Abstract
Purpose
The aim of the study is to report changes in tube shunt placement surgical case times for glaucoma fellows during the course of the academic year.
Patients and Methods
Electronic ...health records were retrospectively reviewed to determine patient demographics, surgical case times (defined as procedure start time to procedure end time), and glaucoma fellow involvement. Only cases with a glaucoma fellow as the primary surgeon were included. Operative case times were compared by first and second halves of the academic year (beginning in July and ending in June) using a two-tailed
t
-test.
Results
Five hundred and seventy-three individual tube shunt surgeries (385 Ahmed, 188 Baerveldt) performed by 28 glaucoma fellows (17 females, 11 males) at Duke University Eye Center and University of North Carolina Medical Center were included. Overall, case times were significantly shorter in the second half of the academic year as compared with the first (55.3 ± 17.1 minutes vs. 61.0 ± 17.4 minutes,
p
<0.001). Both male (57.3 ± 16.8 minutes vs. 63.2 ± 18.6 minutes,
p
= 0.008) and female (53.5 ± 17.3 minutes vs. 59.3 ± 16.4 minutes,
p
= 0.003) fellows demonstrated shorter case times over the academic year; additionally, female fellows trended toward shorter case times than male fellows in both the first half (
p
= 0.072) and second half (
p
= 0.053) of the academic year. Fellows also exhibited shorter case times with both Ahmed implants (54.1 ± 16.2 minutes vs. 59.3 ± 15.8 minutes,
p
= 0.002) and Baerveldt implants (57.8 ± 18.9 minutes vs. 64.2 ± 20.0 minutes,
p
= 0.025) cases over the academic year. Baerveldt case times were significantly longer than Ahmed cases in the first half (
p
= 0.028) and trended toward being longer than Ahmed cases in the second half (
p
= 0.070).
Conclusion
Across 5 years at two academic institutions, glaucoma fellows had shorter primary tube shunt surgical case times in the second half of the academic year. These findings reflect improvement in surgical efficiency throughout glaucoma fellowship. These findings should be taken into consideration when scheduling trainee surgeries at academic medical centers at different points in the academic year.
We report a case of retrocorneal fibrous membrane (RCFM) formation following penetrating keratoplasty (PK) and intraoperative optical coherence tomography (OCT)-guided excision of this membrane.
A ...68-year-old woman with primary open angle glaucoma and corneal decompensation of the right eye secondary to tube shunt presented for 3-month follow-up of PK. On examination of the right eye, the patient was noted to have a glassy pupillary membrane with traction on the iris. Anterior segment OCT confirmed a membrane connecting the iris to host cornea. The patient underwent biopsy and excision of the membrane assisted by intraoperative OCT. Pathological examination was consistent with Descemet's membrane proliferation. We suspect that this membrane represents retained host's Descemet's membrane following corneal transplantation.
This case highlights the existence of RCFM formation in the context of retained host cornea following PK and the role of intraoperative OCT in management.
Purpose: Vogt-Koyanagi-Harada (VKH) syndrome is a systemic inflammatory autoimmune disease with associated ophthalmic pathology. Glaucoma has been reported in patients with VKH. The purpose of this ...report is to examine the frequency and types of glaucoma associated with VKH.
Methods: This was a retrospective case series. Electronic medical records of patients with VKH were reviewed from two medical centers: Duke University and the University of North Carolina.
Results: Of 45 eyes with VKH, 28 (62%) developed ocular hypertension (OHT) or glaucoma. In the patients with VKH and OHT/glaucoma, 18/28 (64%) had posterior synechiae and/or peripheral anterior synechiae.
Conclusions: We have shown a high prevalence of OHT and glaucoma in eyes with VKH. Furthermore, in addition to secondary open angle from corticosteroid treatment and uveitis, secondary angle closure resulting from posterior synechiae, frequently associated with iris bombé configuration, is an important cause of glaucoma in VKH eyes.
Interaction between tertiary educators and students, the authors contend, improves trust and betters student responses to emotional distress while at university. Therefore, the authors introduce the ...'Deskside Manner Framework' as an emerging practice in the tertiary teaching and learning context to aid student transition success. Based on concepts and practice that originated primarily in the medical profession and later in other high credence professional contexts, the deskside manner framework includes: show respect, critical listening, the four Bs and follow up. Deskside manner is transferable and the authors aim to facilitate it through workshops and by developing a digital repository of educator-student interaction stories. Author abstract
Purpose
The purpose of this paper is to provide a state-of-the-art review of research on consumers experiencing vulnerability to describe the current situation of the consumers experiencing ...vulnerability literature and develop an up-to-date synthesised definition of consumers experiencing vulnerability.
