Publications by authors named "Schlenker M"
Objective: Despite a universal health care system, access to vision care in Canada is not necessarily equally accessible to all patients. The purpose of this review was to explore the association between socioeconomic status (SES) and vision care utilization in Canada.
Methods: Medline, Embase, CINAHL, and Cochrane were searched from inception to January 2024 for relevant articles containing original data.
Objective: Assess the cost-effectiveness of Hydrus Microstent combined with cataract surgery (CS) versus CS alone, for treating patients with mild to moderate primary open angle glaucoma (POAG).
Design: Cost-utility analysis using efficacy and safety results of a pivotal randomized clinical trial SUBJECTS: Modeled cohort of patients with mild to moderate POAG and visually significant cataract METHODS: A semi-Markov model was developed to model effects and costs over a 15-year time horizon from the Canadian public healthcare payer perspective for patients with mild or moderate POAG receiving Hydrus Microstent during CS versus CS alone. The model utilizes the HORIZON trial patient cohort.
Purpose: Risk communication is an integral aspect of shared decision-making and evidence-based patient choice. There is currently no recommended way of communicating risks and benefits of cataract surgery to patients. This study aims to investigate whether the way this information is presented influences patients' perception of how risky surgery will be.
View Article and Find Full Text PDFPurpose: To investigate the association between social determinants of health (SDH) in the domains of social and community context, education access, environmental context, economic stability, and healthcare access, with glaucoma prevalence.
Design: Cross-sectional study.
Methods: The study population consisted of adult participants who answered glaucoma-related questions on the 2017 National Health Interview Survey (NHIS), the most recent iteration that includes glaucoma-related questions.
Purpose: To investigate the psychometric performance and responsiveness of Catquest-9SF, a patient-reported questionnaire developed to evaluate visual function as related to daily tasks, in patients referred for cataract surgery in Ontario, Canada.
Methods: This is a pooled analysis on prospective data collected for previous projects. Subjects were recruited from three tertiary care centers in Peel region, Hamilton, and Toronto, Ontario, Canada.
Purpose: To present the effectiveness, risk factors for surgical failure, and adverse events over 12 months in a consecutive diverse cohort of glaucoma patients who underwent solo or combined ab externo SIBS microshunt with mitomycin C (MMC) with or without previous subconjunctival surgery.
Design: Retrospective, consecutive, interventional case series.
Methods: Consecutive glaucomatous eyes on maximally tolerated medical therapy received ab externo SIBS microshunt with MMC implantation as a solo or combined procedure with phacoemulsification from July 2015 to January 2020.
Background: Current methods used to estimate surgical wait times in Ontario may be subject to inconsistencies and inaccuracies. In this population-level study, we aimed to estimate cataract surgery wait times in Ontario using a novel, objective and data-driven method.
Methods: We identified adults who underwent cataract surgery between 2005 and 2019 in Ontario, using administrative records.
Purpose: To determine the effectiveness, risk factors for surgical failure, and adverse events in a large cohort of patients receiving stand-alone ab externo poly(styrene-block-isobutylene-block-styrene) (SIBS) microshunt implantation with mitomycin C (MMC) over 3 years of follow-up.
Design: Retrospective, interventional case series.
Participants: Glaucomatous eyes on maximally tolerated medical therapy with no previous subconjunctival glaucoma surgery.
Background: With an aging population in Ontario, ophthalmologists provide most of their care to older adults, which has prominent human resource implications. In this study, we sought to investigate the supply and demographic characteristics of Ontario's ophthalmologists.
Methods: In this retrospective, population-based analysis, we evaluated cohort demographics, including sex and career stage, of Ontario's ophthalmologists from 2010 to 2019, which we reported using descriptive statistics.
Article Synopsis
- This study compared the effectiveness, safety, and potential failure risks of two surgical approaches (superior vs. inferior) for treating glaucoma using gonioscopy-assisted transluminal trabeculectomy (GATT).
- Both surgical methods showed no significant differences in terms of success rates, highlighting that the type of approach may not impact overall outcomes.
- The research identified new risk factors linked to surgical failure, providing valuable insights for improving glaucoma treatment strategies.
