Cataract & Refractive Surgery | Singapore National Eye Centre

Overview

The research group focuses on research relating to several aspects of cataract/refractive surgery as well as clinician-initiated and industry-initiated studies. The aims are to conduct research focused on techniques, devices, equipment, and intraocular lens implants that will culminate in peer-reviewed publications and patents and ultimately commercialisation is the goal. The team works on developing adjunctive tools e.g., optimising culture protocols, novel biometry formulae and translating these advantages to preclinical animal models and clinical trials.

Clinician-initiated Studies

Clinician or surgeon-initiated studies generally innovate from existing techniques, products, and instruments where there is a clear unmet clinical need. They can also evaluate newer commercially available products used in surgery (femtosecond laser, new versus conventional) in a new way. Studies have also been done to assess cataract patient outcomes in SNEC which are patient-centred.

Industry-initiated Studies

New products in different phases of trials are evaluated for safety and effectiveness. Such products usually include intraocular lens implants and phacoemulsification equipment. Industry-initiated studies include basic science studies, first-in-man studies and post-marketing studies.

This often involves the assessment of the relative benefits and risks of new devices, while spearheading research in the cataract arena. This allows for critical analysis of the efficacy of new intraocular devices, instrumentation, and surgical equipment. Such focus provides further opportunity to add to scientific knowledge, develop systems, practices and instruments that are suitably designed to achieve good results for our Asian patients.

Ongoing Projects

Clinician-initiated

Biometry Measurement Trends and Comparisons, and Formulae Prediction Accuracy in Singapore
Dropped Nucleus Following Cataract Surgery in SNEC
Case Series of Eyes with Subluxated Intraocular Lens Due to Late Spontaneous Posterior Capsule Rupture
Demographics and Clinical Characteristics of Ocular Inflammatory Diseases in Singapore
Laser Wound Healing – Wound Healing Responses Following Femtosecond Laser Corneal Surgery for Refractive and Corneal Transplantation, Assessing Wound Healing Following Lenticule Re-implantation, Assessing Lenticule Integration
Evaluation of the Safety and Efficacy of Biological Corneal Inlay Derived from Small Incision Lenticule Extraction (SMILE) for Presbyopia: A Pilot Study
Phase IIa Clinical Trial on the Use of Biological Inlay for Presbyopia Treatment
Comparison of Femto LDV Z8 Corneal Lenticule Extraction for Advanced Refractive Correction (CLEAR) and Visumax Small Incision Lenticule Extraction (SMILE)

Industry-initiated

A Prospective, Randomised, Controlled, First-in-man Clinical Study for Vivinex® Gemetric® Diffractive Trifocal Toric IOL: MT2 in Cataract Patients
A Comparative Clinical Evaluation of New TECNIS® Presbyopia-correcting Intraocular Lens against a Trifocal Intraocular Lens
Clinical Evaluation of a Small Aperture Extended Depth of Focus Intraocular Lens in Patients with Complex Corneas

