One-Year Visual and Refractive Outcomes following LASIK for Myopia and Myopic Astigmatism with MEL 90 versus Schwind Amaris 750S Excimer Laser: A Comparative Study

Purpose. To compare clinical outcomes following LASIK for myopia performed with MEL 90 vs. Schwind Amaris 750S excimer laser. Methods. Data were collected retrospectively for patients who underwent Femto-LASIK, using the MEL 90 and Schwind Amaris 750S excimer laser for correction of myopia and myopic astigmatism within the range of −1.00 to −10.00 D SE from January 2013 till June 2018. Outcomes were analysed at 12 months for safety, efficacy, enhancement rate, and long-term complications. Results. A total of 328 eyes of 328 patients were analysed. One hundred and sixty-three eyes were treated with Schwind Amaris and the remaining 165 eyes with the MEL 90 laser. Twelve months postoperatively, the mean UDVA, CDVA, residual SE, and cylinder in the Amaris group were −0.10 ± 0.09 logMAR, −0.14 ± 0.06 logMAR, −0.21 ± 0.22 D, −0.13 ± 0.18 D versus −0.05 ± 0.07 logMAR, −0.09 ± 0.08 logMAR, −0.23 ± 0.23 D, and −0.14 ± 0.21 D for the MEL 90 group ( p values >0.05). For the Amaris group, safety and efficacy indices were 1.12 and 1.02, whereas for the MEL 90 group, these indices were 1.08 and 1.00, respectively. No eye in either group had any postop flap-related complications, infectious keratitis, diffuse lamellar keratitis, or keratectasia. Two eyes in the Amaris and 4 eyes in MEL 90 group required enhancement for the progression of myopia. Conclusion. At 12 months, both Schwind Amaris 750S and MEL 90 lasers demonstrated comparable clinical outcomes for myopic LASIK in a single surgeon setting.

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Two-Year Reproducibility of Axial Length Measurements after Combined Phacovitrectomy for Epiretinal Membrane, and Refractive Outcomes

Journal of Clinical Medicine ◽

10.3390/jcm9113493 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3493

Author(s):

Tae Seen Kang ◽

Yong-Il Shin ◽

Cheon Kuk Ryu ◽

Jung Yeul Kim

Keyword(s):

Axial Length ◽

Intraclass Correlation ◽

Prediction Errors ◽

Epiretinal Membranes ◽

Lens Position ◽

Refractive Outcomes ◽

Length Measurements ◽

The Mean ◽

One Year

Purpose: To determine the long-term reproducibility of axial length measurements and mean postoperative prediction errors after combined phacovitrectomy in patients with idiopathic epiretinal membranes. Design: Retrospective cohort study. Methods: The study included 43 patients who underwent combined phacovitrectomy and 30 patients who underwent only phacoemulsification. To determine the effect of vitrectomy, we compared patients treated with phacoemulsification only versus those treated with combined phacovitrectomy. Axial lengths were measured three times with a one-year interval, and the intraclass correlation coefficient (ICC), coefficient of variation (CV), and test–retest standard deviation (TRTSD) were assessed. Results: There was no significant change in axial length, and axial length measurements showed high reproducibility in all groups. ICC, CV, and TRTSD values were 0.997, 0.24%, and 0.056, respectively, for the vitrectomized eyes. The mean postoperative prediction error was −0.37 diopters(D) in vitrectomized eyes (p < 0.001), while it was +0.11 D in patients with phacoemulsification (p = 0.531). The myopic shift was more obvious in eyes with a shallower anterior chamber (p = 0.008) and a thicker lens (p = 0.025). Conclusions: Axial length measurements showed excellent long-term reproducibility at 2 years after combined phacovitrectomy. Myopic shifts were observed after combined phacovitrectomy, which was probably due to changes in the effective lens position after combined phacovitrectomy, rather than to changes in the axial length.

