Glaucoma Fellowship Programme

CUHK-HKEH-PWH International Ophthalmology Fellowship
Glaucoma

Glaucoma Programme Director

Prof THAM Chee Yung, Clement

Prof THAM Chee Yung, Clement

Chairman
S.H. Ho Professor of OVS
Honorary Chief of Service, HKEH
Director, CUHK Eye Centre
Deputy Director, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong
Secretary General & CEO, Asia-Pacific Academy of Ophthalmology (APAO)

Faculty

Prof LEUNG Kai Shun Christopher

Prof LEUNG Kai Shun Christopher

Professor
Head, Graduate Division of Ophthalmology and Visual Sciences

Dr LI Chi Hong Felix

Dr LI Chi Hong Felix

Clinical Associate Professor (Honorary), CUHK
Consultant, AHNH

Dr Nafees Baig

Dr Nafees Baig

Clinical Assistant Professor (Honorary), CUHK
Associate Consultant, HKEH

International Fellows

Dr Maria Elena MENDOZA MENDIETA

Dr Maria Elena MENDOZA MENDIETA

Visiting Scholar (Honorary)

Dr TAN Shaoying Ellen

Dr TAN Shaoying Ellen

Visiting Scholar (Honorary)

Introduction

The Glaucoma Service of the Department of Ophthalmology and Visual Sciences operates at both the Hong Kong Eye Hospital and the Prince of Wales Hospital, the teaching hospital of the Chinese University of Hong Kong. Our 4 Glaucoma Subspecialty Clinics serve the populations living in Kowloon and the eastern region of the New Territories in Hong Kong, and are well attended by over 350 patients each week.
Glaucoma Fellows of the CUHK-HKEH Joint International Ophthalmology Fellowship Programme will actively participate in all clinical services and various research projects. During the Fellowship, each Fellow should aim to be the Principal Investigator of at least 1 glaucoma research project at CUHK. At the conclusion of the Fellowship, each Fellow should be confident in the diagnosis and treatment of common glaucoma diseases, and should have at least 1 publication as first author arising from research done during his / her CUHK Fellowship.

Clinical Attachment for Glaucoma

  • Up to 4 Glaucoma Clinics per week at Hong Kong Eye Hospital and Prince of Wales Hospital
  • At least 1 Glaucoma Operating List per week
  • At least 1 Glaucoma Imaging Session per week
  • At least 1 Glaucoma Laser Session per month

Laser Procedures at Hong Kong Eye Hospital and Prince of Wales Hospital

  • Argon / diode laser peripheral iridoplasty (A/DLPI)
  • Argon / selective / pattern laser trabeculoplasty (ALT/ SLT/ PLT)
  • Laser peripheral iridotomy
  • Transscleral cyclophotocoagulation / endoscopic cyclophotocoagulation (ECP)

Surgical Procedures at Hong Kong Eye Hospital and Prince of Wales Hospital

  • Trabeculectomy +/- phacoemulsification +/- adjunctive chemotherapy
  • Glaucoma drainage device implantation (Ahmed / Baerveldt)
  • Needling revision of trabeculectomy +/- adjunctive chemotherapy
  • Goniotomy
  • Non-penetrating trabecular surgery (NPTS)
  • Goniosynechialysis +/- phacoemulsification
  • Cyclocryosurgery

Main Areas of Research Interest

Angle Closure Glaucoma (ACG)

The CUHK Glaucoma Subspecialty has strong track record in research on the treatment of angle closure glaucoma. Our randomized controlled trials established a role for immediate laser peripheral iridoplasty and early lens extraction in acute attacks of angle closure glaucoma, and compared lens extraction alone against combined phaco-trabeculectomy in chronic ACG. Other studies by our research team have investigated various other important aspects of angle closure glaucoma, including the clinical applications of goniosynechialysis, cyclodestructive procedures, glaucoma drainage devices, and the management of phacomorphic glaucoma and plateau iris syndrome. The investigators are internationally recognized experts in the field of ACG, and have been invited by major journals to write reviews on PACG management.

