Qualitative Comparison of Perceptions Regarding Patient Engagement for Patient Safety by Physicians, Nurses, and Patients.

Purpose: Patient engagement in ensuring patient safety is widely acknowledged, there is still a need to explore how perceptions of patient engagement vary among different stakeholders within the healthcare system. We aimed to compare the perceptions regarding patient engagement for patient safety among physicians, nurses, and patients by exploring the perspectives. Patients and Methods: A qualitative study, comprising three focus group discussions (six to eight people each), was conducted in South Korea. Physicians and nurses who worked at the general hospital level or higher, and patients who had been hospitalized for more than 24 hours, were included. Researchers analyzed the transcripts, and a content analysis was performed to describe influencing elements of patient engagement for patient safety. A word cloud was created through keyword analysis of the transcripts. Results: Based on 479 coded data, three categories and eight sub-categories were derived. The first moment of patient engagement was viewed as the choice of medical institutions. Reputation occupied a large part in the hospital selection for all participants, but they did not know about or use the national hospital evaluation data. Participants said that continuous patient engagement, such as the patient's active questioning attitude, guardian's cooperation, sufficient medical personnel, and patient safety education was required during treatment. However, it was said that patient engagement was ignored after patient safety incidents occurred. They mentioned that they were emotional and busy arguing for their own positions, and that it was difficult to use a medical dispute resolution method in practice. In the word cloud by group, fall, explanation, hospital, and patient were common words. Conclusion: All three groups agreed on the importance of patient engagement for patient safety but differed in its influencing factors. Efforts should be made to reduce the difference between the three groups on how to involve patients for patient safety.

To what extent can patient engagement for patient safety be expanded? In this study, we confirmed the diverse perceptions of patients and medical personnel regarding patient engagement for patient safety. Physicians, nurses, and patients all answered that they did not generally know about the objective medical institutions evaluation data provided by the national, and said that when choosing a medical institution, patients depended on information from their reputation, social media, and web site search. During treatment, both patients and medical personnel expressed their hopes for active and independent engagement from patients, but also expressed the difficulty of requesting cooperation in engagement and difficulties in education. After the patient safety incident, both patients and medical personnel were emotional and occupied in asserting their respective positions, and they complained about difficulties in resolving medical disputes that are difficult to use in practice.

Prioritization of research engaged with rare disease stakeholders: a systematic review and thematic analysis.

BACKGROUND: Although rare diseases (RD) are increasingly becoming a priority for healthcare activities and services around the world, developing research policy for investigating RD in public settings proves challenging due to the limited nature of existing evidence. Rare conditions require the involvement of a wide range of stakeholders in order to promote general awareness and garner political support. Consequently, it is critically important to identify trends in the various types of research focusing on rare disease stakeholders, including the specific topics or issues to be included in surveys and studies focused on RD stakeholders. This systematic review and thematic analysis analyses the existing literature based on RD surveys, including the stakeholders involved, and proposes potential research priorities and initiatives for policy-making related to RD. METHODS: Articles were downloaded and analyzed from across five electronic databases (PubMed, EMBASE, Cochrane Central, Web of Science, and CINHAL) and 115 studies were included. RESULTS: Across 115 studies, the main research participants were patients and/or caregivers (n = 77, 67.0%), health professionals (n = 18, 15.7%), and the public (n = 7, 6.1%). The studies discussed RDs in general (n = 46, 40.0%), endocrine, nutritional, and metabolic diseases (n = 20, 17.4%) and other RDs. Experiences with RD were examined by more than half of the selected studies (n = 74, 64.3%), followed by the opinions of stakeholders (n = 24, 20.9%). Most of the studies used surveys in order to collect relevant data (n = 114, 99.1%). Additionally, the majority of the studies were conducted in high-income countries (n = 92, 80.0%) and rarely in middle and low-income countries (n = 12, 13.8%). CONCLUSION: Stakeholder research on RD reveals that there are significant instances of unmet needs and various challenges faced by the medical system in dealing with RDs. Furthermore, public awareness and support is critical to ensuring political feasibility of increasing national-level investments for RDs and development of medical products and treatment.

Testing the Effect of an Interactive Narrative: The Mediating Role of Transportation and the Moderating Roles of Narrative Ending and Issue Involvement.

