Lai, James C, MD

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Physicians & Surgeons, Optometrists, Physicians & Surgeons, Cardiology

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19 Years

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(808) 523-6131Visit WebsiteMap & Directions321 N Kuakini St Ste 307Honolulu, HI 96817 Write a Review

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Hours

Regular Hours

Mon - Fri:	9:00 am - 5:00 pm

Lai, James C, MD

General Practitioners

Cryotherapy
Scleral buckles are used to repair retinal detachments. A scleral buckle is a permanent band which is placed around the outside of the eye to help support the retina in good position, similar to a belt for one’s pants. They are made usually of either solid silicone rubber or sponge material. They are placed under the conjunctiva (white part of eye) and once healed, are not visible. They have been used for decades and are designed to be safely left in place forever. Cryotherapy is usually used with a scleral buckle to create a permanent seal surrounding the retinal tear. The fluid which has collected under the retina is either surgically removed or is allowed to spontaneously reabsorb. Sometimes a gas bubble will also be injected into the vitreous cavity as part of this procedure. Scleral buckling surgery is performed in an operating room. It is frequently done under local anesthesia and the patient will usually return home the same day as the surgery.

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Specialties

Additional Specialties: Ophthalmology

More Info

Extra Phones

Phone: (808) 524-2575

Fax: (808) 531-4374

Payment method

insurance

Location

Kuakini Medical Plz

Neighborhoods

Kuakini, Liliha - Kapalama

AKA

James C Lai MD

Other Link

http://retinahi.com

Categories

Physicians & Surgeons, Optometrists, Physicians & Surgeons, Cardiology, Physicians & Surgeons, Dermatology, Physicians & Surgeons, Endocrinology, Diabetes & Metabolism, Physicians & Surgeons, Family Medicine & General Practice, Physicians & Surgeons, Gynecology, Physicians & Surgeons, Oncology, Physicians & Surgeons, Ophthalmology

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Details

Phone: (808) 523-6131

Address: 321 N Kuakini St Ste 307, Honolulu, HI 96817

Website: http://retinahi.com

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Lai, James C, MD

General Practitioners

Cryotherapy
Scleral buckles are used to repair retinal detachments. A scleral buckle is a permanent band which is placed around the outside of the eye to help support the retina in good position, similar to a belt for one’s pants. They are made usually of either solid silicone rubber or sponge material. They are placed under the conjunctiva (white part of eye) and once healed, are not visible. They have been used for decades and are designed to be safely left in place forever. Cryotherapy is usually used with a scleral buckle to create a permanent seal surrounding the retinal tear. The fluid which has collected under the retina is either surgically removed or is allowed to spontaneously reabsorb. Sometimes a gas bubble will also be injected into the vitreous cavity as part of this procedure. Scleral buckling surgery is performed in an operating room. It is frequently done under local anesthesia and the patient will usually return home the same day as the surgery.
Primary Care
Retinal artery occlusions can be caused by many different reasons. Usually, the artery becomes blocked by an embolus. The most common sources of the emboli come from the heart or the carotids (arteries in one’s neck). Finding the underlying source of the embolus is critical to trying to prevent more emboli from forming and blocking more arteries to the eye, or even to the heart or brain. Your doctor will therefore often order additional tests to examine your heart (EKG, echocardiogram), your neck vessels (carotid Dopplers), and sometimes your blood to determine if you have any conditions that would predispose you for developing more emboli. Your primary care physician may also elect to place you on blood thinners to lower your risk of future occlusions.
Electrocardiogram

