Surgical Retina Fellowship Programme

CUHK-HKEH-PWH International Ophthalmology Fellowship
Surgical Retina

Surgical Retina Programme Director:

Dr CW Tsang

Dr CW Tsang

Clinical Assistant Professor (Honorary), CUHK
Consultant, HKEH

Faculty:

Dr Mårten BRELÉN

Dr Mårten BRELÉN

Assistant Professor, CUHK

Dr Ernie Lo

Dr Ernie Lo

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

Introduction

The Surgical Retina 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 Surgical Retina 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.
Surgical Retina 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 surgical retina research project at CUHK. At the conclusion of the Fellowship, each Fellow should be confident in the diagnosis and treatment of common surgical retina diseases, and should have at least 1 publication as first author arising from research done during his / her CUHK Fellowship.

Clinical Attachment for Surgical Retina

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

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

  • Pan retinal photocoagulation (PRP)
  • Focal Laser
  • Grid Laser
  • Barrier Laser
  • Photodynamic therapy (PDT)

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

  • Pneumatic retinopexy
  • Scleral buckling surgery
    • buckling and encircling element, cryotherapy, drainage and non-drainage procedures, D-ACE surgical sequence;
  • Pars plana vitrectomy
    • Endolaser, internal drainage, retinotomy and retinectomy, use of heavy liauid, internal tamponade with long lasting gas or silicone oil.
  • Macular surgery
    • Macular hole surgery
    • Epiretinal membrane surgery
    • Use of different adjunct staining
  • Pars plana vitrectomy for proliferative vitreoretinopathy and proliferative diabetic retinopathy
  • Silicone oil removal surgery
  • Pars plana vitrectomy for posterior perforating injury to the globe including IOFB and severe perforation;

Main Areas of Research Interest

Macular surgery

The CUHK Glaucoma Subspecialty has strong track record in research on the treatment of macular surgery. We study the safety and efficacy of different adjunct staining agent for macular surgery. Other studies by our research team include various investigation on important clinical outcome after macular surgery with multifocal ERG animal study and laboratory experimental studies.