Design/methodology/approach
This systematic review, guided by the PRISMA framework, takes a multi-disciplinary approach to identify 310 articles published between 2010 and 2019 examining consumers experiencing vulnerability. Descriptive analysis of the data is undertaken in combination with a thematic and text mining approach using Leximancer software.
Findings
A definition of consumers experiencing vulnerability is developed- “unique and subjective experiences where characteristics such as states, conditions and/or external factors lead to a consumer experiencing a sense of powerlessness in consumption settings”. The findings reveal consumers experiencing vulnerability have often been classified using a uni-dimensional approach (opposed to a multi-dimensional), focussing on one factor of vulnerability, the most prevalent of these being economic and age factors. A lack of research has examined consumers experiencing vulnerability based upon geographical remoteness, gender and sexual exploitation.
Originality/value
This paper is one of the first to examine consumers experiencing vulnerability using a systematic approach and text mining analysis to synthesise a large set of articles, which subsequently reduces the potential for researchers’ interpretative bias. Further, it is the first to generate a data-driven definition of consumers experiencing vulnerability. It provides targeted recommendations to allow further scholarly, policy and practical contributions to this area.
Abstract Purpose To report a rare complication of non-valved glaucoma drainage device surgery. Observations An 85-year-old pseudophakic white male presented with painless vision loss and bloody ...tears. He was 5 weeks removed from uncomplicated non-valved glaucoma drainage device (Baerveldt 101-350, AMO, Santa Clara, CA). There was serosanguinous discharge without apparent source and a 25% layering hyphema in the anterior chamber. The tube was unobstructed in the anterior chamber and not abutting the iris. There was no presence of neovascularization or other abnormal vessels in the angle. After clearing of the hyphema, the patient had persistent vitreous hemorrhage necessitating pars plana vitrectomy. No source of hemorrhage was identified. Conclusions and importance: This is the first report of a rare occurrence of intraocular and extraocular hemorrhage associated following spontaneous release of ligature of a non-valved glaucoma drainage implant. The presumed mechanism was sudden shallowing of the anterior chamber resulting in the tube irritating uveal vasculature. We do not have an explanation for the extraocular blood.
A retrospective study examining the role of glaucoma and cerebrospinal fluid pressure was performed in a mostly Caucasian population of Rochester, Minnesota.4 A subsequent prospective study was ...performed in China,5 revealing similar relationships as the Mayo Clinic studies. Yeoh and Tan found anatomic relationships of the optic nerve to the posterior ethmoid and sphenoid sinus in an Asian population contrasted against past studies in European populations.8 Perhaps differences in craniofacial anatomy, and its intimate relationship to the CSF circulatory system, are responsible for differences as noted by Liu, Wang, Jaggi, and Pircher. Funding/Support: David Fleischman received support from 2016 AGS MAPS grant and 2017 AGS YCS grant; Department of Ophthalmology, University of North Carolina, is a recipient of an unrestricted grant from Research to Prevent Blindness (New York, NY).
Purpose
The purpose of this research is to provide a systematic review of the literature relating to message framing and its effectiveness in persuading consumers to adopt environmentally sustainable ...behaviour, which is a form of pro-social behaviour. Specifically, this paper focuses on three types of message framing: positive–negative, self–other and abstract–concrete.
Design/methodology/approach
This paper reports on a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework identifying 108 articles published relating to message framing and environmental sustainability between 2005 and 2020. Descriptive analysis of the data was undertaken in combination with a thematic approach.
Findings
The results demonstrate that single frames do not reliably increase sustainable consumer behaviour. Instead, the use of two message frames is more consistently effective. However, there is some disparity in relation to the combined effects of two message frames. The research also identifies that the use of three combined message frames is underexplored in the existing literature.
Research limitations/implications
Social marketing and consumer psychology researchers have explored many types of message framing. This study focuses on three common types. Also, the review is limited to valence framing. The authors recognise that visual aspects of message frames also determine the effectiveness of messaging. Another limitation is that only empirical studies published between 2005 and 2020 were reviewed.
Originality/value
Past review papers related to the impact of messaging on sustainable consumer behaviour either focus on one type of message framing, such as the positive–negative frame, or did not categorise message framing into different types. The current review focuses on three types of message framing that have been examined separately and in combination in the literature. Based on the findings, this study proposes a synthesised theoretical framework for future research.
PDF
