Cambridge community Optometry Glaucoma Scheme.

BACKGROUND: With a higher life expectancy, there is an increased demand for hospital glaucoma services in the United Kingdom. DESIGN: The Cambridge community Optometry Glaucoma Scheme (COGS) was initiated in 2010, where new referrals for suspected glaucoma are evaluated by community optometrists with a special interest in glaucoma, with virtual electronic review and validation by a consultant ophthalmologist with special interest in glaucoma. PARTICIPANTS: 1733 patients were evaluated by this scheme between 2010 and 2013. METHODS: Clinical assessment is performed by the optometrist at a remote site. Goldmann applanation tonometry, pachymetry, monoscopic colour optic disc photographs and automated Humphrey visual field testing are performed. A clinical decision is made as to whether a patient has glaucoma or is a suspect, and referred on or discharged as a false positive referral. The clinical findings, optic disc photographs and visual field test results are transmitted electronically for virtual review by a consultant ophthalmologist. MAIN OUTCOME MEASURES: The number of false positive referrals from initial referral into the scheme. RESULTS: Of the patients, 46.6% were discharged at assessment and a further 5.7% were discharged following virtual review. Of the patients initially discharged, 2.8% were recalled following virtual review. Following assessment at the hospital, a further 10.5% were discharged after a single visit. CONCLUSIONS: The COGS community-based glaucoma screening programme is a safe and effective way of evaluating glaucoma referrals in the community and reducing false-positive referrals for glaucoma into the hospital system.

Ten to fourteen year survival and functional analysis of the AGC total knee replacement system.

A study of 562 Anatomic Graduated Component (AGC) total knee arthroplasties that were performed in 402 patients between November 1986 and September 1990 is reported. All patients had implantation with a cemented posterior cruciate-retaining design, with resurfacing of the patella using all polyethylene patella components. Mean age at surgery was 71 years (range 41-92 years). Patients were followed for a minimum of 10 years (range 10-14 years). Nine knees were lost to follow-up (1.4%). The mean Knee Society Score for pain and function were analyzed by Charnley categories: Category A -- 97 (pain) and 89 (function); Category B -- 91 (pain) and 84 (function); and Category C -- 89 (pain) and 62 (function). The survival analysis at 14 years was 97% with revision for any reason as the endpoint and the authors continue to utilize this implant system.