Major Recent Publications:
  1. Lai TY, Kwok AK, Au AW, Lam DS. Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with indocyanine green-assisted internal limiting membrane peeling. Graefes Arch Clin Exp Ophthalmol. 2007 Jan;245(1):148-54.
  2. Lai WW, Fan H, Li H, Lam DS. Combined phacoemulsification and pars plana vitrectomy for macular hole treatment. Acta Ophthalmol Scand. 2006 Jun;84(3):445-6.
  3. Liu DT, Lee VY, Kwok MK, Chan WM, Lam DS. Correlation study between optical coherence tomography and fluorescein angiography in post-membrane peeling recalcitrant macular oedema. Clin Experiment Ophthalmol. 2006 Apr;34(3):282-3.
  4. Yip HK, Lai TY, So KF, Kwok AK. Retinal ganglion cells toxicity caused by photosensitising effects of intravitreal indocyanine green with illumination in rat eyes. Br J Ophthalmol. 2006 Jan;90(1):99-102.
  5. Kwok AK, Lai TY, Yip WW. Vitrectomy and gas tamponade without internal limiting membrane peeling for myopic foveoschisis. Br J Ophthalmol. 2005 Sep;89(9):1180-3.
  6. Kwok AK, Lai TY, Wong VW. Idiopathic macular hole surgery in Chinese patients: a randomised study to compare indocyanine green-assisted internal limiting membrane peeling with no internal limiting membrane peeling. Hong Kong Med J. 2005 Aug;11(4):259-66.
  7. Li FC, Yuen HK, Lam DS. Macular hole surgery with and without indocyanine green assistance. Eye (Lond). 2005 Sep;19(9):1020-1.
  8. Kwok AKh, Lai TY, Yuen KS. Epiretinal membrane surgery with or without internal limiting membrane peeling. Clin Experiment Ophthalmol. 2005 Aug;33(4):379-85.
  9. Kwok AK, Lai TY, Yeung CK, Yeung YS, Li WW, Chiang SW. The effects of indocyanine green and endoillumination on rabbit retina: an electroretinographic and histological study. Br J Ophthalmol. 2005 Jul;89(7):897-900.
  10. Kwok AK, Yeung CK, Lai TY, Chan KP, Pang CP. Effects of trypan blue on cell viability and gene expression in human retinal pigment epithelial cells. Br J Ophthalmol. 2004 Dec;88(12):1590-4.
  11. Kwok AK, Lai TY, Li WW, Woo DC, Chan NR. Indocyanine green-assisted internal limiting membrane removal in epiretinal membrane surgery: a clinical and histologic study. Am J Ophthalmol. 2004 Aug;138(2):194-9.
  12. Gopwani R, Yuen HK, Lam DS. Anatomical and visual outcome of macular hole surgery with infracyanine green-assisted peeling of the internal limiting membrane, endodrainage, and silicone oil tamponade. Am J Ophthalmol. 2004 Jun;137(6):1162
  13. Kwok AK, Lai TY, Li WW, Yew DT, Wong VW. Trypan blue- and indocyanine green-assisted epiretinal membrane surgery: clinical and histopathological studies. Eye (Lond). 2004 Sep;18(9):882-8. PubMed PMID: 15002012.
  14. Leung DY, Kwok AK. Delayed and repeated massive suprachoroidal hemorrhage after pars plana vitrectomy. Jpn J Ophthalmol. 2004 Jan-Feb;48(1):84-5.
  15. Lee VY, Kwok AK, Wong TH, Lam DS. Method of macular hole repair with minimal vitrectomy. Retina. 2003 Dec;23(6):887-8.
  16. Kwok AK, Lai TY, Yuen KS, Tam BS, Wong VW. Macular hole surgery with or without indocyanine green stained internal limiting membrane peeling. Clin Experiment Ophthalmol. 2003 Dec;31(6):470-5.
  17. Kwok AK, Lai TY, Chan NR. Epiretinal membrane formation with internal limiting membrane wrinkling after Nd:YAG laser membranotomy in valsalva retinopathy. Am J Ophthalmol. 2003 Oct;136(4):763-6.
  18. Kwok AK, Lai TY, Yew DT, Li WW. Internal limiting membrane staining with various concentrations of indocyanine green dye under air in macular surgeries. Am J Ophthalmol. 2003 Aug;136(2):223-30.
  19. Kwok AK, Lai TY. Internal limiting membrane removal in macular hole surgery for severely myopic eyes: a case-control study. Br J Ophthalmol. 2003 Jul;87(7):885-9.
  20. Kwok AK, Lai TY, Yip WW. Correlation of clinical and optical coherence tomography findings in postoperative macular hole closure status. Ophthalmic Surg Lasers Imaging. 2003 Jan-Feb;34(1):25-32.
  21. Yam HF, Kwok AK, Chan KP, Lai TY, Chu KY, Lam DS, Pang CP. Effect of indocyanine green and illumination on gene expression in human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci. 2003 Jan;44(1):370-7.