There has been a growing literature focusing on the persuasive effect of interactive narratives, but the findings are mixed. Furthermore, very few studies have examined how the impact of interactive narratives varies depending on story features and characteristics of the recipients. Informed by the research of interactive narratives and message framing, the current study empirically tests the indirect effect of an interactive narrative on attitude change using a digital anti-indoor tanning game, with transportation as a mediator and narrative ending and issue involvement as two second-stage moderators. Findings suggested a moderated moderated mediation relationship in which the indirect effect of the interactive narrative was the strongest for low-involvement participants when they experienced a loss-framed ending and was the weakest for high-involvement participants when they encountered the same type of ending. Theoretical and practical implications were discussed.

Evaluating a game-based randomized experiment to increase melanoma identification among adults living in the U.S.

BACKGROUND: Although cutaneous melanoma diagnoses are rising, morbidity and mortality can be reduced through early detection. This investigation seeks to improve melanoma identification accuracy, attitudes, and intentions among a lay population by comparing the effectiveness of different melanoma identification training strategies and the effect of real-time decisional feedback on a melanoma identification task. We developed an innovative, game-based approach and hypothesize differences among frequently used melanoma identification training modalities (i.e, the Asymmetry/Border/Color/Diameter [ABCD] rule, the Ugly Duckling Rule [UDS], and a modality that combines them both, ABCDF (where the F stands for 'funny looking"), and investigate differences in types of immediate feedback on a melanoma identification task. METHODS: We conducted a national online randomized experiment to test a 4 (melanoma training strategies: ABCD, UDS, ABCD-F, control) × 3 (feedback: Dermatological, Dermatological + Motivational, control) factorial design on melanoma identification, skin cancer beliefs (perceived susceptibility, severity, response efficacy, self-efficacy), attitudes, and prevention intentions. RESULTS: ABCD training (p < .001) and UDS training (p = .05) resulted in significantly higher melanoma identification than the control. All training types resulted in significantly higher self-efficacy than the control (p = .02). Both Dermatological (p = .02) and Dermatological + Motivational feedback (p = .01) elicited significantly lower melanoma identification than the control condition, although this effect may be due to differences observed among participants who received UDS training. There was a significant main effect of feedback on self-efficacy (p = .002), where both Dermatological and Dermatological + Motivational feedback elicited higher levels of self-efficacy than the control. CONCLUSIONS: Our results suggest that game-based ABCD and UDS training strategies could increase melanoma identification accuracy. Real-time feedback reduced accuracy, but was associated with increased self-efficacy related to melanoma detection outcomes.

Consent for Intimate Exams on Unconscious Patients: Sharpening Legislative Efforts.

The practice of nonconsensual intimate exams performed on unconscious patients by medical students during their training has received significant attention in the last several years. Clinicians, medical students, bioethicists, lawyers, and the public have called for explicit and specific consent to take place before all educational intimate examinations of unconscious patients. In response, since January of 2019, dozens of bills have been proposed in more than twenty states, and thirteen of these have been signed into law (in addition to six that passed before 2019). Here, we consider the content of these enacted bills, drawing attention to five variable features and offering these five corresponding legislative recommendations, in hopes of narrowing in on the appropriate ethical scope of consent laws surrounding educational intimate exams: (1) use gender-neutral language; (2) include all intimate exams, not solely pelvic exams; (3) focus on unconscious patients; (4) focus on educational exams; and (5) regulate systems, not individuals.

Determinants of Legislation on Social Health Insurance in Transition Countries.

This study aims to address the question: Why did transition countries enact laws related to social health insurance (SHI) at different times, even though they experienced dissolution of the Soviet Union at the same time in the early 1990s? We used Ragin's fuzzy-set qualitative comparative analysis to investigate the configurations of causal conditions that affected the speed of developing SHI-related legislation in 24 post-socialist countries. The potential causal conditions were health status, economic status, level of governance, level of democracy, issue salience, and number of medical professionals. We found 3 pathways that led to the enactment of SHI-related laws and 1 pathway that inhibits enactment. The key factors impacting enactment of SHI-related laws were non-corrupt governments and realization of democracy. In addition, medical professionals' involvement in policymaking could be the factor to enact SHI-related laws. Further research is needed for more in-depth analysis regarding what the laws specifically include, type of health insurance systems that were adopted based on the laws, and if the legislation contributed toward achieving universal health coverage.

Macrophage peroxiredoxin 5 deficiency promotes lung cancer progression via ROS-dependent M2-like polarization.