Major Recent Publications:
  1. Lam DS, Leung DY, Tham CC, Li FC, Kwong YY, Chiu TY, Fan DS.
    Randomized trial on early phacoemulsification versus laser peripheral iridotomy to prevent intraocular pressure rise after acute primary angle-closure.
    Ophthalmology. 2008;115(7):1134-40.
  2. Lam DS, Lai JS, Tham CC, Chua JK, Poon AS.
    Argon laser peripheral iridoplasty versus conventional systemic medical therapy in treatment of acute primary angle-closure glaucoma: a prospective, randomized, controlled trial.
    Ophthalmology 2002;109(9):1591-6.
  3. Lam DS, Chua JK, Tham CC, Lai JS.
    Efficacy and safety of immediate anterior chamber paracentesis in the treatment of acute primary angle-closure glaucoma: a pilot study.
    Ophthalmology 2002;109(1):64-70.
  4. Lam DS, Lai JS, Tham CC.
    Immediate argon laser peripheral iridoplasty (ALPI) as treatment for acute attack of primary angle closure glaucoma: a preliminary study.
    Ophthalmol. 1998; 105:2231-6.
  5. Tham CC, Kwong YY, Leung DY, Lam SW, Li FC, Chiu TY, Chan JC, Lam DS, Lai JS.
    Phacoemulsification versus phaco-trabeculectomy in chronic angle closure glaucoma with cataract – complications.
    Archives of Ophthalmology. 2009. In press.
  6. Tham CC, Leung DY, Kwong YY, Li FC, Lai JS, Lam DS.
    Effects of phacoemulsification versus combined phaco-trabeculectomy on drainage angle status in primary angle closure glaucoma (PACG).
    J Glaucoma. 2009. [Epub ahead of print]
  7. Tham CC, Kwong YY, Leung DY, Lam SW, Li FC, Chiu TY, Chan JC, Lam DS, Lai JS.
    Phacoemulsification versus combined phaco-trabeculectomy in medically-uncontrolled chronic angle closure glaucoma with cataract.
    Ophthalmology. 2009;116(4):725-31, 731.e1-3. Epub 2009 Feb 25.
  8. Tham CC, Lai JS, Kwong YY, Lam SW, Chan JC, Chiu TY, Lam DS.
    Correlation of previous acute angle closure attack with extent of synechial angle closure in chronic primary angle-closure glaucoma patients.
    Eye. 2009;23(4):920-3. Epub 2008 Apr 18.
  9. Tham CC, Kwong YY, Leung DY, Lam SW, Li FC, Chiu TY, Chan JC, Chan CH, Poon AS, Yick DW, Chi CC, Lam DS, Lai JS.
    Phacoemulsification versus combined phaco-trabeculectomy in medically-controlled chronic angle closure glaucoma with cataract.
    Ophthalmology. 2008;115(12):2167-2173.e2. Epub 2008 Sep 18.
  10. Tham CC, Kwong YY, Lai JS, Lam DS.
    Effect of a previous acute angle closure attack on the corneal endothelial cell density in chronic angle-closure glaucoma patients.
    J Glaucoma. 2006;15(6):482-5.
  11. Tham CC, Li FC, Leung DY, Kwong YY, Yick DW, Lam DS.
    Microincisional bimanual phaco-trabeculectomy in management of co-existing glaucoma and cataract.
    J Cataract Refract Surg. 2006;32(11):1917-20.
  12. Tham CC, Lai JS, Poon AS, Lai TY, Lam DS.
    The results of trabeculectomy with adjunctive intra-operative mitomycin C in Chinese glaucoma patients.
    Ophthalmic Surgery, Lasers, and Imaging. 2006:37(1):33-41.
  13. Tham CC, Kwong YK, Ritch R, Lai JS, Lam DS.
    Argon Laser Peripheral Iridoplasty (ALPI).
    Techniques in Ophthalmology. 2005;3(4):176-81.
  14. Tham CC, Lai JS, Poon AS, Chan JC, Lam SW, Chua JK, Lam DS.
    Immediate argon laser peripheral iridoplasty (ALPI) as initial treatment for acute phacomorphic angle closure (phacomorphic glaucoma) before cataract extraction: a preliminary study.
    Eye. 2005;19(7):778-83.
Normal Tension Glaucoma
Major Recent Publications:
  1. Leung DY, Tham CC, Li FC, Kwong YY, Chi SC, Lam DS.
    Silent cerebral infarct and visual field progression in newly diagnosed normal-tension glaucoma: a cohort study.
    Ophthalmology. 2009 Jul;116(7):1250-6. Epub 2009 May 30.
  2. Lam CY, Fan BJ, Wang DY, Tam PO, Yung Tham CC, Leung DY, Ping Fan DS, Chiu Lam DS, Pang CP.
    Association of apolipoprotein E polymorphisms with normal tension glaucoma in a Chinese population.
    J Glaucoma. 2006 Jun;15(3):218-22.
Glaucoma Imaging
Optic disc and nerve fiber layer imaging

Measurement of optic disc parameters and retinal nerve fiber layer thickness is important for detecting and following glaucoma. High speed, high resolution imaging of the retina and optic disc is now possible with the availability of new imaging technologies including spectral domain optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy. The investigators are developing new algorithms to detect and analyze progressive damage of the optic nerve head and nerve fiber layer in glaucoma.

