Meta-analysis of laparoscopic spleen-preserving distal pancreatectomy versus laparoscopic distal pancreatectomy with splenectomy: An insight into confounding by indication.

AIMS: To evaluate comparative outcomes of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and laparoscopic distal pancreatectomy with splenectomy (LDPS). METHODS: A systematic search of multiple electronic data sources and bibliographic reference lists were conducted. Comparative studies reporting outcomes of LSPDP and LDPS were considered followed by evaluation of the associated risk of bias according to ROBINS-I tool. Perioperative complications, clinically important postoperative pancreatic fistula (POPF), infectious complications, blood loss, conversion to open, operative time and duration of hospital stay were the investigated outcome parameters. RESULTS: Nineteen studies were identified enrolling 3739 patients of whom 1860 patients underwent LSPDP and the remaining 1879 patients had LDPS. The patients in the LSPDP and LDPS groups were of comparable age (p = 0.73), gender (p = 0.59), and BMI (p = 0.07). However, the patient in the LDPS group had larger tumour size (p = 0.0004) and more malignant lesions (p = 0.02). LSPDP was associated with significantly lower POPF (OR:0.65, p = 0.02), blood loss (MD:-28.30, p = 0.001), and conversion to open (OR:0.48, p < 0.0001) compared to LDPS. Moreover, it was associated with significantly shorter procedure time (MD: -22.06, p = 0.0009) and length of hospital stay (MD: -0.75, p = 0.005). However, no significant differences were identified in overall perioperative (OR:0.89, p = 0.25) or infectious (OR:0.67, p = 0.05) complications between two groups. CONCLUSIONS: LSPDP seems to be associated with lower POPF, bleeding and conversion to open compared to LDPS in patients with small-sized benign tumours. Moreover, it may be quicker and reduce hospital stay. Nevertheless, such advantages are of doubtful merit about large-sized or malignant tumours. The available evidence is subject to confounding by indication.

Short and long term outcomes of laparoscopic fenestrating or reconstituting subtotal cholecystectomy versus laparoscopic total cholecystectomy in the management of acute cholecystitis.

BACKGROUND: Strasberg proposed classifying subtotal cholecystectomy techniques into fenestrating (fSC) and reconstituting (rSC) subtypes. The aim of this study is to compare our outcomes of laparoscopic subtotal cholecystectomies of both subtypes against laparoscopic total cholecystectomy (TC) in difficult emergency laparoscopic cholecystectomies. METHODS: Patients undergoing emergency laparoscopic cholecystectomy were identified over 2 years and all Nassar scale 3 and 4 cholecystectomies were included for analysis. RESULTS: 108 fSC and 24 rSC were compared against 317 TC. Patients undergoing fSC and rSC were older and more likely to be male. fSC (128 min) and rSC (141 min) recorded longer median operative times than TC (109). Post-operative ERCP was more common after rSC (16.7%). Patients undergoing fSC (2 days) and rSC (3.5 days) had longer post-operative stays. Bile leaks were more likely in fSC (9.3%) and rSC (8.3%) compared to TC (1.9%), Long term morbidity was higher in the rSC group (12.5% vs 10%). And these were solely due to gallbladder remnant complications. CONCLUSION: Laparoscopic fSC and rSC techniques are associated with a higher rate of bile leaks and rSC has more long term morbidty as compared to TC.

Trabectome outcomes across the spectrum of glaucoma disease severity.

PURPOSE: To compare the efficacy of ab-interno trabeculotomy with Trabectome® in mild glaucoma versus moderate/severe glaucoma along the spectrum of glaucoma disease severity. METHODS: Subjects with at least 12 months follow-up were separated into two groups based on glaucoma severity. Severity was determined based on optic nerve cup-to-disc ratio and/or automated visual field data, with cup-to-disc ratio < 0.7 and/or visual field mean deviation ≤ 6.0 dB used to define the mild group (n = 1127), and cup-to-disc ratio > 0.7 and/or visual field mean deviation > 6.0 dB used to define the moderate/severe group (n = 1071). These groups were further subdivided into patients undergoing Trabectome with cataract surgery or Trabectome alone. Mean IOP reduction, medication usage, and success rates were compared between the two groups. Success was defined as IOP reduction of 20% or more from pre-operative IOP and IOP less than 21 mmHg with no secondary surgery throughout the follow-up period. RESULTS: The mean post-operative IOP and success rates were similar between the groups. IOP reduction for the mild group was 26% (from pre-op IOP of 24 to 16.1 mmHg) and for the moderate/severe group was 24% (from pre-op IOP of 22.6 to 15.7 mmHg) at 12 Months. The overall rate of success at 12 months for the mild group was 86% and for the moderate/severe group was 83%. CONCLUSION: Trabectome surgery maintains efficacy across the spectrum of glaucoma disease severity. This particular minimally invasive glaucoma surgery procedure can be an excellent choice for subjects with moderate/advanced glaucoma as well as for early glaucoma with or without cataract surgery and is applicable to a broad patient population.