Publications

Han SB, Liu YC, Setiawan M, Lee IXY, Patil M, Ong HS, Mehta JS. Effects of Different Capsulotomy and Fragmentation Energy Levels on the Generation of Oxidative Stress Following Femtosecond Laser-assisted Cataract Surgery. Biomolecules. 2024 Mar 7;14(3):318. doi: 10.3390/biom14030318. PMID: 38540738; PMCID: PMC10967854.
Chan JS, Han E, Lim CHL, Kurz AC, Shuman J, Liu YC, Riau AK, Mehta JS. Incisional Surface Quality of Electron-beam Irradiated Cornea-extracted Lenticule for Stromal Keratophakia: High nJ-energy vs. Low nJ-energy Femtosecond Laser. Front Med (Lausanne). 2023 Dec 15;10:1289528. doi: 10.3389/fmed.2023.1289528. PMID: 38162883; PMCID: PMC10754972.
Liu C, Lin MT, Lee IXY, Mehta JS, Liu YC. Impact of Corrected Refractive Power on the Corneal Denervation and Ocular Surface in Small-incision Lenticule Extraction and LASIK. J Cataract Refract Surg. 2023 Nov 1;49(11):1106-1113. doi: 10.1097/j.jcrs.0000000000001278. Epub 2023 Aug 7. PMID: 37867284; PMCID: PMC10583913.
Gan ATL, Fenwick EK, Ang M, Mehta JS, Lamoureux EL. Bilateral Sequential Small-incision Lenticule Extraction and LASIK Result in Similar Short-term Quality-of-life Outcomes. J Cataract Refract Surg. 2023 Mar 1;49(3):305-311. doi: 10.1097/j.jcrs.0000000000001103. PMID: 36730347.
Liu YC, Setiawan M, Chin JY, Wu B, Ong HS, Lamoureux E, Mehta JS. Randomized Controlled Trial Comparing 1-Year Outcomes of Low-energy Femtosecond Laser-assisted Cataract Surgery versus Conventional Phacoemulsification. Front Med (Lausanne). 2021 Dec 17;8:811093. doi: 10.3389/fmed.2021.811093. PMID: 34977102; PMCID: PMC8718704.
Chin JY, Lin MT, Lee IXY, Mehta JS, Liu YC. Tear Neuromediator and Corneal Denervation Following SMILE. J Refract Surg. 2021 Aug;37(8):516-523. doi: 10.3928/1081597X-20210423-01. Epub 2021 Aug 1. PMID: 34388069.
Liu YC, Yam GH, Lin MT, Teo E, Koh SK, Deng L, Zhou L, Tong L, Mehta JS. Comparison of Tear Proteomic and Neuromediator Profiles Changes between Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser-assisted In-situ Keratomileusis (LASIK). J Adv Res. 2020 Nov 5;29:67-81. doi: 10.1016/j.jare.2020.11.001. PMID: 33842006; PMCID: PMC8020296.
Liu YC, Jung ASJ, Chin JY, Yang LWY, Mehta JS. Cross-sectional Study on Corneal Denervation in Contralateral Eyes Following SMILE Versus LASIK. J Refract Surg. 2020 Oct 1;36(10):653-660. doi: 10.3928/1081597X-20200730-01. PMID: 33034357.
Ang M, Farook M, Htoon HM, Mehta JS. Randomized Clinical Trial Comparing Femtosecond LASIK and Small-incision Lenticule Extraction. Ophthalmology. 2020 Jun;127(6):724-730. doi: 10.1016/j.ophtha.2019.09.006. Epub 2019 Sep 12. PMID: 31619358.
Konstantopoulos A, Liu YC, Teo EP, Nyein CL, Yam GH, Mehta JS. Corneal Stability of LASIK and SMILE When Combined with Collagen Cross-linking. Transl Vis Sci Technol. 2019 May 20;8(3):21. doi: 10.1167/tvst.8.3.21. PMID: 31143527; PMCID: PMC6526961.
Damgaard IB, Ang M, Mahmoud AM, Farook M, Roberts CJ, Mehta JS. Functional Optical Zone and Centration Following SMILE and LASIK: A Prospective, Randomized, Contralateral Eye Study. J Refract Surg. 2019 Apr 1;35(4):230-237. doi: 10.3928/1081597X-20190313-01. PMID: 30984980.
Liu YC, Setiawan M, Ang M, Yam GHF, Mehta JS. Changes in Aqueous Oxidative Stress, Prostaglandins, and Cytokines: Comparisons of Low-energy Femtosecond Laser-assisted Cataract Surgery versus Conventional Phacoemulsification. J Cataract Refract Surg. 2019 Feb;45(2):196-203. doi: 10.1016/j.jcrs.2018.09.022. Epub 2018 Dec 6. PMID: 30528516.