Strategies for cancer treatment have traditionally focused on suppressing cancer cell behavior, but many recent studies have demonstrated that regulating the tumor microenvironment (TME) can also inhibit disease progression. Macrophages are major TME components, and the direction of phenotype polarization is known to regulate tumor behavior, with M2-like polarization promoting progression. It is also known that reactive oxygen species (ROS) in macrophages drive M2 polarization, and M2 polarization promote lung cancer progression. Lung cancer patients with lower expression of the antioxidant enzyme peroxiredoxin 5 (Prx5) demonstrate poorer survival. This study revealed that Prx5 deficiency in macrophages induced M2 macrophage polarization by lung cancer. We report that injection of lung cancer cells produced larger tumors in Prx5-deficit mice than wild-type mice independent of cancer cell Prx5 expression. Through co-culture with lung cancer cell lines, Prx5-deficient macrophages exhibited M2 polarization, and reduced expression levels of the M1-associated inflammatory factors iNOS, TNFα, and Il-1ß. Moreover, these Prx5-deficient macrophages promoted the proliferation and migration of co-cultured lung cancer cells. Conversely, suppression of ROS generation by N-acetyl cysteine (NAC) inhibited the M2-like polarization of Prx5-deficient macrophages, increased expression levels of inflammatory factors, inhibited the proliferation and migration of co-cultured lung cancer cells, and suppressed tumor growth in mice. These findings suggest that blocking the M2 polarization of macrophages may promote lung cancer regression.

Evaluating a Transformational Health Game to Influence Perceptions of the Condoms-as-Evidence Policy.

Objective: Some countries treat carrying condoms as evidence of prostitution, commonly referred to as "condoms-as-evidence" policy/practice. This policy has deleterious outcomes on the health and safety of sex workers worldwide. This study evaluates the impact of a simulation game that advocates against the policy in an effort to increase advocacy attitudes and intentions against condoms-as-evidence policies and practices. Materials and Methods: A between-subjects randomized experiment (N = 70) was conducted to evaluate the effectiveness of the intervention game relative to a pamphlet. The game, Cops & Rubbers, is a simulation-based tabletop game situating participants in the role of a sex worker trying to balance competing financial, safety, and health-related goals. The research for and development of the pamphlet was funded by Open Society Foundations to highlight the impact of the condoms-as-evidence policy and elicit advocacy efforts. Results: Although the game elicited similar levels of advocacy attitudes toward the pamphlet, it elicited significantly higher advocacy intentions than the pamphlet. Conflicting results were witnessed in psychological reactance. Conclusion: The present results demonstrate the utility of games as an advocacy tool for health and human rights among a polarizing topic such as sex worker advocacy. These results have both practical utility and research implications. From a practical standpoint, we demonstrate that the game can increase advocacy intentions and tangibly contribute to human rights and health issues. Furthermore, these results have the potential to inform novel game design strategies to influence persuasive outcomes in transformational games.

Emergency department utilization and risk factors for mortality in older patients: an analysis of Korean National Emergency Department Information System data.

OBJECTIVE: With trends in population aging an increasing number of older patients are visiting the emergency department (ED). This study aimed to identify the characteristics of ED utilization and risk factors for in-hospital mortality in older patients who visited EDs. METHODS: This nationwide observational study used National Emergency Department Information System data collected during a 2-year period from January 2016 to December 2017. The characteristics of older patients aged 70 years or older were compared with those of younger patients aged 20 to 69 years. Risk factors associated with in-hospital mortality were analyzed by multivariable logistic regression. RESULTS: A total of 6,596,423 younger patients and 1,737,799 older patients were included. In the medical and nonmedical older patient groups, significantly higher proportions of patients were transferred from another hospital, utilized emergency medical services, had Korean Triage and Acuity Scale scores of 1 and 2, required hospitalization, and required intensive care unit admission in the older patient group than in the younger patient group. ED and post-hospitalization mortality rates increased with age; in particular, older medical patients aged 90 or older had an in-hospital mortality rate of 9%. Older age, male sex, transfer from another hospital, emergency medical service utilization, a high Korean Triage and Acuity Scale score, systolic blood pressure <100 mmHg, respiratory rate >20/min, heart rate >100/min, body temperature <36°C, and altered mental status were associated with in-hospital mortality. CONCLUSION: Development of appropriate decision-making algorithms and treatment protocols for high risk older patients visiting the ED might facilitate appropriate allocation of medical resources to optimize outcomes.