Investigating the effect of ionic strength on the suppression of dendrite formation during metal electrodeposition.

The effect of ionic strength on the electrodeposition of silver has been investigated in acetonitrile (MeCN) containing TBAPF6 or in the ionic liquid [EMIm][OTf]. The use of an ionic liquid allows a greater ionic strength to be investigated as the solubility limits of supporting electrolytes in organic solvents can be overcome using neat ionic liquid. The SEM and XRD data show that polycrystalline silver is deposited in a fcc structure and that dendrite formation is retarded at high ionic strength. Electrochemical measurements undertaken in electrolytes of low ionic strength indicate that the deposition and growth of a few nuclei is preferred and leads to dendrite formation. However, at higher ionic strength, the deposition and growth of significantly more nuclei is observed and therefore dendrite growth rates and tip currents are lower leading to the deposition of spherical particulates. Crucially, the data shows that if the ionic strength of the electrolyte is controlled there are no differences between ionic liquids and molecular solvents for the electrodeposition of silver.

Preoperative C-Reactive Protein-to-Albumin Ratio and Its Ability to Predict Outcomes of Pancreatic Cancer Resection: A Systematic Review.

OBJECTIVES: To evaluate the ability of the c-reactive protein-to-albumin ratio (CAR) in predicting outcomes in patients undergoing pancreatic cancer resection. METHODS: A systematic search of electronic information sources and bibliographic reference lists was conducted. Survival outcomes and perioperative morbidity were the evaluated outcome parameters. RESULTS: Eight studies reporting a total of 1056 patients undergoing pancreatic cancer resection were identified. The median cut-off value for CAR was 0.05 (range 0.0003-0.54). Using multivariate analysis, all studies demonstrated that a higher CAR value was an independent and significant predictor of poor overall survival in patients undergoing pancreatic cancer resection. The estimated hazard ratio (HR) ranged from 1.4 to 3.6. Although there was a positive correlation between the reported cut-off values for CAR and HRs for overall survival, it was weak and non-significant (r = 0.36, n = 6, p = 0.480). There was significant between-study heterogeneity. CONCLUSIONS: Preoperative CAR value seems to be an important prognostic score in predicting survival outcomes in patients undergoing pancreatic cancer resection. However, the current evidence does not allow the determination of an optimal cut-off value for CAR, considering the heterogeneous reporting of cut-off values by the available studies and the lack of knowledge of their sensitivity and specificity. Future research is required.

Role of High-Resolution CT Thorax in Diagnosing Interstitial Lung Disease and Its Association With Smoking and Connective Tissue Disorder.