Retinal ganglion cells imaging and neuroprotection

In collaboration with Prof. Robert Weinreb at the Hamilton Glaucoma Center of UCSD, an animal model was developed to visualize individual retinal neurons in vivo. This model provides a non-invasive approach for longitudinal study of the mechanism of retinal ganglion cell degeneration and the effect of neuroprotective agents.

Anterior chamber angle imaging

Angle closure glaucoma is a major cause of blindness in Asia. In collaboration with Prof. Robert Ritch at the New York Eye and Ear Infirmary, the investigators are investigating the morphology of the anterior chamber angle and other biometric risk factors in relation to angle closure glaucoma.

Major Recent Publications:
  1. Leung CK, Cheung CY, Weinreb RN, Qiu K, Liu S, Li H, Xu G, Fan N, Pang CP, Tse RK, Lam DS.
    Evaluation of retinal nerve fiber layer progression in glaucoma with optical coherence tomography guided progression analysis (GPA).
    Invest Ophthalmol Vis Sci. 2009 In press.
  2. Leung CK, Ye C, Weinreb RN, Cheung CY, Qiu Q, Liu S, Xu G, Lam DS.
    Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: A study on diagnosic agreement with Heidelberg Retinal Tomograph. Ophthalmology 2009 In Press
  3. Leung CK, Cheung CY, Weinreb RN, Qiu Q, Liu S, Li H, Xu G, Fan N, Huang L, Pang CP, Lam DS.
    Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a variability and diagnostic performance study. Ophthalmology. 2009;116:1257-63.
  4. Leung CK, Weinreb RN.
    Experimental detection of retinal ganglion cell damage in vivo.
    Exp Eye Res. 2009;88:831-6.
  5. Leung CK, Cheung CY, Lin D, Pang CP, Lam DS, Weinreb RN.
    Longitudinal variability of optic disc and retinal nerve fiber layer measurements. Invest Ophthalmol Vis Sci. 2008;49:4886-92.
  6. Leung CK, Lindsey JD, Crowston JG, Lijia C, Chiang S, Weinreb RN.
    Longitudinal profile of retinal ganglion cell damage after optic nerve crush with blue-light confocal scanning laser ophthalmoscopy.
    Invest Ophthalmol Vis Sci. 2008;49:4898-902.
  7. Leung CK, Li H, Weinreb RN, Liu J, Cheung CY, Lai RY, Pang CP, Lam DS.
    Anterior chamber angle measurement with anterior segment optical coherence
    tomography: a comparison between slit lamp OCT and Visante OCT.
    Invest Ophthalmol Vis Sci. 2008;49:3469-74.
  8. Leung CK, Lindsey JD, Crowston JG, Ju WK, Liu Q, Bartsch DU, Weinreb RN.
    In vivo imaging of murine retinal ganglion cells. J Neurosci Methods. 2008 15;168:475-8.
  9. Leung CK, Chan WM, Chong KK, Chan CK, Yung WH, Tsang MK, Tse KK, Lam DS. Alignment Artifacts in Optical Coherence Tomography Analyzed Images. Ophthalmology. 2007;114:263-70.
  10. Leung CK, Cheung CY, Li H, Dorairaj S, Yiu CK, Wong AL, Liebmann J, Ritch R, Weinreb R, Lam DS.
    Dynamic analysis of dark-light changes of the anterior chamber angle with anterior segment OCT. Invest Ophthalmol Vis Sci. 2007;48:4116-22.

Instruction Course Presentations by Faculty at Major International Scientific Conferences (to be completed)

