable patients with Klebsiella sepsis.

关键词： Klebsiella pneumoniae endogenous endophthalmitis screening liver abscess sepsis

Corneal injection track: an unusual complication of intraocular lens implantation and review

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International Journal of Ophthalmology(English edition) 2015年第3期8卷 631-633页

作者： Julie Y.C.Lok alvin L.young Department of Ophthalmology & Visual Sciences the Chinese University of Hong Kong Prince of Wales Hospital Alice Ho Miu Ling Nethersole Hospital

Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens(IOL) implantation by injection,allowing for stable wound construction and less postoperative astigmatism. It is a safe procedure with high success rate with the advancement in machines,improvement of IOL injection systems and further maturation of surgeons’ techniques. Despite the large number of operations performed every day, foldable IOL injection leading to an intra-stromal corneal track is a very rare complication. We report a case of this unusual finding in a 70-year-old gentleman who has undergone cataract operation in November 2011 in our hospital and will review on the complications related to foldable IOL injection.

关键词： foldable intraocular lens phacoemulsification cornea complications

Regarding successful use of 23G cutter for anterior vitrectomy and scleral-fixated intraocular lens implantation

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International Journal of Ophthalmology(English edition) 2017年第12期10卷 1947-1948页

作者： koushik tripathy yuan bo liang yoly fong alvin young ICARE Eye Hospital&Postgraduate Institute Uttar Pradesh 201301India Clinical and Epidemiological Eye Research Center the Affiliated Eye HospitalSchool of Optometry and OphthalmologyWenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina Department of Ophthalmology&Visual Sciences.the Chinese University of Hong Kong Prince of Wales HospitalShatinHong KongChina

Citation： Tripathy K. Regarding successful use of 23G cutter for anterior vitrectomy and scleral-fixated intraocular lens implantation. IntJ Ophthalmol 2017;10（12）：1947-1948

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Corneal blindness and current major treatment concerngraft scarcity

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International Journal of Ophthalmology(English edition) 2017年第7期10卷 1154-1162页

作者： Kah Hie Wong Ka Wai Kam Li Jia Chen alvin L.young Department of Ophthalmology and Visual Sciences Chinese University of Hong Kong Department of Ophthalmology and Visual Sciences Prince of Wales Hospital

According to World Health Organization, the global prevalence of blindness in 2010 was 39 million people, among which 4% were due to corneal opacities. Often, the sole resort for visual restoration of patients with damaged corneas is corneal transplantation. However, despite rapid developments of surgical techniques, instrumentations and immunosuppressive agents, corneal blindness remains a prevalent global health issue. This is largely due to the scarcity of good quality corneal grafts. In this review, the causes of corneal blindness, its major treatment options, and the major contributory factors of corneal graft scarcity with potential solutions are discussed.

关键词： corneal blindness keratoplasty corneal graft corneal donation eye banking

Management of cytomegalovirus corneal endotheliitis

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Eye and Vision 2021年第1期8卷 18-30页

作者： Angela H.Y.Wong Wee Nie Kua alvin L.young Kelvin H.Wan Department of Ophthalmology Tuen Mun HospitalHong KongChina Department of Ophthalmology and Visual Sciences Prince of Wales HospitalHong KongChina Department of Ophthalmology and Visual Sciences The Chinese University of Hong KongHong KongChina

Background:Cytomegalovirus(CMV)can manifest as corneal endotheliitis in immunocompetent *** diagnosis is prudent to prevent endothelial cell loss,which could ultimately lead to corneal *** DNA was first detected in an eye with corneal endotheliitis in 2006;since then,clinical evidence from numerous case reports and case series have *** text:In this narrative review,we identified several drugs,including ganciclovir,valganciclovir,and their combination in oral,intravenous,intravitreal,and topical forms in different concentrations,together with the judicious use of topical steroids,have reported variable *** has yet to be any prospective comparative study evaluating the efficacy and safety of these assorted forms of treatment;clinical evidence is based on case reports and case *** endotheliitis presenting with corneal edema can masquerade as other corneal diseases and thus poses a great challenge especially in post-keratoplasty *** awareness is needed before and after keratoplasty to start prompt prophylaxis and ***:There is no consensus on the management of CMV *** studies are much needed to elucidate the optimal treatment modality,regime,and duration in the treatment and prophylaxis of CMV endotheliitis.

关键词： Cytomegalovirus CMV Endotheliitis Keratoplasty Corneal transplant Cornea

Long-term outcomes of endothelial keratoplasty in Chinese eyes at a University Hospital

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Eye and Vision 2014年第1期1卷 51-54页

作者： alvin L young Rachel PW Kwok Vishal Jhanji Lulu L Cheng Srinivas K Rao Department of Ophthalmology and Visual Sciences The Chinese University of Hong KongPrince of Wales HospitalShatinHong KongChina Darshan Eye Clinic ChennaiIndia.