Introduction Interstitial lung diseases (ILDs) primarily affect the interstitium, an alveolar wall tissue between the capillary endothelium and the alveolar epithelium. The term 'interstitial,' however, is misleading since alveolar spaces, peripheral airways, and vessels can be involved in most of these disorders.They often require a multidisciplinary diagnosis i.e., an integration of clinical, radiological, and pathological findings. A chest radiograph is relatively insensitive because of nonspecific patterns. Generally, these disorders can progress to irreversible pulmonary fibrosis and are an important cause of morbidity and mortality. It is critical to make a prompt and accurate diagnosis of the underlying causes so that patients can be managed appropriately. ILD is subdivided into idiopathic interstitial pneumonia, of which idiopathic pulmonary fibrosis (IPF) is one subset, and diffuse parenchymal lung diseases, which may be secondary to a variety of occupational or environmental exposures or others. They can complicate multiple rheumatic or connective tissue diseases (CTDs). Apart from ILD, other forms of lung damage involving the pleura, vasculature, airways, and lymphatic tissue can complicate CTDs. Aims  Aims include studying the role of high-resolution computed tomography (HRCT) in diagnosing various ILDs based on morphologic patterns, evaluating the correlation between ILD and various connective tissue disorders and the prevalence of complications in such patients, and evaluating the association of smoking with various ILDs. Methods This is a retrospective study in which HRCT thorax was performed on a 128-slice Philips CT scanner machine on 50 patients from December 2020 to February 2022 in SVP Hospital, Ahmedabad. No age or gender bias was followed. Result Out of 50 patients studied, 19 (38%) patients had the usual interstitial pneumonia (UIP) pattern and 12 (24%) had the nonspecific interstitial pneumonia (NSIP) pattern. These two were the most common among all ILD patterns. Other patterns found were hypersensitivity pneumonitis (5; 10%), respiratory bronchiolitis-related ILD (3;6%), and organizing pneumonia (2; 4%). In nine patients, the morphologic pattern was either subtle (3; 6%) or mixed (6; 12%), and the final diagnosis remained inconclusive; patients were advised clinical correlation and biopsy. Eleven (22%) patients had a history of smoking. Among smokers, the most common pattern was UIP while all patients with respiratory bronchiolitis (RB) ILD had a history of smoking. Fourteen (28%) patients showed a positive association with CTD. Among them, rheumatoid arthritis (RA) was the most common CTD and the most common pattern among RA patients was UIP. Ten (20%) of patients developed pulmonary arterial hypertension, of which two patients who had connective tissue disorder developed pulmonary arterial hypertension at a young age (24 years). The rest of the patients who developed pulmonary arterial hypertension were above 45 years of age. Among these, two were smokers. Conclusion HRCT plays an important role in the diagnosis of ILD on the basis of various morphological patterns. CTD plays a significant role in the development of ILD. UIP is the most common ILD among patients with a smoking history and RA. NSIP Is the most common in patients with CTD other than RA. Pulmonary arterial hypertension (PAH) develops early in patients with CTD. There is a significant risk of the development of PAH in patients with chronic ILD.

Endometriotic Intramyometrial Cyst -A Diagnostic Dilemma.

BACKGROUND: Endometriosis is a pathological state in which the endometrial glands and stroma are originated at sites other than the uterine cavity. Endometriotic cystic lesions are principally positioned in ovaries but, infrequently, can also be encountered in the myometrium. It is a rare manifestation which poses a multitude of differential diagnoses and therapeutic options. CASE STUDY: A 27-year-old female patient walked into hospital complaining of severe abdominal pain since 2 days with a medical history of dysmenorrhoea since one and a half years. On examination, the abdomen was found to be soft with the existence of lower abdominal tenderness. An Ultrasonography revealed a myometrial posterior wall cyst of size 4 x 4 cm with thick wall and spotted internal echoes favoring a differential diagnosis of either an endometriotic cyst or rudimentary horn. Both ovaries were found normal. The patient was taken for laparoscopy in which a bulge was seen on the posterior uterine wall. It was punctured to expose a myometrial cyst with dark chocolate colored fluid collection. The intact cyst was enucleated and sent for histopathology, which confirmed the diagnosis of the endometriotic cyst. Upon the literature survey, it was found that only two such cases were available in the literature on internet which described a similar pathology. CONCLUSION: Endometrioma should be considered as a probable pathology whenever myometrial cysts are encountered. A focused transvaginal examination can be very accommodating as a diagnostic modality to set up proper management. This case should not only make the health careproviders rethink the etiopathogenesis of endometriosis and debate the credibility of the retrograde menstruation hypothesis but also encourage to accurately investigate any lesion anywhere in the body, which looks like an endometriotic chocolate cyst. In this case, it is evident that a myometrial spot is rare but not impossible. These rare occurrences shall direct to diversify the perception of this pathology.

Comparison of Intraocular Pressure, Usage of Topical Steroids, Need for Intraocular Pressure Lowering Drops, and Incidence of Glaucoma Surgery Up to 2 Years After Penetrating Keratoplasty and Endothelial Keratoplasty.