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Microcatheter–Assisted Circumferential Trabeculotomy in Primary Congenital Glaucoma: Long-Term Clinical Outcomes

Journal of Clinical Medicine ◽

10.3390/jcm11020414 ◽

2022 ◽

Vol 11 (2) ◽

pp. 414

Author(s):

Luigi Fontana ◽

Alberto Neri

Keyword(s):

Clinical Outcomes ◽

Primary Outcome ◽

Glaucoma Surgery ◽

Congenital Glaucoma ◽

Primary Congenital Glaucoma ◽

Age At Surgery ◽

The Mean ◽

One Year

Purpose: The purpose of this study was to report the long-term efficacy and clinical outcomes of microcatheter-assisted circumferential trabeculotomy (MCT) in children with primary congenital glaucoma (PCG). Methods: This is a single-center retrospective study including consecutive children with PCG who underwent MCT with > two years follow up. The primary outcome was surgical success, defined as intraocular pressure (IOP) ≤ 21 mmHg with (qualified) or without (complete) medications, measured at six months, one year, and then annually. Secondary outcomes were visual acuity (VA), refraction, axial length (AXL), complications, reinterventions, and number of medications. Results: Twelve eyes of ten patients were included. In eight children only one eye was affected. The mean ± standard deviation (SD) age at surgery was 6.3 ± 4.1 months. The mean postoperative follow-up was 66 ± 35 months. The mean IOP was 34.3 ± 9.6 mmHg preoperatively and 14.6 ± 2.3 mmHg postoperatively at the last visit (p < 0.001). Complete success was achieved at all time points in 10 out of 12 eyes, while 2 eyes had a qualified success. At three years of age, the mean VA of the operated eyes was 0.25 ± 0.12 logMAR, the mean spherical equivalent was −0.78 ± 1.43 diopters, and the mean AXL was 23.78 mm. Transient hyphema was the only complication observed. None of the children required additional glaucoma surgery. Conclusions: Circumferential trabeculotomy for PCG effectively lowers the IOP at more than two years after surgery. Following this procedure, the prognosis for the visual function is good, and the refractive error is low. Postoperative complications were not significant.

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Satisfactory long-term clinical outcomes after bone marrow stimulation of osteochondral lesions of the talus

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-021-06630-8 ◽

2021 ◽

Author(s):

Quinten G. H. Rikken ◽

Jari Dahmen ◽

Sjoerd A. S. Stufkens ◽

Gino M. M. J. Kerkhoffs

Keyword(s):

Bone Marrow ◽

Clinical Outcomes ◽

Degenerative Changes ◽

Osteochondral Lesions ◽

Ankle Osteoarthritis ◽

Bone Marrow Stimulation ◽

Marrow Stimulation ◽

The Mean

Abstract Purpose The purpose of the present study was to evaluate the clinical and radiological outcomes of arthroscopic bone marrow stimulation (BMS) for the treatment of osteochondral lesions of the talus (OLTs) at long-term follow-up. Methods A literature search was conducted from the earliest record until March 2021 to identify studies published using the PubMed, EMBASE (Ovid), and Cochrane Library databases. Clinical studies reporting on arthroscopic BMS for OLTs at a minimum of 8-year follow-up were included. The review was performed according to the PRISMA guidelines. Two authors independently conducted the article selection and conducted the quality assessment using the Methodological index for Non-randomized Studies (MINORS). The primary outcome was defined as clinical outcomes consisting of pain scores and patient-reported outcome measures. Secondary outcomes concerned the return to sport rate, reoperation rate, complication rate, and the rate of progression of degenerative changes within the tibiotalar joint as a measure of ankle osteoarthritis. Associated 95% confidence intervals (95% CI) were calculated based on the primary and secondary outcome measures. Results Six studies with a total of 323 ankles (310 patients) were included at a mean pooled follow-up of 13.0 (9.5–13.9) years. The mean MINORS score of the included studies was 7.7 out of 16 points (range 6–9), indicating a low to moderate quality. The mean postoperative pooled American Orthopaedic Foot and Ankle Society (AOFAS) score was 83.8 (95% CI 83.6–84.1). 78% (95% CI 69.5–86.8) participated in sports (at any level) at final follow-up. Return to preinjury level of sports was not reported. Reoperations were performed in 6.9% (95% CI 4.1–9.7) of ankles and complications related to the BMS procedure were observed in 2% (95% CI 0.4–3.0) of ankles. Progression of degenerative changes was observed in 28% (95% CI 22.3–33.2) of ankles. Conclusion Long-term clinical outcomes following arthroscopic BMS can be considered satisfactory even though one in three patients show progression of degenerative changes from a radiological perspective. These findings indicate that OLTs treated with BMS may be at risk of progressing towards end-stage ankle osteoarthritis over time in light of the incremental cartilage damage cascade. The findings of this study can aid clinicians and patients with the shared decision-making process when considering the long-term outcomes of BMS. Level of evidence Level IV.

