Search

To evaluate the 72-month clinical results of trabectome surgery (TOM) in patients with primary open-angle glaucoma (POAG), secondary OAG and childhood glaucoma. A total of 305 eyes from 249 glaucoma patients were analyzed in the current retrospective single-center study. Kaplan-Meier analysis was performed using three criteria: criterion A (postoperative intraocular pressure [IOP] ≤ 21 mmHg and ≥ 20% reduction from baseline IOP); criterion B (postoperative IOP ≤ 18 mmHg and ≥ 20% reduction from baseline IOP); and criterion C (postoperative IOP ≤ 16 mmHg and ≥ 20% reduction from baseline IOP). The changes in IOP, medication score, success probability, results of the multivariate analysis for success and failure risk factors, and complications were analyzed. The baseline IOP in all glaucoma patients decreased from 29.2 ± 9.8 mmHg with a 5.3 ± 1.7 medication score to 16.4 ± 5.8 mmHg (− 43.8%) with a 4.2 ± 1.5 medication score at 72 months (p

To analyze the rate and time of occurrence of intraocular pressure (IOP) elevation early after trabectome surgery (TOM) and the characteristics of glaucoma patients recovering from IOP elevation. Four hundred sixty eyes of 460 glaucoma (191 primary and 269 secondary open-angle glaucoma) patients who underwent TOM were evaluated. IOP elevation early after TOM was diagnosed when IOP increased by more than 5 mmHg over baseline within 1 week to 3 months. If the IOP decreased with the administration of anti-glaucoma eye drops alone, patients were classified as recovered. If the IOP did not decrease despite additional anti-glaucoma eye drop use, patients were classified as non-recovered. The rate and time of occurrence of IOP elevation early after TOM were investigated. Demographic and ocular variables related to recovery and non-recovery were identified by multivariate logistic regression analysis. Of the 460 patients, IOP elevation early after TOM occurred in 102 (22.2%). IOP elevation occurred most frequently at postoperative week 1. Of the 102 patients with IOP elevation, 55 (53.9%) recovered and 47 (46.1%) did not. A large hyphema size the day after surgery was associated with increased likelihood of recovery from IOP elevation (odds ratio [OR], 6.6). A history of past selective laser trabeculoplasty (SLT; OR, 0.10) and high baseline IOP (OR, 0.86) were associated with reduced likelihood of recovery from IOP elevation. IOP elevation early after TOM occurred most frequently at postoperative week 1. Patients with a large hyphema size, no history of SLT, and a lower baseline IOP recovered from IOP elevation early after TOM. A large hyphema the day after surgery suggested an increased likelihood of recovery from IOP elevation.

In the absence of a widely accepted and common definition of social enterprise (SE), a large research project, the "International Comparative Social Enterprise Models" (ICSEM) Project, was carried out over a five-year period; it involved more than 200 researchers from 55 countries and relied on bottom-up approaches to capture the SE phenomenon. This strategy made it possible to take into account and give legitimacy to locally embedded approaches, thus resulting in an analysis encompassing a wide diversity of social enterprises, while simultaneously allowing for the identification of major SE models to delineate the field on common grounds at the international level. These SE models reveal or confirm an overall trend towards new ways of sharing the responsibility for the common good in today’s economies and societies. We tend to consider as good news the fact that social enterprises actually stem from all parts of the economy. Indeed, societies are facing many complex challenges at all levels, from the local to the global level. The diversity and internal variety of SE models are a sign of a broadly shared willingness to develop appropriate―although sometimes embryonic―responses to these challenges, on the basis of innovative economic/business models driven by a social mission. In spite of their weaknesses, social enterprises may be seen as advocates for and vehicles of the general interest across the whole economy. Of course, the debate about privatisation, deregulation and globalised market competition―all factors that may hinder efforts in the search for the common good–has to be addressed as well. The first of a series of four ICSEM books, Social Enterprise in Asia will serve as a key reference and resource for teachers, researchers, students, experts, policy makers, journalists and other categories of people who want to acquire a broad understanding of the phenomena of social enterprise and social entrepreneurship as they emerge and develop across the world.