PRECIS: A retrospective review of 239 eyes comparing intraocular pressure (IOP), steroid needs, IOP-lowering drop needs, and incidence of glaucoma surgery between endothelial keratoplasty and penetrating keratoplasties (PKP) at multiple timepoints postoperatively up to 2 years. PURPOSE: The purpose of this study was to compare postoperative IOP, steroid use, IOP-lowering drop use, and need for glaucoma surgery between PKP, Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSEK). MATERIALS AND METHODS: A retrospective chart review of all PKP, DMEK, and DSEK surgeries was performed between July 1, 2012 and July 1, 2017 at the University of California, Irvine. Patients with a prior history of glaucoma, corneal or glaucoma surgery, concurrent major or emergent surgery, active infection, and eye disease with synechiae were excluded. A total of 239 patients who underwent PKP (N=127), DMEK (N=46), or DSEK (N=66) were included. IOP, steroid use, IOP-lowering drop use, and need for glaucoma surgery were compared at postoperative day 1, postoperative week 1 (POW1), and postoperative month 1 to 24 (POM1-24). RESULTS: IOP for PKP was higher than DMEK and DSEK at POW1, POM1, POM6, and POM24 (P<0.05). IOP for PKP was higher than DMEK at POM12 (P=0.028). There was no significant difference in IOP between DMEK and DSEK for all timepoints. PKP required more steroids than DSEK and DMEK at POM3, POM6, POM12, and POM24 (P<0.05). More IOP-lowering drops were required for DSEK than DMEK and PKP at postoperative day 1 and POW1 (P<0.05). More IOP-lowering medications were used for DSEK than DMEK at POM3 and POM12 (P<0.05). About 6% to 7% of patients needed glaucoma surgery by POM24. CONCLUSIONS: Endothelial keratoplasties had decreased IOP and steroid needs compared with PKPs postoperatively up to 2 years. The rate of glaucoma surgery and IOP-lowering drop needs were similar between the groups.

Examining the effects of forest fire on terrestrial carbon emission and ecosystem production in India using remote sensing approaches.

Remote sensing techniques are effectively used for measuring the overall loss of terrestrial ecosystem productivity and biodiversity due to forest fires. The current research focuses on assessing the impacts of forest fires on terrestrial ecosystem productivity in India during 2003-2017. Spatiotemporal changes of satellite remote sensing derived burn indices were estimated for both fire and normal years to analyze the association between forest fires and ecosystem productivity. Two Light Use Efficiency (LUE) models were used to quantify the terrestrial Net Primary Productivity (NPP) of the forest ecosystem using the open-source and freely available remotely sensed data. A novel approach (delta NPP/delta burn indices) is developed to quantify the effects of forest fires on terrestrial carbon emission and ecosystem production. During 2003-2017, the forest fire intensity was found to be very high (>2000) across the eastern Himalayan hilly region, which is mostly covered by dense forest and thereby highly susceptible to wildfires. Scattered patches of intense forest fires were also detected in the lower Himalayan and central Indian states. The spatial correlation between the burn indices and NPP were mainly negative (-0.01 to -0.89) for the fire-prone states as compared to the other neighbouring regions. Additionally, the linear approximation between the burn indices and NPP showed a positive relation (0.01 to 0.63), suggesting a moderate to high impact of the forest fires on the ecosystem production and terrestrial carbon emission. The present approach has the potential to quantify the loss of ecosystem productivity due to forest fires.

Electrochemical study of dialcarb "distillable" room-temperature ionic liquids.