The Interplay between Message Framing and Message Recipients' Regulatory Focus in Promoting HPV Prevention Strategies.

Limited awareness and low uptake rate of Human papillomavirus (HPV) prevention strategies among females require the development of more effective educational interventions. Regulatory focus theory posits the matching of framing valence with the recipients' regulatory focus increases persuasiveness. Following regulatory focus theory, we examined how individual regulatory focus changed the effects of gain- and loss-framed messages on promoting consistent condom use and HPV DNA testing for HPV prevention. We also explored whether this interaction effect impacts the influences of target individuals' initial attitudes about condom use and HPV DNA testing on post attitudes and intentions. Results of Study 1 showed that, in general, the gain-framed message fit with regulatory focus (i.e., promotion focus) promoted more positive attitudes about consistent condom use than the gain-framed message nonfit with their regulatory focus (i.e., prevention focus).Nevertheless, the gain-framed message nonfit with regulatory focus (i.e., prevention focus) strengthened the negative relationship between initial attitudes and intentions, which promoted the intentions to use condom consistently among people who initially held negative attitudes toward consistent condom use. In Study 2, we did not observe a significant interaction effect of message framing and regulatory focus in the HPV DNA testing context. However, we observed that the gain-framed message nonfit with regulatory focus (i.e., prevention focus) led to the changes in the significance of the initial attitudes - post attitudes relationship from significant to non-significant. Thus, the reliance on initial negative attitudes about HPV DNA testing in decision-making decreased. Theoretical and practical implications of our research were discussed.

A Meta-analysis of Narrative Game-based Interventions for Promoting Healthy Behaviors.

Health interventions that use serious games have become increasingly popular. However, many of these games have been designed with few immersive game features which would improve users' engagement with the persuasive messages. To address this issue, researchers have incorporated narrative elements in games to facilitate message processing and enhance behavioral change. There have been theoretical debates about whether narratives benefit these interventions; empirical evidences for their effects are slightly mixed. This meta-analysis provides a deeper understanding of the overall impact of narrative game-based interventions on health-related behaviors and their psychological determinants. Combining the results from 22 studies, this meta-analysis found that narrative game-based interventions were effective in changing behaviors, knowledge, self-efficacy, and enjoyment. These effects were moderated by factors such as the genre of the game, the genre of the story, group play, and participant age. Implications of the findings and suggestions for future design of narrative game-based interventions were discussed.

A Comparison of Metaphor Modality and Appeals in the Context of Skin Cancer Prevention.

Health communication experts continually seek out effective strategies to strengthen persuasive campaigns. While there is evidence that verbal metaphors can improve persuasion, little attention has been given to the potential of visual metaphors to enhance health communication effects. To fill this gap, an experiment was conducted to test the effects of metaphor modality (visual vs. verbal) and type of fear appeal used (death-based or appearance-based) on skin protection intentions. Additionally, the moderating role of an individual characteristic (need for cognition), and the mediating role of two processing outcomes (message elaboration and perceived message effectiveness) were examined. Results indicated that there was no significant difference between the main effects of metaphor modality and type of fear appeal, but these message features interacted making the death-based fear appeal the most effective strategy. Need for cognition directly affected perceptions of effectiveness but did not affect skin protection intentions nor message elaboration. Of the two message processing outcomes examined, only perceived message effectiveness mediated the relationship between metaphor modality and skin protection intentions. Theoretical explanations and practical implications are discussed.

Medical malpractice related to drug-induced anaphylaxis: An analysis of lawsuit judgments in South Korea.