Chua D, Htoon HM, Lim L, Chan CM, Mehta JS, Tan DTH, Rosman M. Eighteen-year Prospective Audit of LASIK Outcomes for Myopia in 53 731 eyes. Br J Ophthalmol. 2019 Sep;103(9):1228-1234. doi: 10.1136/bjophthalmol-2018-312587. Epub 2018 Oct 24. PMID: 30355717.
Fuest M, Liu YC, Arundhati A, Li L, Tan D, Mehta JS. Long-term Outcomes of Hemi-automated Lamellar Keratoplasty. Clin Exp Ophthalmol. 2018 Jun 1. doi: 10.1111/ceo.13331. [Epub ahead of print].
Damgaard IB, Riau AK, Liu YC, Tey ML, Yam GH, Mehta JS. Reshaping and Customization of SMILE-derived Biological Lenticules for Intrastromal Implantation. Invest Ophthalmol Vis Sci. 2018 May 1;59(6):2555-2563. doi: 10.1167/iovs.17-23427.
Fuest M, Siregar SR, Farrag A, Htoon HM, Tan D, Mehta JS. Long-term Follow-up of Deep Anterior Lamellar Keratoplasty after Descemet Stripping Automated Endothelial Keratoplasty. Graefes Arch Clin Exp Ophthalmol. 2018 May 8. doi: 10.1007/s00417-018-3997-6. [Epub ahead of print].
Ang M, Baskaran M, Werkmeister RM, Chua J, Schmidl D, Aranha Dos Santos V, Garhöfer G, Mehta JS, Schmetterer L. Anterior Segment Optical Coherence Tomography. Prog Retin Eye Res. 2018 Apr 7. pii: S1350-9462(17)30085-X. doi: 10.1016/j.preteyeres.2018.04.002. [Epub ahead of print] Review.
Liu YC, Wen J, Teo EPW, Williams GP, Lwin NC, Mehta JS. Higher-order-aberrations Following Hyperopia Treatment: Small Incision Lenticule Extraction, Laser-assisted In Situ Keratomileusis and Lenticule Implantation. Transl Vis Sci Technol. 2018 Mar 29;7(2):15. doi: 10.1167/tvst.7.2.15. eCollection 2018 Apr.
Williams GP, Wu B, Liu YC, Teo E, Nyein CL, Peh G, Tan DT, Mehta JS. Hyperopic Refractive Correction by LASIK, SMILE or Lenticule Reimplantation in a Non-human Primate Model. PLoS One. 2018 Mar 28;13(3):e0194209.doi:10.1371/journal.pone.0194209. eCollection 2018.
Damgaard IB, Ang M, Farook M, Htoon HM, Mehta JS. Intraoperative Patient Experience and Postoperative Visual Quality After SMILE and LASIK in a Randomized, Paired-eye, Controlled Study. Refract Surg. 2018 Feb 1;34(2):92-99. doi: 10.3928/1081597X-20171218-01.
Liu YC, Ng XW, Teo EPW, Ang HP, Lwin NC, Chan NSW, Venkatraman SS, Wong TT, Mehta JS. A Biodegradable, Sustained-released, Tacrolimus Microfilm Drug Delivery System for the Management of Allergic Conjunctivitis in a Mouse Model. Invest Ophthalmol Vis Sci. 2018 Feb 1;59(2):675-684. doi: 10.1167/iovs.17-23066.
Tan RKY, Wang X, Perera SA, Girard MJA. Numerical Stress Analysis of the Iris Tissue Induced by Pupil Expansion: Comparison of Commercial Devices. PLoS One. 2018 Mar 14;1.
Tan RKY, Perera SA, Tun TA, Boote C, Girard MJA. Performance of a Temperature-controlled Shape-memory Pupil Expander for Cataract Surgery. J Cataract Refract Surg. 2020 Jan;46(1):116-124. 24.
Soh YQ, Peh GS, Mehta JS. Evolving Therapies for Fuchs' Endothelial Dystrophy. Regen Med. 2018 Jan;13(1):97-115. doi: 10.2217/rme-2017-0081.
Foo VHX, Bong TSH, Tsai A, Lim LS, Perera SA. 1 Year Surgical Outcomes and Safety of Combined Trans Pars Plana Vitrectomy with Iris Fixated Posterior Chamber Intraocular Lens for Subluxated Intraocular Lens and Cataracts. Clin Ophthalmol. 2021 Oct 7;15:4049-4057. doi: 10.2147/OPTH.S333302.