Electrode-dependent potential windows (see picture, GC=glassy carbon) are determined for five dialkylammonium carbamate (dialcarb) room-temperature ionic liquids in a systematic study of their physical and electrochemical properties. The viscosity and conductivity of the dialcarb ionic liquids, which are "distillable" at low temperature, are comparable to those of some conventional room-temperature ionic liquids. The physical and electrochemical properties of five "distillable" room-temperature ionic liquids from the dialcarb family (dialkylammonium carbamates formed from CO(2) and dialkyl amines) are systematically investigated. In particular dimethyl (DIMCARB), diethyl (DIECARB), dipropyl (DIPCARB), methylethyl (MEETCARB), and methylpropyl (MEPRCARB) carbamate ionic liquids are studied. The temperature dependence of the viscosity and conductivity of MEETCARB exhibit an Arrhenius-type relationship. Except for DIPCARB, which has too high a resistance, a reference potential scale is available by using the IUPAC recommended redox system, that is the cobalticenium/cobaltocene (Cc(+)/Cc) process, which exhibits an ideal reversible voltammetric response. Oxidation of decamethylferrocene, but not ferrocene, also is ideal in DIMCARB, DIECARB, MEETCARB, and MEPRCARB. The magnitudes of the potential windows of the electrochemically viable dialcarbs are investigated and follow the order of glassy carbon>Au>Pt>Hg. Diffusion coefficients of Cc(+), DmFc, and double-layer capacitance values are compared in each dialcarb. Despite the considerable viscosity of the dialcarbs, steady-state voltammetric behavior is achieved at a rotating disk electrode for rotation rates of 1000 rpm or higher.

Association of Retinopathy of Prematurity and Plateau iris.

We present a case series describing a unique entity as it relates to plateau iris. There have been many established risk factors for plateau iris, but we present the following cases that describe patients with plateau iris in the setting of prematurity and/or retinopathy of prematurity as well as high myopia or emmetropia. We believe this to be a distinct form of plateau iris resulting from abnormal ciliary body and angle development in the preterm infant. Subjects were treated according to standard of care, with laser peripheral iridotomies, laser iridoplasty, and even glaucoma drainage implants, as indicated.

Acute liver failure due to primary angiosarcoma: a case report and review of literature.

BACKGROUND: Hepatic angiosarcoma is a primary sarcoma of the liver, accounting for only 2% of all primary hepatic malignancies. Acute liver failure is an extremely rare presentation of a primary liver tumour. CASE PRESENTATION: We report a case of a seventy year-old man who presented with a very short period of jaundice leading to fulminant hepatic failure (FHF). On further investigation he was found to have primary angiosarcoma of liver. CONCLUSION: The treatment outcomes for hepatic angiosarcoma are poor, we discuss the options available and the need for prompt investigation and establishment of a diagnosis.

Anaesthetic management of an infant posted for ventricular septal defect closure with right-sided eventration of diaphragm.

Eventration of the diaphragm is a rare entity, characterised by abnormal elevation of a dome of diaphragm. In this condition, the diaphragm is composed of fibrous tissue with few or no interspersed muscle fibres. Eventration can be congenital or acquired. Congenital eventration results from inadequate development of muscles or absence of phrenic nerve. The common cause of acquired eventration is injury to the phrenic nerve from traumatic birth injury or surgery for heart disease. The perioperative anaesthetic management of diaphragmatic eventration along with ventricular septal defect with severe pulmonary hypertension makes this case both challenging and unique.

Clinical and pathological correlation of cotton wool spots in secondary angle closure glaucoma.

PURPOSE: Cotton Wool Spots (CWS) are a commonly described retinal finding in the posterior segment associated with an extensive number of systemic diseases. The appearance of a CWS in the setting of glaucoma has rarely been reported and has not been correlated with pathology to localized loss of the nerve fiber layer previously. In this case report, we augment a previous report of an 18 year old female with a diagnosis of low grade ciliary body melanoma. This patient experienced eventual mechanical angle closure with a CWS appearing in the posterior pole in the setting of acute elevation of intraocular pressure (IOP). This eye underwent enucleation and pathology evaluation. OBSERVATIONS: Fundus photography documented a CWS in the posterior segment during a period of acute elevation in IOP. Subsequently the eye was enucleated due to pain from refractory angle closure glaucoma secondary to low grade iris-ciliary body ring melanoma. The specific site of the prior CWS was studied with 1µ Epon retinal step sections stained with a novel AgNO3 solution. Light microscopy demonstrated a retinal nerve fiber layer scar and inner nuclear layer collapse in the prior location of the CWS. Light microscopy and transmission electron microscopy shortly after enucleation had demonstrated temporal quadrant laminar optic nerve (ON) retrograde axonal transport block. CONCLUSIONS AND IMPORTANCE: Although not commonly associated with glaucoma, CWS can present in the setting of acute elevations of IOP and may be associated with loss of nerve fiber layer. This loss of nerve fiber layer can confound the ability to judge glaucoma progression based on nerve fiber layer thickness via optical coherence tomography and changes in disc contours. Patient care may benefit from care provider's awareness of this possible phenomenon in the setting of angle closure.

