Ophthalmology
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The Accreditation Council for Graduate Medical Education (ACGME) has mandated that all residency programs implement an assessment process of 6 core competencies. Assessment of surgical competence is also included in the mandate. We describe our local efforts to meet this new mandate. ⋯ We propose a potential blueprint for meeting the challenge of assessing the new ACGME competencies in ophthalmology and translating the national mandate into local compliance.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention Study.
To investigate the risk factors associated with visual field (VF) progression in the Advanced Glaucoma Intervention Study (AGIS) with pointwise linear regression (PLR) analysis of serial VFs. ⋯ Both increasing age and greater IOP fluctuation increase the odds of VF progression by 30% (for each 5-year increment in age and 1-mmHg increase in IOP fluctuation). The higher risk conferred by IOP fluctuation was consistently observed in eyes with and without a history of cataract extraction.
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Comparative Study
Optic nerve head circulation in nonarteritic anterior ischemic optic neuropathy and optic neuritis.
To quantify optic nerve head circulatory abnormalities in patients with unilateral nonarteritic anterior ischemic optic neuropathy (NAION) or optic neuritis (ON), and to assess the potential of such measurements to differentiate NAION from ON. ⋯ Optic nerve head circulatory abnormalities are present in patients with NAION or ON. This is the first demonstration of such abnormalities in ON, a finding consistent with the recent attention given to the phenomenon of axonal loss in this disease. Although there are differences in the circulatory abnormalities between the 2 diseases that provide insights into the pathophysiological mechanisms at play, they are not large enough to enable the clinician to distinguish between ON and NAION in an individual patient.
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Randomized Controlled Trial Comparative Study Clinical Trial
Laserinterferometric assessment of pilocarpine-induced movement of an accommodating intraocular lens: a randomized trial.
To measure the axial movement of an accommodating intraocular lens (IOL) induced by ciliary muscle contraction after application of pilocarpine. ⋯ Pilocarpine induced a small but significant forward movement of the accommodating IOL. However, the amount of movement was calculated to result in a refractive change of <0.5 diopters (D) in most patients, reaching 1 D or slightly more in only single cases, with a large variability of movement. Neither polishing of the capsule bag nor a posterior capsulorhexis could enhance the accommodative ability.
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Randomized Controlled Trial Clinical Trial
Droperidol and dolasetron alone or in combination for prevention of postoperative nausea and vomiting after vitrectomy.
Droperidol and the new serotonin-3 antagonists are effective drugs for the prophylaxis of postoperative nausea and vomiting (PONV). The aim of this trial was to evaluate whether dolasetron could be a substitute for droperidol, because the Food and Drug Administration has required a Black Box warning on the droperidol package insert. ⋯ Low-dose droperidol (10 microg. kg(-1)) but not dolasetron (12.5 mg) reduced postoperative nausea and vomiting after vitreoretinal surgery. Dolasetron (12.5 mg) is not an equivalent substitute for droperidol.