Corneal biomechanics predict the outcome of selective laser trabeculoplasty in medically uncontrolled glaucoma.

PURPOSE: To evaluate the predictive value of clinical parameters, including biomechanical properties on the outcome of selective laser trabeculoplasty (SLT) in medically uncontrolled open angle glaucoma (OAG). METHODS: Sixty-eight eyes from 68 patients with OAG and IOP insufficiently regulated by topical medications were enrolled. Patients' follow-up occurred 6 and 12 months after the procedure. The recorded parameters intraocular pressure (IOP), angle characteristics, central corneal thickness (CCT) and biomechanical properties of the eyes, including corneal hysteresis CH and corneal resistance factor CRF measured with the Ocular Responses Analyzer (ORA, Reichert Ophthalmic Instruments) were tested on their predictive value of SLT-induced IOP lowering effect using correlation analyses and regression models. RESULTS: Mean IOP reduction 12 months after SLT was 4.2 ± 5.7 mmHg (23.2%, from baseline 18.1 ± 5.2 mmHg). The preoperative IOP correlated significantly with IOP reduction (maximum Spearman's correlation r = 0.75, p < 0.001). In linear regression analysis, the corneal biomechanical properties (CH and CRF) together with the baseline IOP revealed good modelling for the IOP lowering effect of SLT (R(2) = 0.64, respectively). CONCLUSIONS: In addition to the baseline IOP biomechanical properties (CH and CRF) are significant predictors of SLT induced IOP lowering effect in medically uncontrolled OAG.

[A study of ambulatory treatment for pulmonary tuberculosis in foreigners residing in Japan].

We studied 130 cases of pulmonary tuberculosis in foreigners residing in Japan to obtain the results as follows; 1. Of the cases of pulmonary tuberculosis in foreigners who are registered and receiving treatment in Japan, 20.3% were treated at three dispensaries of the Japan Antituberculosis Association in Tokyo. 2. The nationality of the cases treated was China in more than half of them, followed by the Republic of Korea. 3. The number of days taken from entry into Japan to the start of treatment was about 11.4 months; 0.9% of the total number of cases examined by chest radiophotography required medical treatment. 4. Their living conditions in Japan according to questionnairing are: 56.2% have jobs in Japan; working hour, 4.99 +/- 1.19 hours a day; 64.4% take night work; 57.6% work in food/drink service industry; living space is 12.5 m2; 52.4% share the same house with other persons, living together with 1.6 persons. 5. As for the type of illness at the start of treatment, GAKKAI classification type III accounted for 90% and spread 1 83.8%. GAKKAI classification type II accounted for 10%, consisting of many relatively mild cases. 6. The defaulter rate was high at 40.8%. The reason for defaulting was broken down to discontinuation on his own 68%, repatriation 15% and side-effects 19%. The time to default was average 3.2 +/- 3.1 months after the start of treatment. They defaulted 1.2 +/- 0.4 times on the average. 7. To reduce the defaulter rate to the minimum in treating the foreigners residing in Japan, the following may be needed. a. To give guidance on the regimen including the need of treatment and risk associated with discontinuation of treatment at the first visit. b. Measures to reduce the amount to be born by the individual in the medical expenses. c. Preparation of a pamphlet for therapeutic guidance in foreign languages.