Background:Endothelial keratoplasty(EK)is used increasingly for the management of cases with endothelial ***-term outcomes of the surgery are not widely reported in the *** report our experience of EK in Chinese eyes at a University teaching ***:Retrospective analysis was performed for all cases of EK performed between 2005 and *** analyzed included indication for surgery,associated surgical procedures,complications,best-corrected visual acuity(BCVA)and overall graft ***:Overall,22 eyes of 21 patients underwent EK(13 males,8 females,mean age 71.8±11.3 years).Pseudophakic bullous keratopathy was the leading indication for surgery(n=12)followed by Fuchs’endothelial dystrophy(n=4),or both(n=3).Other indications for surgery included failed penetrating keratoplasty(n=2)and endothelial decompensation due to multiple surgeries(n=1).Triple procedure was performed in 5(22.7%)*** were noted in the form of postoperative interface hemorrhage(n=2,9%)and graft dislocation(n=1,4.5%).The mean postoperative endothelial cell density was 1069±585.8 cells/*** mean postoperative pachymetry was 675.8±108.5μ*** mean preoperative and postoperative intraocular pressure was 11.3±3.2 and 13.9±4.5 mmHg *** the last follow-up(mean,47.4±13.7 months),BCVA was≥20/70 in 9(40.9%)*** of poor BCVA included primary graft failure(n=4),graft decompensation(n=4),advanced glaucoma(n=2)and irreversible graft rejection(n=2).Graft remained clear in 12(54.5%)cases at the last *** graft survival was 19.7±17.7 months(median 17.5 months).Conclusions:Nearly half of the EK grafts in our study survived over a period of five *** failure,glaucoma and graft rejection were the main causes of poor graft survival.

关键词： Endothelial keratoplasty Keratoplasty Long-term outcomes

High speed small gauge anterior vitrectomy cutter for scleral fixated intraocular lens implantation

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International Journal of Ophthalmology(English edition) 2017年第1期10卷 77-80页

作者： Yuan Bo Liang Yoly Y.Y. FonG Lulu L. Cheng alvin L. young Clinical and Epidemiological Eye Research Center the Affiliated Eye Hospital School of Optometry and OphthalmologyWenzhou Medical University Wenzhou 325027 ZhejiangProvince China Department of Ophthalmology ＆ Visual Sciences the ChineseUniversity of Hong Kong Prince of Wales Hospital ShatinHong Kong China

AIM： To report the outcomes of anterior vitrectomy using high speed cutter for scleral fixated intraocular lens （SFIOL） implantation in patients with posterior capsular rupture .METHODS： Medical records of 51 patients with posterior capsular rupture who received high speed cutter anterior vitrectomy via limbal incision with SFIOL implantation from June 2011 to December 2013 were reviewed retrospectively for visual outcomes and ***： Totally 51 eyes of 51 patients were identified （23 males and 28 females）. Mean age at surgery was 67.2±15y （range 27-91y）, with mean follow-up of 23±8.2mo （range 12-40mo）. The 49 （96.1%） eyes had improvement or unchanged of final postoperative visual acuity. The most common complication was vitreous haemorrhage （5.9%） and transient rise in intraocular pressure （5.9%） which all spontaneously resolved CONCLUSION： High speed cutter anterior vitrectomy via limbal incision is a safe and effective method for those with posterior capsular rupture for SFIOL implantation.

关键词： cataract aphakia posterior capsular rupture intraocular lens scleral fixation

Orthokeratology lens related infections

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World Journal of Ophthalmology 2014年第3期4卷 63-70页

作者： Kelvin Ho-Nam Wan Vishal Jhanji alvin L young Department of Ophthalmology Tuen Mun Hospital and Tuen Mun Eye Center Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Department of Ophthalmology and Visual Sciences Prince of Wales Hospital Alice Ho Liu Ling Nethersole Hospital

Orthokeratology is a reversible technique that temporarily changes the curvature of the cornea with the aim of addressing refractive errors. The United States Food and Drug Administration(FDA) granted approval for using reverse geometry contact lenses to correct myopia without any age restriction. Information from the pre-market applications to the FDA was rated as level Ⅱ evidence. Another unapproved use of overnight orthokeratology is for the prevention of myopic progression. Although orthokeratology is advocated to reduce myopic progression, there are limited long-term studies with substantial evidence of its benefits. Much of this evidence comes from non-robust experimental studies using historical or self-selected controls with relative high dropout rates. Although some positive results have been published in temporarily reducing the myopic refractive error and its progression, the use of these lenses can be associated with serious complications such as microbial keratitis. Microbial keratitis is a potentially vision-threatening adverse response associated with contact lens wear. In fact, contact lens wearhas been shown to be the predominant risk factor of microbial keratitis in some developed countries. Most of the published cases on overnight orthokeratology related microbial keratitis occurred in children or adolescents. Parents considering orthokeratology must make an informed decision about its temporary benefit and its potential for permanent loss of vision. The ophthalmic community should be reminded of the potential complications of orthokeratology.

关键词： Orthokeratology Infections Microbial keratitis Cornea Corneal ulcer Contact lens Myopia