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Arthroscopic Versus Open Anterior Shoulder Stabilization: A Prospective Randomized Clinical Trial With 15-Year Follow-up With an Assessment of the Glenoid Being “On-Track” and “Off-Track” as a Predictor of Failure

The American Journal of Sports Medicine ◽

10.1177/03635465211018212 ◽

2021 ◽

pp. 036354652110182

Author(s):

Craig R. Bottoni ◽

John D. Johnson ◽

Liang Zhou ◽

Sarah G. Raybin ◽

James S. Shaha ◽

...

Keyword(s):

Clinical Outcomes ◽

Shoulder Instability ◽

Anterior Shoulder Instability ◽

Shoulder Stabilization ◽

Mri Studies ◽

Open Stabilization ◽

The Mean ◽

Recurrent Anterior Shoulder Instability

Background: Recent studies have demonstrated equivalent short-term results when comparing arthroscopic versus open anterior shoulder stabilization. However, none have evaluated the long-term clinical outcomes of patients after arthroscopic or open anterior shoulder stabilization, with inclusion of an assessment of preoperative glenoid tracking. Purpose: To compare long-term clinical outcomes of patients with recurrent anterior shoulder instability randomized to open and arthroscopic stabilization groups. Additionally, preoperative magnetic resonance imaging (MRI) studies were used to assess whether the shoulders were “on-track” or “off-track” to ascertain a prediction of increased failure risk. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A consecutive series of 64 patients with recurrent anterior shoulder instability were randomized to receive either arthroscopic or open stabilization by a single surgeon. Follow-up assessments were performed at minimum 15-year follow-up using established postoperative evaluations. Clinical failure was defined as any recurrent dislocation postoperatively or subjective instability. Preoperative MRI scans were obtained to calculate the glenoid track and designate shoulders as on-track or off-track. These results were then correlated with the patients’ clinical results at their latest follow-up. Results: Of 64 patients, 60 (28 arthroscopic and 32 open) were contacted or examined for follow-up (range, 15-17 years). The mean age at the time of surgery was 25 years (range, 19-42 years), while the mean age at the time of this assessment was 40 years (range, 34-57 years). The rates of arthroscopic and open long-term failure were 14.3% (4/28) and 12.5% (4/32), respectively. There were no differences in subjective shoulder outcome scores between the treatment groups. Of the 56 shoulders, with available MRI studies, 8 (14.3%) were determined to be off-track. Of these 8 shoulders, there were 2 surgical failures (25.0%; 1 treated arthroscopically, 1 treated open). In the on-track group, 6 of 48 had failed surgery (12.5%; 3 open, 3 arthroscopic [ P = .280]). Conclusion: Long-term clinical outcomes were comparable at 15 years postoperatively between the arthroscopic and open stabilization groups. The presence of an off-track lesion may be associated with a higher rate of recurrent instability in both cohorts at long-term follow-up; however, this study was underpowered to verify this situation.

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Evaluating the Safety and Efficacy of a Highly Viscous 33-mg/mL Hyaluronic Acid Volumizing Filler in the Treatment of Facial Wrinkles: An Open-Labeled, Clinical Trials

Galen Medical Journal ◽

10.31661/gmj.v8i0.1148 ◽

2019 ◽

Vol 8 ◽

pp. e1148

Author(s):

Elnaz Razavian ◽

Setareh Tehrani

Keyword(s):