  22. Kwok AK, Lai TY, Man-Chan W, Woo DC. Indocyanine green assisted retinal internal limiting membrane removal in stage 3 or 4 macular hole surgery. Br J Ophthalmol. 2003 Jan;87(1):71-4.
  23. Cheung BT, Yuen CY, Lam DS, Tang HM, Yan YN, Chen WQ. ICG-assisted peeling of the retinal ILM. Ophthalmology. 2002 Jun;109(6):1039-40
  24. Kwok AK, Li WW, Pang CP, Lai TY, Yam GH, Chan NR, Lam DS. Indocyanine green staining and removal of internal limiting membrane in macular hole surgery: histology and outcome. Am J Ophthalmol. 2001 Aug;132(2):178-83.
Retinal detachment
Major Recent Publications:
  1. Tsang CW, Cheung BT, Lam RF, Lee GK, Yuen CY, Lai TY, Lam DS. Primary 23-gauge transconjunctival sutureless vitrectomy for rhegmatogenous retinal detachment. Retina. 2008 Oct;28(8):1075-81.
  2. Yam JC, Liu DT, Lee VY, Lam PT, Lam DS. Giant retinal tear after pneumatic retinopexy. Acta Ophthalmol. 2008 Mar;86(2):232-3.
  3. Liu DT, Lee VY, Chi-Lai L, Lam DS. Stenotrophomonas maltophilia and Mycobacterium chelonae coinfection of the extraocular scleral buckle explant. Ocul Immunol Inflamm. 2007 Nov-Dec;15(6):441-2.
  4. Fok AC, Lai TY, Wong VW, Wong AL, Lam DS. Spontaneous resolution of retinal pigment epithelial tears and pigment epithelial detachment following blunt trauma. Eye (Lond). 2007 Jun;21(6):891-3.
  5. Cheung BT, Lai TY, Yuen CY, Lai WW, Tsang CW, Lam DS. Results of high-density silicone oil as a tamponade agent in macular hole retinal detachment in patients with high myopia. Br J Ophthalmol. 2007 Jun;91(6):719-21
  6. Lam RF, Lai WW, Cheung BT, Yuen CY, Wong TH, Shanmugam MP, Lam DS. Pars plana vitrectomy and perfluoropropane (C3F8) tamponade for retinal detachment due to myopic macular hole: a prognostic factor analysis. Am J Ophthalmol. 2006 Dec;142(6):938-44.
  7. Shanmugam PM, Lam DS. Optic pit associated serous macular detachment. Int Ophthalmol. 2005 Jun;26(3):119-20.
  8. Liu DT, Chan CK, Fan DS, Lam SW, Lam DS, Chan WM. Choroidal folds after 25 gauge transconjunctival sutureless vitrectomy. Eye (Lond). 2005 Jul;19(7):825-7.
  9. Kwok AK, Cheng LL, Tse MW, Cheung EY, Lam DS. Outcomes of primary rhegmatogenous retinal detachment in myopes of five or more diopters. Ophthalmic Surg Lasers. 2002 May-Jun;33(3):188-94.
  10. Liu DT, Chan WM, Fan DS, Lam DS. An infected hydrogel buckle with Corynebacterium pseudotuberculosis. Br J Ophthalmol. 2005 Feb;89(2):245-6.
  11. Kwok AK, Lam SW, Lai TY, Lam DS. Endophotocoagulation to retinal pigment epithelium as an adjuvant therapy in the management of retinal detachment caused by a highly myopic macular hole. Ophthalmic Surg Lasers. 2002 Mar-Apr;33(2):155-7.
  12. Kwok AK, Cheng LL, Gopal L, Sharma T, Lam DS. Endolaser around macular hole in the management of associated retinal detachment in highly myopic eyes. Retina. 2000;20(5):439-44.
  13. Tam BS, Kwok AK, Bhende P, Lam DS. Spontaneous reattachment of retinal detachment in a highly myopic eye with a macular hole. Eye (Lond). 2000 Aug;14 (Pt 4):661-2.
  14. Lam DS, Young AL, Leung AT. Retinal detachment surgery in Marfan’s syndrome. Retina. 1999;19(6):578-9.
Clinical outcome of pars plana vitrectomy
Major Recent Publications:
  1. Luk FO, Kwok AK, Lai TY, Lam DS. Presence of crystalline lens as a protective factor for the late development of open angle glaucoma after vitrectomy. Retina. 2009 Feb;29(2):218-24
  2. Liu DT, Fan AH, Lee VY, Lam DS. Residual intraocular perfluorodecalin masquerading as a retained intraocular foreign body: how to differentiate by simple measures. Acta Ophthalmol. 2008 Oct 24.
  3. Lam RF, Cheung BT, Yuen CY, Wong D, Lam DS, Lai WW. Retinal redetachment after silicone oil removal in proliferative vitreoretinopathy: a prognostic factor analysis. Am J Ophthalmol. 2008 Mar;145(3):527-533.
  4. Lam RF, Lai WW, Chan WM, Liu DT, Lam DS. Vitrectomy for diabetic macular edema with and without internal limiting membrane removal. Ophthalmologica. 2006;220(3):206
  5. Tan CS, Mahmood U, O’Brien PD, Beatty S, Kwok AK, Lee VY, Au Eong KG. Visual experiences during vitreous surgery under regional anesthesia: a multicenter study. Am J Ophthalmol. 2005 Dec;140(6):971-975.
  6. Lam DS, Yuen CY, Tam BS, Cheung BT, Chan WM. Sutureless vitrectomy surgery. Ophthalmology. 2003 Dec;110(12):2428-9