One-year outcomes of AquaLase cataract surgery.

The authors report surgical experience and clinical outcomes up to 1 year postoperatively in patients who underwent cataract surgery with the AquaLase liquefaction device (Alcon Laboratories, Fort Worth, TX). The device is a handpiece option for use with Alcon's Infiniti Vision System that uses heated balanced saline solution micropulses to liquefy lenticular material. Twenty-seven eyes of 23 patients underwent cataract extraction with the use of the AquaLase liquefaction device. The average age of participants was 68 years, and the average nuclear sclerotic grade was 1.96 on a 4-point scale. Outcomes were judged by metrics such as visual acuity, inflammation, endothelial cell count, and postoperative posterior capsule opacification. At 30 days postoperatively, 78% of eyes had a best-corrected visual acuity of 20/20. Visual acuity was 20/25 or better 1 year postoperatively in 88% of patients without complications except conversion to ultrasound phacoemulsification for two dense cataracts.

Anaesthetic management of infants posted for repair of anomalous origin of left coronary artery from pulmonary artery.

First described in 1908, anomalous origin of left coronary artery from pulmonary artery is a very rare congenital anomaly. Here, the right coronary artery is usually enlarged and has a normal origin from aorta. Numerous collaterals connect the two coronary arteries over right ventricular outflow tract or interventricular septum. It is one of the most common causes of myocardial ischaemia and infarction in children.

Comparison of Baerveldt 101-350 Glaucoma Implant (BGI) versus Trabeculectomy with ExPress™ Shunt for the Treatment of Primary Open Angle Glaucoma.

Importance: Trabeculectomy is very effective in lowering intraocular pressure for the treatment of glaucoma, but it carries with it possible complications and failure. The ExPress shunt (Alcon Laboratories, Fort Worth, TX, USA) is an adjunctive device that can be used at the time of trabeculectomy to create an external fistuliztion. An alternative established and highly efficacious technique is the implantation of a glaucoma drainage device for sustained intraocular pressure (IOP) lowering. Specifically, evidence has established the Baerveldt 101-350 glaucoma implant (BGI) to have the best sustained IOP lowering in long-term follow-up amongst the many options for glaucoma drainage devices. Objective: To compare outcomes in eyes that underwent Baerveldt 101-350 glaucoma implant (BGI) and trabeculectomy with ExPress shunt (Trab) in primary open angle glaucoma without any prior incisional glaucoma surgery. Design, Setting, and Participants: This was a retrospective study of outcomes in patients identified by CPT codes as having undergone glaucoma implantation or trabeculectomy (with ExPress shunt) for the treatment of Primary Open Angle Glaucoma between 2012 and 2015 at a single institution by 2 fellowship trained glaucoma surgeons. A total of 57 eyes that underwent Baerveldt 101-350 glaucoma implant and 38 eyes that underwent trabeculectomy cases with ExPress™ shunt were included in the study. All patients were diagnosed with primary open angle glaucoma. Cases were included into the study if the patient underwent BGI or trabeculectomy with ExPress shunt without any prior incisional glaucoma surgery. Main Outcomes and Measures: Main outcomes included IOP, medications, visual acuity (VA), and secondary glaucoma surgery, if any. Results: Survival rate at 12 months was 85% in the BGI group and 80% in trabeculectomy with ExPress Shunt. A statistically significant difference was not found in the survival distributions between surgery groups using the log-rank test. A total of 12 trabeculectomy and 9 BGI cases failed by our definition of success. These cases were included in the analysis of IOP, number of glaucoma medications, and VA. The mean IOP was reduced from 20.6 ± 5.6 mmHg to 12.4 ± 3.2 mmHg and from 20.7 ± 5.5 mmHg to 11.3 ± 4.8 mmHg at one year post-operation in the BGI group and the trabeculectomy with ExPress shunt group, respectively. On average, the BGI group showed an IOP reduction of 7.7 ± 6.1 mmHg, while trabeculectomy with ExPress shunt experienced a decrease of 7.9 ± 5.2 mmHg at one year post-operation. Medications were reduced from 3.5 ± 0.8 to 2.6 ± 1.3 at one year in the BGI group and from 3.7 ± 0.5 to 0.6 ± 1.8 in the trabeculectomy with ExPress shunt group. At one year post-operation, the BGI group had an average of 0.9 ± 1.1 medication reduction, while trabeculectomy with ExPress shunt cases had a reduction of 3.2 ± 1.3 medications. VA was compared in logMar. At baseline, the average for BGI logMar was 0.5 ± 0.7 and the average for trabeculectomy was 0.2 ± 0.3. At one year post-operation, the BGI group's VA was 0.4 ± 0.4 while the trabeculectomy with ExPress shunt group's VA was 0.1 ± 0.1. Conclusions and Relevance: The Baerveldt 101-350 glaucoma implant and trabeculectomy (with ExPress™ shunt) may have similar rates of success in the surgical treatment of primary open angle glaucoma in eyes that are naïve to prior incisional glaucoma surgery, with a higher dependence on topical medications post-operation in patients undergoing Baerveldt glaucoma implantation.