Hyaluronic Acid ◽

High Volume ◽

Soft Tissue Augmentation ◽

Nodule Formation ◽

Safety And Efficacy ◽

Significant Correction ◽

Clinically Significant ◽

One Year ◽

First Time

Background: The 33-mg/mL hyaluronic acid (HA) formulation is a highly concentrated, cross-linked, cohesive, smooth, and completely reversible volumizing filler approved by Conformité Européene. For the first time, we aimed to evaluate the long-term efficacy and safety of the 33-mg/mL HA filler for soft tissue augmentation in the treatment of facial wrinkles. Materials and Methods: After optimal wrinkle correction was achieved in the patients undergoing treatment by injecting the 33-mg/mL HA filler at the injection site plus one touch-up at a 2-week interval, the safety and efficacy of the filler were assessed on the 5-point Facial Volume Loss Scale through the 1-year study period. Patients were evaluated daily for 14 days and after 6 and 12 months post-treatment. Results: A total of 86 subjects were treated. The mean wrinkle scores of the patients were 3.95+0.79 (range of 3-5) before treatment, 2.3+0.94 (range 1-5) six months after treatment, and 2.93+1.29 (range of 1-5) one year after treatment. Clinically significant mean wrinkle correction (P=0.001) was still evident at>12 months of treatment through 33-mg/mL HA formulation. A clinically significant correction at>12 months after treatment was maintained by 79% of patients. Nodule formation and swelling were more frequent when the 33-mg/mL HA filler was used compared with the use of less concentrated HA fillers. One patient developed angioedema-like swelling and induration last few months. Conclusion: The 33-mg/mL HA filler can provide long-term correction lasting for one year or more. Adverse effects, especially swelling and nodule formation were more common in this filler compared with less concentrated HA fillers. The side effects were correlated with the volume of the injected filler. We recommend using this concentration with low volume or combining high volume with lower concentration. [GMJ.2019;8:e1148]

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Identifying Effectors of Outcomes in Patients with Large Umbilical Hernias

The American Surgeon ◽

10.1177/000313481608200727 ◽

2016 ◽

Vol 82 (7) ◽

pp. 613-621 ◽

Cited By ~ 3

Author(s):

Steven A. Groene ◽

Davis W. Heniford ◽

Tanushree Prasad ◽

Amy E. Lincourt ◽

Vedra A. Augenstein

Keyword(s):

Umbilical Hernia ◽

Defect Size ◽

Long Term Outcomes ◽

Preoperative Pain ◽

The Mean ◽

The Difference ◽

One Year

Quality of life (QOL) has become an important focus of hernia repair outcomes. This study aims to identify factors which lead to ideal outcomes (asymptomatic and without recurrence) in large umbilical hernias (defect size ≥9 cm2). Review of the prospective International Hernia Mesh Registry was performed. The Carolinas Comfort Scale was used to measure QOL at 1-, 6-, and 12-month follow-up. Demographics, operative details, complications, and QOL data were evaluated using standard statistical methods. Forty-four large umbilical hernia repairs were analyzed. Demographics included: average age 53.6 ± 12.0 and body mass index 34.9 ± 7.2 kg/m2. The mean defect size was 21.7 ± 16.9 cm2, and 72.7 per cent were performed laparoscopically. Complications included hematoma (2.3%), seroma (12.6%), and recurrence (9.1%). Follow-up and ideal outcomes were one month = 28.2 per cent, six months = 42.9 per cent, one year = 55.6 per cent. All patients who remained symptomatic at one and two years were significantly symptomatic before surgery. Symptomatic preoperative activity limitation was a significant predictor of nonideal outcomes at one year ( P = 0.02). Symptomatic preoperative pain was associated with nonideal outcomes at one year, though the difference was not statistically significant ( P = 0.06). Operative technique, mesh choice, and fixation technique did not impact recurrence or QOL. Repair of umbilical hernia with defects ≥9 cm2 had a surprising low rate of ideal outcomes (asymptomatic and no recurrence). All patients with nonideal long-term outcomes had preoperative pain and activity limitations. These data may suggest that umbilical hernia should be repaired when they are small and asymptomatic.

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Liver function tests and one year risperidone treatment in children and adolescents

European Psychiatry ◽

10.1016/s0924-9338(11)71990-3 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 280-280

Author(s):

A. Erdogan ◽

N. Yurteri ◽

A.E. Tufan ◽

H. Ankarali ◽

E. Demirci

Keyword(s):