Drug-induced anaphylaxis (DIA) is a highly paradoxical disorder involving a fatal response to medicines prescribed for therapeutic purposes. This study aimed to improve the awareness on DIA and to prevent errors through an analysis of lawsuit judgments.Sentenced judgments involving DIA from 1998 to 2017 using the database of the Korean Supreme Court Judgment System were collected. General characteristics, results, and recognized negligence of DIA litigation cases were analyzed.Of 27 lawsuit cases included, antibiotics (n = 6, 22.2%), radiocontrast media (n = 6, 22.2%), and non-steroidal anti-inflammatory drugs (n = 5, 18.5%) were the most common drugs that had caused DIA. Cardiac arrest was reported in 23 cases (85.2%). The median time interval from drug administration to diagnosis and from diagnosis to cardiac arrest were 7 (interquartile range, IQR = 0-35) and 5 minutes (IQR = 0-33), respectively, suggesting insufficient time to cope with anaphylaxis. Consequently, either death (n = 18, 66.7%) or ischemic brain injury (n = 9, 33.3%) occurred in all cases. Violation of duty of care was recognized in 19 cases (70.4%) with median awarded amount of $106,060 (IQR = $70,296-$168,363). The recognized negligence included inadequate observation after drug administration (n = 6), delayed or missed epinephrine administration (n = 6), ignoring a history of allergy or drug hypersensitivity (n = 6), and prescription error (n = 5).It is necessary to improve the awareness on DIA, because making a trivial error in any process of history taking, drug prescription and administration, observation, and/or emergency treatment may have fatal consequences that can lead to indemnity.

Cultural factors influencing teenage pregnancy in Jamaica.

A literature review was undertaken to identify key factors associated with teenage pregnancy in Jamaica. Using the PEN-3 cultural model, we first categorised these factors to develop a theoretical taxonomy that can be used to help health intervention planners to understand and address the phenomenon. Next, we examined the validity of this initial taxonomy by comparing it with cultural factors identified in semi-structured focus group discussions with Jamaican teenage mothers. Cultural factors identified in the initial literature review - such as parental interaction and control, the intergenerational transmission of teenage pregnancy and experiences of sexual abuse - were largely confirmed and built upon. Results highlight promising opportunities for health communication among young women in Jamaica with a focus on self-efficacy, resilience and positive cultural factors.

The effects of continuity of care on hospital utilization in patients with knee osteoarthritis: analysis of Nationwide insurance data.

BACKGROUND: Korea's rapidly aging population has led to a rise in the prevalence of knee osteoarthritis (which reached upwards of 21.3% in 2017) in elderly people aged 65 years and over. Most patients with knee osteoarthritis require ongoing management in the community or through primary care. Continuity of care is a desirable attribute of primary care. However, previous studies on the association between continuity of care and health outcomes have focused on specific disease populations, particularly diabetes mellitus and hypertension. The objectives of this study were to determine whether there is an association between continuity of care for outpatients with knee osteoarthritis and health outcomes. METHODS: We conducted a cohort study using claims data from 2014. The study population included 131,566 patients. We measured hospital admission and medical costs during the final 3 months and the continuity of care by Most Frequent Provider Continuity (MFPC), Modified Modified Continuity Index (MMCI), and Continuity of Care (COC) index in the 9 preceding months, using multiple logistic regression analyses to determine which index best explains continuity. We evaluated the relationship between COC and hospital admissions, using negative binomial regression analysis due to over-dispersion. Finally, multiple regressions were used to examine the relationship between the COC and medical costs. RESULTS: We selected the COC index to determine the association between hospital admission and cost; the area under the receiver operating characteristic curve (AUC) of the COC was the largest (0.904), while those for the MFPC (0.894) and MMCI (0.893) were similar. The negative binomial regression analysis showed that continuity of care was significantly related to hospitalization, with the relative risk (RR) of hospital admission being low for patients with high continuity of care [RR = 27.17 for those with the reference group COC (0.76-1.00); 95% CI, 3.09-3.51]. Continuity of care was significantly related to medical costs after considering other covariates. A higher COC index was associated with a lower cost. CONCLUSIONS: Higher continuity of care for knee osteoarthritis patients might decrease hospital admission and medical costs.

Interpersonal Communication in Response to an Intervention and Its Impact on Smoking Cessation Within a Low-Income Population.

BACKGROUND: It is a priority to develop population-based strategies for reducing barriers to smoking cessation among low-income populations. Harnessing secondary transmission such as interpersonal communication (IC) has helped to reduce tobacco use, but there is a dearth of quasi-experimental research that examines IC and the full spectrum of smoking cessation behaviors, particularly in the context of population-level programs. AIMS: Using quasi-experimental methods, we examined IC in response to a population-level intervention and its impact on the full spectrum of smoking cessation outcomes among low-income smokers. METHOD: We used propensity score matching; three different propensity score matching procedures were used to estimate and approximate experimental effects. We assessed four cessation outcomes: utilization of a free tobacco quitline (QL), making a quit attempt, and being smoke-free for 7 and 30 days at follow-up. We also examined predictors of IC. RESULTS: IC was significantly related to QL utilization (effect sizes ranging from 0.135 to 0.166), making a quit attempt (effect sizes ranging from 0.115 to 0.147), being smoke-free for 7 days (effect sizes ranging from 0.080 to 0.121), and being smoke-free for 30 days at follow-up (effect sizes ranging from 0.058 to 0.082). Program-related and participant characteristics predicted IC, such as receiving emotional direct mail materials and living with a fellow smoker. DISCUSSION: IC in response to a population-based program affected the cessation process, and IC had a marked impact on sustained cessation. CONCLUSION: Population-based programs should aim to harness psychosocial dynamics such as IC to promote sustained cessation among low-income populations.