Ophthalmologists

Glaucoma
Lasers are one of the most important tools that retinal specialists have. These lasers are very different from the types that are used in refractive surgery or glaucoma surgery. These lasers are usually performed right in the office.
Ophthalmology
Retina Consultants of Hawaii is proud to be comprised of three physicians who take their education and training as seriously as they do patient care. Our doctors are all trained at the top institutions for ophthalmology and also have certified vitreoretinal fellowships from eye institutions that are consistently ranked in the top 12 of the US News and World Report Best Ophthalmology programs. Meet our doctors, here!
Macular Degeneration
ICG is most helpful in patients with polypoidal choroidal vasculopathy, a variation of wet age-related macular degeneration. Abnormal blood vessels that grow underneath the retina are sometimes blocked by blood or pigment when imaged with fluorescein. These same blood vessels may be visible with ICG. ICG is also useful in evaluating ocular tumors and inflammatory conditions.
Cataracts
Once patients develop symptoms, your eye doctor will make the diagnosis of an epiretinal membrane after a dilated retinal examination. A fluorescein angiogram and/or OCT may be recommended to help evaluate whether there is leakage in the retina associated with the scar tissue. Treatment is not indicated unless the patient is bothered by one’s symptoms. The only definitive treatment to remove the scar tissue is with a surgery called vitrectomy. Surgery can be considered if the patient’s visual complaints are disturbing and create difficulty for them to function. It also considered if there is significant leakage noted on fluorescein angiography which would cause a risk to the patient’s vision over time. Specialized instruments are used to peel the scar tissue from the retinal surface. It may take up to 2 – 3 months to gain back the majority of vision after the surgery. However, patients who have had epiretinal membrane present for extended periods of time or have significant leakage may take longer for recovery. This depends on many different issues including how long the pucker has been present, whether there is associated retinal vascular leakage, or if there is a significant cataract. Statistics show that the majority of patient’s visual improvement is at least 3 lines achieved, but again this depends on the preexisting findings. Some patients may achieve 20/20 vision, although this is less likely. Typical symptoms such as distortion and blurriness are alleviated with successful surgery.
Eye Exam
Your eye doctor can often diagnose AMD with a dilated eye examination. Often, additional testing such as fluorescein angiography, ICG angiography, and OCT will also be obtained to determine the type of macular degeneration that is present. These tests are also very useful in guiding treatment options.

Pregnancy

Colon Cancer
Avastin (bevicazumab) – This is a drug that is FDA approved for the treatment of colon cancer. However, it has also been found to be useful in the treatment of wet AMD. Although it is not the same, Avastin is similar to the smaller Lucentis molecule. Avastin has been used in many clinics around the world as an alternative treatment to help slow down the progression of wet-AMD.

Endocrinologist

Diabetes Care
Diabetic Retinopathy
Vitrectomy is the surgical removal of the jelly in the back of the eye (vitreous). The vitreous is not needed to see well, and can be safely removed from the eye. Vitrectomy is performed to fix many conditions including but not limited to retinal detachment, macular hole, macular pucker, vitreous hemorrhage, diabetic retinopathy, vein occlusions, retained lens fragments, dislocated lens implant, and severe eye injury. Vitrectomy is performed in the operating room either under local or general anesthesia. Three small incisions (< 1mm in size ) are made into the sclera (white part of eye). An infusion line is placed into one of the incisions to fill the eye with a salt solution to replace the vitreous as it is removed from the eye. Microscopic instruments are then inserted into the two remaining incisions to perform the necessary operation. Instruments that are used for the vitrectomy include light sources to help with visualization, microscopic forceps, scissor, cutters, and lasers. At the end of the operation, it is sometimes necessary to place either a gas bubble or silicone oil into the eye to help push and keep the retina in good position. The gas bubble can last anywhere between several days to weeks and will eventually get reabsorbed by the eye and replaced with the body’s own fluids anywhere. During the time that one has a bubble in the eye, they will may need to maintain their head in certain positions and avoid flying at very high altitudes.

Ultrasound
Your eye doctor will dilate your eyes, and look for areas of bleeding and swelling, abnormal blood vessels, scar tissue, and retinal detachment. Tests such as fluorescein angiography, optical coherence tomography, and ultrasound may be used to help determine the severity level of the diabetic retinopathy and help guide management options.
Radiation Therapy

Lesions
At the APVRS meeting, Dr. Kokame was a co-chair of the session on The Spectrum of Pachychoroid Disease. This session highlighted diseases associated with a thick choroid, including pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, and central serous chorioretinopathy. Dr. Kokame’s presentation was entitled, “New Findings on Anti-VEGF Resistance in PCV.” Polypoidal choroidal vasculopathy characterized by aneurysmal or polypoidal lesions in the subretinal neovascular complex were shown to have increased anti-VEGF resistance compared to eyes with typical wet AMD. This is important as there is alternative effective therapy for PCV with combined photodynamic therapy and anti-VEGF injection, which can improve visual results and lessen treatment burden.
Burns

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