Liver Function ◽

Children And Adolescents ◽

Liver Enzymes ◽

Antipsychotic Agent ◽

Liver Function Tests ◽

Function Tests ◽

The Mean ◽

One Year ◽

Risperidone Treatment

ObjectiveRisperidone is an atypical antipsychotic agent, despite its many advantages and widespread use, there is increasing attention to the adverse effects associated with long-term exposure to this drug.We aimed to investigate the changes in the liver function tests (LFTs) associated with one year risperidone treatment in children and adolescents.MethodsOne hundred youths who treated with risperidone more than one year were included in the study. For this study, patients’ baseline and follow-up weight and hepatobiliary function tests including alanine aminotransferases(ALT) and aspartat aminotransferases (AST), gamma gluatamyl transerase (GGT), alkaline phosphatase (ALP) and serum bilirubin levels were measured baseline, after the treatment period of six months and one year.ResultsAsymptomatic liver function test abnormalities mostly ALP elevation was found in subjects treated with risperidone. The mean levels of liver enzymes and billuribin of the patients were significantly higher after one year of treatment than the baseline. Also the mean levels of liver enzymes and billuribin of the patients were significantly higher after one year of treatment than the six months. There was significant association between changes in weight, risperidone dose and liver enzymes and billuribin levels.ConclusionsThese findings suggest that risperidone treatment in the long term commonly leads to liver function changes however it rarely may induce a serious hepatic toxicity at therapeutic doses in children and adolescents.

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The effectiveness of TBL with real patients in neurology education in terms of knowledge retention, in-class engagement, and learner reactions

AJP Advances in Physiology Education ◽

10.1152/advan.00130.2016 ◽

2017 ◽

Vol 41 (1) ◽

pp. 38-43 ◽

Cited By ~ 5

Author(s):

Mustafa Kemal Alimoglu ◽

Selda Yardım ◽

Hilmi Uysal

Keyword(s):

Student Satisfaction ◽

Retention Test ◽

Knowledge Retention ◽

Learner Engagement ◽

The Mean ◽

Exam Scores ◽

One Year ◽

Academic Year ◽

Real Patients

In our medical school, we changed from a lecture-based method to a team-based learning (TBL) method to teach “polyneuropathies” in the neurology clerkship starting from the 2014 to 2015 academic year. Real patients were used instead of written scenarios in TBL sessions. This study aimed to compare former lecture-based and the current TBL methods in terms of knowledge retention, in-class learner engagement, and learner reactions. First, we determined in-class engagement and satisfaction of the students for the lectures given in the 2013–2014 academic year. The following year, besides the same criteria, we also determined individual (IRAT) and group readiness test (GRAT) scores in the TBL group. End-of-clerkship exam scores for both groups were recorded. Additionally, opinions of patients about their experiences throughout the TBL process were determined. One year later (2015 for lecture and 2016 for TBL), both groups sat for an MCQ test to determine their knowledge retention levels. We found no difference between groups regarding end-of-clerkship exam scores. The mean knowledge retention test score of the TBL group was significantly higher than that of the lecture group (5.85 ± 1.74 vs. 3.28 ± 1.70). The differences between IRAT, GRAT, and retention test scores in the TBL group were significant. The mean student satisfaction score on a five-point scale was 3.01 ± 0.9 (median = 3) in the lecture group and 4.11 ± 1.1 (median = 4) in the TBL group. Our results seem encouraging for use of TBL performed with real patients in neurology education to achieve better long-term knowledge retention and higher in-class engagement and student satisfaction.

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THE PROFILE OF MULTIPLE SCLEROSIS IN GENERAL PRACTICE

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.103 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.6-e4

Author(s):

Sophie Binks ◽

Liz Green

Keyword(s):

Multiple Sclerosis ◽

Primary Care ◽

Team Approach ◽

Improvement Project ◽

Flu Vaccination ◽

The Mean ◽

One Year ◽

Primary Care Professionals

IntroductionMultiple sclerosis (MS) is a long-term neurological condition requiring a multi-disciplinary team approach. Recently, NICE highlighted the role of primary care professionals in MS management through an updated clinical guideline. This quality improvement project investigated aspects of MS patient care in a large Brighton GP practice.MethodElectronic GP records were searched to identify all currently registered patients with a diagnosis of MS. Details of initial presentation, epidemiology and care received over a one-year period were examined.ResultsThere were 19 patients, representing a prevalence of 186 per 100,000. Most patients first presented in GP with sensory disturbance, optic neuritis or motor symptoms. The mean number of primary care contacts per patient per year was 4.3, compared to 0.4 contacts per person per year with a neurologist and 0.5 with the MS nurse. 46% of GP consultations were wholly or partially related to the patient's MS. Around half of patients took up proactive interventions such as flu vaccination (47%) and Vitamin D monitoring (50%).ConclusionsPrimary care professionals are significant contributors to the care of people with MS with frequent patient contact. During this project, patients were reminded of preventive care opportunities and this will be re-audited in 2015.

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