Use of Western Medicine and Traditional Korean Medicine for Joint Disorders: A Retrospective Comparative Analysis Based on Korean Nationwide Insurance Data.

This study aimed to compare the usage of Western medicine and traditional Korean medicine for treating joint disorders in Korea. Data of claims from all medical institutions with billing statements filed to HIRA from 2011 to 2014 for the four most frequent joint disorders were used for the analysis. Data from a total of 1,100,018 patients who received medical services from 2011 to 2014 were analyzed. Descriptive statistics are presented as type of care and hospital type. All statistical analyses were performed using IBM SPSS for Windows version 21. Of the 1,100,018 patients with joint disorders, 456,642 (41.5%) were males and 643,376 (58.5%) were females. Per diem costs of hospitalization in Western medicine clinics and traditional Korean medicine clinics were approximately 160,000 KRW and 50,000 KRW, respectively. Among costs associated with Western medicine, physiotherapy cost had the largest proportion (28.78%). Among costs associated with traditional Korean medicine, procedural costs and treatment accounted for more than 70%, followed by doctors' fees (21.54%). There were distinct differences in patterns of medical care use and cost of joint disorders at the national level in Korea. This study is expected to contribute to management decisions for musculoskeletal disease involving joint disorders.

THE IMPORTANCE OF MONITORING DOMESTIC PUBLIC HEALTH LAW AND LEGAL SYSTEMS SUPPORTING GLOBAL HEALTH GOVERNANCE: DEVELOPMENT OF AN ANALYTICAL FRAMEWORK TO ASSESS THE DOMESTIC PUBLIC HEALTH LAW SITUATION IN THE WESTERN PACIFIC REGION COUNTRIES.

The aims of this study are to present an argument that emphasizes the usefulness of an analysis framework for analyzing public health law and legal systems; identifying methods for improving the application of this framework, including its academic value for public health law; and enhancing the future use of the framework for supporting global health governance. To help formulate the initial analysis framework and tool, we have, along with expert consultations, conducted a literature review on global health governance and public health law. Meetings were also held with World Health Organization (WHO) Western Pacific Regional Office (WPRO) technical staff members on the applicability and benefits of the framework and tool. Monitoring public health laws and legal systems of countries can be used to understand governance and improve people's health.

Long-term trends in intraocular pressure after combined vitrectomy with sub-tenon injection of triamcinolone acetonide.

PURPOSE: To evaluate the long-term effect of vitrectomy by itself and combined vitrectomy with sub-Tenon injection of triamcinolone acetonide (TA) on intraocular pressure (IOP). METHODS: In a retrospective cohort study, the medical records of 56 eyes of 56 patients who underwent nonemergent vitrectomy and were followed up for at least 24 months were reviewed. Thirty-two eyes of 32 patients underwent combined vitrectomy with sub-Tenon injection of TA. Twenty-four eyes of 24 patients underwent vitrectomy only. Increased IOP of >4 mmHg from the baseline, change in IOP from the baseline, and preoperative and postoperative measured IOPs were recorded and compared between the two groups, and with fellow eyes. RESULTS: Minimum follow-up period was 24 months. Except the IOP at postoperative 1 day, there were no significant differences between vitrectomized eyes and nonvitrectomized fellow eyes. There were also no differences between vitrectomized eyes and eyes that underwent combined vitrectomy with sub-Tenon injection of TA. And in the comparison of the vitrectomy-only eye group and the vitrectomy with sub-Tenon TA eye group, there was also no significant difference during the whole follow-up period. CONCLUSION: Vitrectomy by itself or combined vitrectomy with sub-Tenon injection of TA does not seem to increase IOP in the long term.