Vision retention in early versus delayed glaucoma surgical intervention in patients with Boston Keratoprosthesis type 1.

IMPORTANCE: The loss of vision following Boston Keratoprosthesis (BKPro) surgery due to glaucoma occurs at a high frequency as diagnosis and management of glaucoma after this procedure pose challenges. OBJECTIVE: To compare visual outcomes in patients undergoing Boston Keratoprosthesis surgery with and without prior or concurrent glaucoma surgery. DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective, observational cohort study of patients who underwent Boston Type I Keratoprosthesis surgery. 19 eyes of 18 patients who had undergone BKPro and met the inclusion criteria were identified. Twelve eyes received BKPro with prior or concurrent glaucoma surgery (Group 1), and seven eyes were identified undergoing BKPro surgery without prior or concurrent glaucoma surgery (Group 2). MAIN OUTCOMES AND MEASURES: Main outcome included best corrected visual acuity at each follow up. RESULTS: In Group 1, mean best corrected visual acuity (BCVA) within a year of BKPro surgery was 20/100 (range 20/40 to Count Fingers (CF); n = 12) and mean BCVA at 1 year from BKPro surgery was 20/115 (range 20/30 to CF; n = 12). 7 out of 12 patients retained or had improved BCVA at 1 year follow up after BKPro implantation, and 5 out of 12 patients had mild BCVA worsening. In Group 2, the mean BCVA within a year of BKPro surgery was 20/140 (ranging from 20/25 to hand motion vision (HM); n = 7) and mean BCVA at 1 year from BKPro surgery was Count Fingers (range 20/60 to Light Perception (LP); n = 6). 4 out of 6 patients lost significant vision at one year after BKPro. CONCLUSIONS AND RELEVANCE: BKPro patients with early glaucoma surgical intervention retained vision significantly better compared to patients with late or no intervention. Our preliminary findings support the recommendation for concurrent or pre-emptive glaucoma surgical intervention in patients undergoing BKPro implantation.

Superhydrophobic Fabrics for Oil/Water Separation Based on the Metal-Organic Charge-Transfer Complex CuTCNAQ.

The fabrication of a superhydrophobic nylon textile based on the organic charge-transfer complex CuTCNAQ (TCNAQ=11,11,12,12-tetracyanoanthraquinodimethane) is reported. The nylon fabric, which is metallized with copper, undergoes a spontaneous chemical reaction with TCNAQ dissolved in acetonitrile to form nanorods of CuTCNAQ that are intertwined over the entire surface of the fabric. This creates the necessary micro- and nanoscale roughness that often allows the Cassie-Baxter state to be obtained with high robustness, thereby achieving a superhydrophobic/superoleophilic surface without the need for a fluorinated surface. The material is characterized with SEM, FTIR spectroscopy, and X-ray photoelectron spectroscopy, and investigated for its ability to separate oil and water in two modes, namely through filtration and as an absorbent material. It is found that the fabric can separate dichloromethane, olive oil, and crude oil from water, and reduce the water content of the oil during the separation process. The fabric is reusable, highly durable, and tolerant to conditions such as seawater, hydrochloric acid, and extensive time periods on the shelf. Given that CuTCNAQ is a copper-based semiconductor, there may also be the possibility of other uses in areas such as photocatalysis and antibacterial applications.