Predictors of Early Onset Glaucoma.

Purpose/Relevance: To determine the influence of hypertension (HTN), type 2 diabetes (DM2), migraine, and obstructive sleep apnea (OSA) on the onset of primary open-angle glaucoma (POAG) to enhance predictive accuracy. Methods: In this cross-sectional study, data for 389 eligible patients with POAG were collected through medical records review and phone surveys. All data were assessed collectively using stepwise multiple regression analysis to determine the relative contribution to age at POAG diagnosis. We used the following groups, based on age at diagnosis, HTN for patients with or without DM2 (model 1), HTN for patients with DM2 (model 2), DM2 for patients with or without HTN (model 3), and DM2 for patients with HTN (model 4). Results: In model 1, age at HTN diagnosis was associated with age at POAG diagnosis (ß = 0.14; 95% CI, 0.01-0.26, p = 0.04). In model 2, age at HTN diagnosis was not associated with age at POAG diagnosis (p > 0.05). In model 3, age at DM2 diagnosis was associated with age at POAG diagnosis (ß = 0.37; 95% CI 0.16-0.58, p = 0.001). In model 4, age at DM2 diagnosis was associated with age at POAG diagnosis (ß = 0.40; 95% CI 0.00-0.15, p = 0.003). Asian race/ethnicity was associated with early onset of POAG in model 3 (ß = -6.44; 95% CI -12.34-0.54, p = 0.033). OSA and migraine did not influence the onset of POAG. Conclusion: Our study found that the diagnosis of DM2 and HTN at an earlier age is associated with the early onset of POAG.

Conversion of Elbow Arthrodesis to Total Elbow Arthroplasty: A Case Report and Literature Review.

Elbow arthrodesis is a salvage operation designed to relieve pain and enable weight bearing in young patients with painful arthritic joints who have failed all other treatment modalities. Unfortunately, elbow arthrodesis is poorly tolerated by many patients because there is no fusion position that accommodates all activities of daily living. As indications for elbow arthroplasty expand and implant design improves, patients living with elbow arthrodesis may seek conversion to arthroplasty to regain a functional range of motion. Only one case of elbow arthrodesis to elbow arthroplasty conversion has been reported in the English literature to date. We present the case of a 58 year old male, five years status post elbow arthrodesis, unable to perform his ADLs adequately, who was successfully converted to a total elbow arthroplasty. Indications, contraindications, and technical pearls are discussed.