Purpose: To track operative phases of cataract surgery over a resident's training to measure action times and frequencies as a surrogate for competency and skill progression.
Design: An n = 1 panel study.
Methods: Cataract surgery video recordings performed by a single resident between 2021-2022 were collected.
Eliminating low-yield testing can reduce the burden on modern health care systems. Our purpose is to determine whether routine preoperative assessment impacts the incidence of perioperative complications in ophthalmic surgery. We conducted a comprehensive search of Ovid MEDLINE, EMBASE, and Cochrane Library databases to identify studies investigating the incidence of perioperative complications following any preoperative assessment for patients undergoing ophthalmic surgery (PROSPERO ID#164008).
View Article and Find Full Text PDFAttention Deficit Hyperactivity Disorder, also known as ADHD, is a neurodevelopmental disorder diagnosed in children. The exact cause of ADHD is not known, but, along with genetic factors, it is possible that environmental factors including toxins and diet may affect symptom severity. Of these dietary components, artificial food coloring (AFC), while approved by the Food and Drug Administration (FDA), has been suspected to be associated with ADHD symptoms.
View Article and Find Full Text PDFObjective: To explore the utility of the Catquest 9SF visual function (VF) questionnaire along with visual acuity (VA) for determining appropriateness and priority for cataract surgery. To evaluate the feasibility of administering the Catquest-9SF in a clinical setting using web-based electronic data capture and interpretation.
Design: Prospective multicentred interventional observational study.
Objective: Preoperative fasting is routinely performed to prevent anaesthesia-related pulmonary aspiration. To capture patients' experiences with preoperative fasting, a 13-item questionnaire was developed and validated using Rasch analysis and shortened to 6 items. This extension study aims to assess this questionnaire's ability to discriminate between participants with a short versus long duration of fasting and early versus late day surgery.
View Article and Find Full Text PDFImportance: Some ophthalmologists may be reluctant to prescribe oral carbonic anhydrase inhibitors, given the potential for life-threatening systemic adverse reactions.
Objective: To conduct a population-based analysis of the safety of oral or topical carbonic anhydrase inhibitors in clinical care.
Design, Setting, And Participants: This matched longitudinal cohort study took place in Ontario, Canada.
Background: To assess the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in uveitic glaucoma (UG).
Methods: A retrospective interventional case series in which 33 eyes of 32 patients with UG underwent GATT with or without concomitant cataract extraction and intraocular lens implantation (CE/IOL) at three Canadian treatment centres from October 2015 to 2020. The main outcome measure was surgical success defined as an intraocular pressure (IOP) ≤18 mm Hg and at least one of the following: IOP within one mm Hg of baseline on fewer glaucoma medications as compared with baseline or a 30% IOP reduction from baseline on the same or fewer medications.
Background: There is a high variability in the use of postoperative eye protection among ophthalmologists. Postoperative eye protection treatment modalities include an eye shield, an eye patch, an ocular bandage, and instant vision. The aim of this study was to review and compare the evidence on the various options for eye protection.
View Article and Find Full Text PDFExisting characterizations of coronavirus disease 2019 (COVID-19) admissions have occurred primarily in urban settings. This report describes demographic and clinical characteristics of the first COVID-19 patients presenting to a 6-hospital integrated health care system in rural/suburban southcentral Pennsylvania. Medical records of adult patients admitted with COVID-19 between March and May of 2020 were retrospectively reviewed for demographics, symptomatology, imaging, and lab values.
View Article and Find Full Text PDFPurpose: To evaluate the accuracy of 12 intraocular lens (IOL) power calculations: Barrett Universal II, EVO, Haigis, Hill-RBF version 2.0, Hoffer Q, Holladay 1, Holladay 2, Kane, Olsen, SRK/T, Super Formula and T2.
Methods: In this retrospective consecutive case series, cataract extraction and IOL implantation cases in Toronto, Canada, were recruited between 2017 and 2019.
Background/aims: Determine the association between physician-deemed and patient-reported appropriateness and prioritization for cataract surgery.
Methods: Prospective cohort study of 471 patients of 7 ophthalmologists referred for cataract surgery. Ophthalmologists rated patients for cataract surgery appropriateness and prioritization using a visual analogue scale of 0-10 preoperatively.