  7. Kwok AK, Hui M, Pang CP, Chan RC, Cheung SW, Yip CM, Lam DS, Cheng AF. An in vitro study of ceftazidime and vancomycin concentrations in various fluid media: implications for use in treating endophthalmitis. Invest Ophthalmol Vis Sci. 2002 Apr;43(4):1182-8.
  8. Kwok AK, Neoh E, Lam DS. Reversed self-sealing pars plana sclerotomies. Retina. 2001;21(5):562.
  9. Kwok AK, Tham CC, Loo AV, Fan DS, Lam DS. Ultrasound biomicroscopy of conventional and sutureless pars plana sclerotomies: a comparative and longitudinal study. Am J Ophthalmol. 2001 Aug;132(2):172-7.
  10. Lee YW, Kwok AK, Lam DS. Prevention of visual field defects after macular hole surgery. Br J Ophthalmol. 2000 Dec;84(12):1439.
  11. Kwok AK, Lam DS. Nonvitrectomizing vitreous surgery. Ophthalmology. 2000 Nov;107(11):1963.
  12. Kwok AK, Sharma T, Lam DS. Early primary pars plana vitrectomy in severe eye injuries. Retina. 1999;19(1):87-8.
  13. Kwok AK, Lee YW, Lam DS. Topical anesthesia in posterior vitrectomy. Retina. 2000;20(5):565-6.
  14. Kwok AK, Cheng LL, Gopal L, Sharma T, Lam DS. Endolaser around macular hole in the management of associated retinal detachment in highly myopic eyes. Retina. 2000;20(5):439-44.
  15. Kwok AK, Cheng LL, Lam DS. Long-term follow-up of retinal detachment from macular hole. Ophthalmology. 2000 Oct;107(10):1800-1.
  16. Lam DS, Chua JK, Leung AT, Fan DS, Ng JS, Rao SK. Sutureless pars plana anterior vitrectomy through self-sealing sclerotomies in children. Arch Ophthalmol. 2000 Jun;118(6):850-1.
  17. Kwok AK, Tam P, Lam DS. Topical anesthesia for combined phacoemulsification and posterior vitrectomy. J Cataract Refract Surg. 2000 Apr;26(4):475.
  18. Lam DS, Chan WM, Tam BS. Silicone oil tamponade for macular holes. Ophthalmology. 2000 Jan;107(1):1.
  19. Lam DS, Chan WM, Tam BS. Macular hole surgery using thrombin-activated fibrinogen and selective removal of the internal limiting membrane. Retina. 1999;19(5):478-9.
  20. Kwok AK, Van Newkirk MR, Lam DS, Fan DS. Sub-Tenon’s anesthesia in vitreoretinal surgery: a needleless technique. Retina. 1999;19(4):291-6.
  21. Kwok AK, Tham CC, Lam DS, Li M, Chen JC. Modified sutureless sclerotomies in pars plana vitrectomy. Am J Ophthalmol. 1999 Jun;127(6):731-3
Anterior segment related posterior segment surgery
Major Recent Publications:
  1. Lai TY, Kwok AK, Yeung YS, Kwan KY, Woo DC, Yuen KS, Loo AV. Immediate pars plana vitrectomy for dislocated intravitreal lens fragments during cataract surgery. Eye (Lond). 2005 Nov;19(11):1157-62.
  2. Lee VY, Liu DT, Lim E, Chan WM, Lam DS. Management of posteriorly dislocated posterior chamber intraocular lenses by vitrectomy and pars plana removal. Retina. 2005 Apr-May;25(3):385;
  3. Lee VY, Kwok AK. Multiport-illumination-system-assisted phacoemulsification in eyes with dense vitreous hemorrhage during combined cataract and vitreous surgery. J Cataract Refract Surg. 2003 Jul;29(7):1252-5.
  4. Lam DS, Young AL, Rao SK, Cheung BT, Yuen CY, Tang HM. Combined phacoemulsification, pars plana vitrectomy, and foldable intraocular lens implantation. J Cataract Refract Surg. 2003 Jun;29(6):1064-9.
  5. Kwok AK, Li KK, Lai TY, Lam DS. Pars plana vitrectomy in the management of retained intravitreal lens fragments after cataract surgery. Clin Experiment Ophthalmol. 2002 Dec;30(6):399-403.
  6. Kwok AK, Cheng AC, Lam DS. Surgical technique for transcleral-fixation of a dislocated posterior chamber intraocular lens. Am J Ophthalmol. 2001 Sep;132(3):406-8.
  7. Kwok AK, Tham CC, Lam DS. Primary intraocular lens implantation during pars plana vitrectomy and intraretinal foreign body removal. Retina. 2000;20(5):567-8.
  8. Lam DS, Tam BS, Chan WM, Bhende P. Combined cataract extraction and submacular blood clot evacuation for globe perforation caused by retrobulbar injection. J Cataract Refract Surg. 2000 Jul;26(7):1089-91.
  9. Lam DS, Rao SK, Chan WM, Leung AT. Combined phacoemulsification and pars plana vitrectomy. J Cataract Refract Surg. 1999 Oct;25(10):1309-11.
  10. Kwok AK, Young AL, Bhende P, Lam DS. Retinal detachment in phakic eyes with anterior chamber intraocular lenses to correct severe myopia. Am J Ophthalmol. 1999 Sep;128(3):395-6.