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Objective

To evaluate and compare the surgeon’s learning experience with an ab-interno gelatin microstent (XEN-45, Allergan) to other glaucoma surgeries.

Design

Cross-sectional survey study.

Methods

All surgeons in Canada who used the gelatin microstent were identified and given an anonymous online survey (FluidSurveys, Survey Monkey) designed to evaluate key factors associated with the device, including prior surgical experience, patient selection criteria, analysis of each surgical step, and postoperative care. The survey was validated using input from 3 experienced glaucoma surgeons.

Results

Surgeons were in early to mid-career (11.8 ± 7.2 operating years) and experienced with filtration surgery (94.1% very comfortable). Surgeons would more commonly operate on patients who had moderate to advanced disease (88.2% and 76.5% of surgeons felt appropriate to operate, respectively); had a diagnosis of primary open angle glaucoma or pseudoexfoliative glaucoma (70.6%); were on 2, 3, or 4 glaucoma medications (70.6%, 75.5%, 70.6%, respectively); and had previously undergone microinvasive glaucoma surgery (83.3%). Creation of the scleral tunnel into the subconjunctival space was rated the most difficult step of the surgery. Most surgeons (52.9%) required 6–10 cases to be comfortable with the procedure and felt it was easier to gain proficiency with ab-interno microstent implantation than traditional filtration surgery (94.1% agree or strongly agree).

Conclusion

The group of glaucoma surgeons surveyed felt it was easier to gain proficiency with gelatin microstent implantation than with traditional filtration surgery.  相似文献   
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Aims/hypothesis  

Poorly controlled type 1 diabetes mellitus can cause reduced skeletal muscle mass and weakness during adolescence, which may affect long-term management of the disease. The aim of this study was to determine whether regular voluntary physical activity and leucine feeding restore rates of protein synthesis and deficits in skeletal muscle mass in a young, hypoinsulinaemic/hyperglycaemic rat model of diabetes.  相似文献   
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ObjectiveTo review the trends in adult strabismus procedures in Ontario from 2000–2013.DesignPopulation-based, retrospective data analysis.ParticipantsAll patients 18 years or older who underwent a strabismus related procedure in Ontario and all ophthalmologists who performed these procedures from 2000-2013.MethodsOntario Health Insurance Plan billing claims for strabismus procedures were collected and subdivided by number of muscles repaired, the use of adjustable sutures, repeat procedures, and pharmacological injection of the extraocular muscles adjusted by the total adult population. The number of ophthalmologists performing adult strabismus surgery was also analyzed, subdivided by high-volume and low-volume surgeons.ResultsFrom 2000–2013, per 100 000 adult population, the number of total strabismus surgeries in Ontario increased 26.0%; single-muscle surgery increased 24.2%, 2-muscle surgery increased 43.1%, and 3 or more muscle surgery increased 3.8%. During the study period, strabismus procedures using adjustable sutures increased 30.3%, and repeat procedures increased 19.1%. The number of surgeons performing adult strabismus surgery decreased 30.0% from 2000–2013. In 2013, 92.6% of surgeries were performed by 35.7% of surgeons who performed adult strabismus surgery.ConclusionFrom 2000–2013, more strabismus surgery was performed in adults by fewer surgeons, including procedures using adjustable sutures and repeat procedures. These increases may be due to increases in health care funding and a heightened awareness of the functional and psychosocial benefits of strabismus surgery.  相似文献   
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