  1. Tham CC (Instruction course organizer, chair, and course instructor), RojanaPongpun P, Agulto M, Thygesen J.
    Course title: Laser for angle closure glaucoma
    Presentation by Tham CC: Argon laser peripheral iridoplasty and argon laser trabeculoplasty in angle closure glaucoma
    World Ophthalmology Congress 2009, July 2009, Boston, USA.
  2. Lam DS, Tham CC, Leung DY, Leung CK, Lam PT.
    Update on management of acute primary angle closure glaucoma.
    American Academy of Ophthalmology (AAO), November 2008, Atlanta, USA.
  3. Goldberg I (Australia), Tham CC (Hong Kong), Healey PR (Australia), Fang SK (Malaysia), Rojanapongpun P (Thailand), Park KH (Korea), Ho CL (Singapore), Agulto MB (Philippines), Chew P (Singapore), Wang N (China), Lu DW (Taiwan), Sihota R (India).
    SEAGIG Instruction Course: ‘Safe and effective glaucoma drainage device implantation’
    Joint Meeting of South East Asia Glaucoma Interest Group and Asian Angle Closure Glaucoma Club 2008 (SEAGIG-AACGC 2008), September 2008,Seoul, South Korea.
  4. Tham CC (Senior Instructor), Wong HT, Chiu TY.
    Topical anesthesia in trabeculectomy and phaco-trabeculectomy.
    American Academy of Ophthalmology (AAO), November 2007, New Orleans, USA.
  5. Tham CC (Senior Instructor), Aung T, Leung D.
    Surgical management of chronic angle closure glaucoma.
    American Academy of Ophthalmology (AAO), November 2007, New Orleans, USA.
  6. Lam DS, Tham CC, Leung DY, Leung CK.
    Update on management of acute primary angle closure glaucoma.
    American Academy of Ophthalmology (AAO), November 2007, New Orleans, USA.
  7. Tham CC (Senior Instructor), Thygesen J, Liebmann J.
    Laser surgery of the iris and angle.
    2nd AIGS World Glaucoma Congress, July 2007, Singapore.
  8. Goldberg I, Tham CC, Rojanapongpun P, Fang SK, Healey P, Ho CL, Agulto M.
    SEAGIG Instruction Course: ‘Safe and effective glaucoma drainage device implantation’
    2nd AIGS World Glaucoma Congress, July 2007, Singapore.
  9. Tham CC (Senior Instructor), Wong HT, Chiu TY.
    Topical anesthesia in trabeculectomy and phaco-trabeculectomy.
    American Academy of Ophthalmology (AAO), November 2006, Las Vegas, USA.
  10. Goldberg I, Tham CC, Rojanapongpun P, Fang SK, Healey P, See J, Ho CL, Agulto M.
    SEAGIG Instruction Course: ‘All you wanted to know about glaucoma drainage devices but were too afraid to ask!’
    American Academy of Ophthalmology (AAO), November 2006, Las Vegas, USA.
  11. Lam DS, Tham CC, Leung DY.
    Update on management of acute primary angle closure glaucoma.
    American Academy of Ophthalmology (AAO), November 2006, Las Vegas, USA.
  12. Tham CC (Course coordinator), Ge J, Rojanapongpun P, Huang L, Congdon N.
    Glaucoma Instruction Course – Combined Phaco-Trabeculectomy
    The 6th International Symposium of Ophthalmology_Hong Kong, August 2006, Hong Kong, China.
  13. Goldberg I, Chew PT, Tham CC, Agulto M, Rojanapongpun P, Healey P, Ho CL, Fang SK.
    SEAGIG Instruction Course: ‘All you wanted to know about glaucoma drainage devices but were too afraid to ask!’
    The 21st Congress of the Asia-Pacific Academy of Ophthalmology (APAO), June 2006, Singapore.
  14. Tham CC (Chairman and Course Moderator), Palmberg P, Cronemberger S, RojanaPongpun P, Costa V, Ritch R, Lam D, Foster P.
    Lens extraction in angle closure glaucoma.
    Management strategy – acute angle closure.
    Instruction course: Angle closure glaucoma.
    World Ophthalmology Congress (WOC), February 2006, Sao Paolo, Brazil.
  15. Tham CC (Senior Instructor), Lam DS, Lai JS.
    Update on management of acute and chronic angle-closure glaucoma.
    Annual Scientific Meeting of American Academy of Ophthalmology (AAO), October 2005, Chicago, United States of America.
  16. Nolan W, Tham CC, Chew P, Aquino MC, Wong HT.
    Angle closure glaucoma.
    The Conjoint Meeting of the Asian Oceanic Glaucoma Society (AOGS) and the ANZ Glaucoma Club, September 2005, Cairns, Australia.
  17. Aung T, Tham CC, Mackey D, Jamieson R, Craig J, Healey P.
    Genetics in Glaucoma.
    The Conjoint Meeting of the Asian Oceanic Glaucoma Society (AOGS) and the ANZ Glaucoma Club, September 2005, Cairns, Australia.
  18. Seah S, Tham CC, Melamed S, Shah P.
    Lasers in Glaucoma.
    The Conjoint Meeting of the Asian Oceanic Glaucoma Society (AOGS) and the ANZ Glaucoma Club, September 2005, Cairns, Australia.
  19. Tham CC (Senior Instructor), Lam DS, Lai JS.
    Phaco-trabeculectomy and trabeculectomy under topical or intra-cameral anesthesia.
    The Congress of the American Society of Cataract and Refractive Surgery (ASCRS), April 2005, Washington DC, United States of America.
  20. Tham CC (Senior Instructor), Lam DS, Leung DY.
    New approaches in the management of acute primary angle closure (APAC).
    The 20th Congress of the Asia Pacific Academy of Ophthalmology (APAO), March 2005, Kuala Lumpur, Malaysia.
  21. Lam DS, Lai JS, Tham CC.
    New strategies in the management of angle closure glaucoma.
    Annual Scientific Meeting of American Academy of Ophthalmology (AAO), November 2003, Anaheim, United States of America.