AIM To compare the corneal biomechanical properties difference by ocular response analyzer (ORA) in normal tension glaucoma (NTG) patients with different visual field (VF) progression speed. METHODS NTG patients with well-controlled Goldmann applanation tonometer (GAT) who routinely consulted Kitasato University Hospital Glaucoma Department between January 2010 and February 2014 were enrolled. GAT and ORA parameters including corneal compensated intraocular pressure (IOPcc), Goldmann estimated intraocular pressure (IOPg), corneal hysteresis (CH), corneal resistance factor (CRF) were recorded. VF was tested by Swedish interactive threshold algorithm (SITA)-standard 30-2 fields. All patients underwent VF measurement regularly and GAT did not exceed 15 mm Hg at any time during the 3y follow up. Patients were divided into four groups according to VF change over 3y, and ORA findings were compared between the upper 25(th) percentile group (slow progression group) and the lower 25(th) percentile group (rapid progression group). RESULTS Eighty-two eyes of 56 patients were studied. There were 21 eyes (21 patients) each in rapid and slow progression groups respectively. GAT, IOPcc, IOPg, CH, CRF were 12.1±1.4 mm Hg, 15.8±1.8 mm Hg, 12.8±2.0 mm Hg, 8.4±1.1 mm Hg, 7.9±1.3 mm Hg respectively in rapid progression group and 11.5±1.3 mm Hg, 13.5±2.1 mm Hg, 11.2±1.6 mm Hg, 9.3±1.1 mm Hg, 8.2±0.9 mm Hg respectively in slow progression group (P=0.214

Changing in the work environment in recent years, an occupational physician needs to make a countermeasure to mental health disorders. When the occupational physician works with employees who have, or are suspected of having, high-functioning developmental disorders, it is necessary to consider the following: Whether, in the course of addressing problems faced by employees, occupational health staff members are able to consider the possibility of developmental disorders. An additional issue is whether the occupational physician, when working with the treating psychiatrist, is able to appropriately provide precise information. Furthermore, when an employee is diagnosed with a developmental disorder, there are questions of whether a smooth internal company approach is possible in the context of appropriate workplace support, and whether it is possible to obtain the understanding of colleagues prior to implementing appropriate workplace assignments and accommodations. Additionally, it is necessary to consider the career paths of employees with high-functioning developmental disorders that are discovered subsequent to being hired. In this paper, introducing some cases, It was summarized the challenges of developmental disabilities in the workplace and discussed correspondence in the workplace.

To evaluate the short-term results of Trabectome surgery performed on Japanese patients.Retrospective observational study. Trabectome surgery was performed on 117 eyes from 101 patients at Kitasato University Hospital from December 2010 to June 2013, involving 48 eyes with primary open-angle glaucoma (POAG), 62 eyes with secondary open-angle glaucoma (SOAG), and 7 eyes with developmental glaucoma. Trabectome surgery alone was performed on 34 phakic eyes (the phakic group) and 35 pseudophakic eyes (the pseudophakic group), and Trabectome surgery combined with phacoemulsification (the combined surgery group) was performed on 48 eyes. The main outcomes assessed were intraocular pressure (IOP), number of IOP-lowering medications, and success probabilities using Kaplan-Meier life-table analyses. Failure risk factors were identified using the Cox proportional hazards ratio.In all cases, after a mean follow-up of 18.5 ± 13.5 months, IOP was reduced from 31.6 ± 9.9 (SD) mmHg using 5.0 ± 1.7 medications to 16.4 ± 5.4 mmHg using 3.8 ± 1.8 medications. One year after surgery, IOP was reduced from 29.4 ± 7.8 to 16.1 ± 3.8 mmHg in POAG, from 33.6 ± 11.1 to 14.7 ± 2.9 mmHg in SOAG, from 33.0 ± 10.2 to 15.7 ± 3.3 mmHg in the phakic group, from 32.6 ± 9.3 to 15.3 ± 3.0 mmHg in the pseudophakic group, and from 29.9 ± 10.0 to 15.2 ± 3.0 mmHg in the combined surgery group. There were no statistically significant differences in IOP at each measurement point, either between POAG and SOAG or among the three procedure subtypes. The POAG and SOAG success rates at 12 months using postoperative IOP ≤ 21 mmHg and ≥20 % reduction in baseline as criteria were 53.9 and 77.2 %, respectively (p = 0.024, log-rank test). Twenty-one eyes (17.9 %) needed additional trabeculectomy. None of the univariate and multivariate risk factors for failure were detected.Trabectome surgery is safe and effective for Japanese patients whose target IOP is 18 mmHg or above. However, it is necessary to carefully consider Trabectome surgery for advanced POAG cases.