A simple surgical technique for splitting a single donor cornea for performing deep anterior lamellar keratoplasty and Descemet membrane endothelial keratoplasty without using a microkeratome.

Purpose: To describe a simple manual surgical technique for splitting a single-donor eye for performing both deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK) without using a microkeratome.

Methods: Twenty-three eyes with anterior stromal pathology and 23 eyes with irreversible endothelial dysfunction were evaluated for keratoplasty at a tertiary eye care referral center. Twenty-three healthy donor corneas were split into two parts.

Four in one: Four recepients with a single donor tissue - A novel concept for eye transplantation surgery post-COVID-19.

A donor corneo-scleral button was dissected into four parts using a simple manual technique. The anterior corneal lamellae was stripped from the Descemet's Membrane (DM) and Deep Anterior Lamellar Keratoplasty (DALK) was performed in a patient with advanced keratoconus after removing the recipient's stroma using the big bubble technique. Descemet's Membrane Endothelial Keratoplasty (DMEK) was done with the stripped donor DM in a patient with Fuch's endothelial dystroph (FECD).

Two-year clinical outcome after Descemet membrane endothelial keratoplasty using a standardized protocol.

Purpose: The purpose of this study is to evaluate 2-year clinical outcome after Descemet membrane endothelial keratoplasty (DMEK) in a variety of endothelial dysfunctions using a standardized protocol.

Methods: : From a group of 230 eyes which underwent DMEK for Fuchs' endothelial corneal dystrophy (FECD), aphakic and pseudophakic bullous keratopathy, failed full thickness corneal transplants, ICE syndrome, failed DSEK, and TASS the clinical outcomes [best spectacle-corrected visual acuity (BSCVA), central endothelial cell density (ECD)] were evaluated before, and at 6, 12, and 24 months and the success rate, failure rate and postoperative complications were also analyzed.

Results: Out of 230 eyes, 144 eyes (70%) had BSCVA 6/9 or better 2 years postoperatively.

Long-term clinical outcomes after Descemet Membrane Endothelial Keratoplasty (DMEK) in Irido-Corneal Endothelial Syndrome.

Purpose: To evaluate the long-term clinical outcomes after Descemet Membrane Endothelial Keratoplasty (DMEK) in Irido-Corneal Endothelial Syndrome (ICE).

Observation: Four eyes of four patients diagnosed with ICE syndrome were treated with DMEK. Postoperatively, best corrected visual acuity (BCVA) and central endothelial cell density (ECD) were documented at 6, 12, 24 and 36 months for all the cases.

Evaluating an Electronic Health Record Intervention for Management of Heart Failure Among Veterans.

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A virtual model to assess maximum treatable area in LASIK and feasibility of a temporal hinge.

Purpose: To generate virtual models using different hinge locations and to investigate the advantages of a temporal hinge to a superior in LASIK.

Methods: The study design was cross sectional. An image processing software was used to construct virtual LASIK models of 56 slit lamp photos of eyes.

Simultaneous Descemet's membrane endothelial keratoplasty and posterior iris-claw-fixated intra ocular lens implantation (IOL) in management of aphakic bullous keratopathy.

To evaluate the efficacy of combined procedure of Descemet's membrane endothelial keratoplasty (DMEK) and posterior iris-claw-fixated intra ocular lens (IOL) implantation in the management of aphakic bullous keratopathy (ABK). Sankara eye centre, a tertiary eye care centre. A prospective case series analysis.

Bilateral Mooren's ulcer - Customised corneal graft with additional amniotic membrane graft.

Mooren's ulcer (MU) is a rare and painful peripheral corneal ulceration which occurs in the absence of any associated scleritis, and any detectable systemic disease. A 60-year-old male patient was referred to us with bilateral peripheral corneal ulceration. Best corrected visual acuity (BCVA) in both eyes was counting finger at one metre.

Pilot program to improve self-management of patients with heart failure by redesigning care coordination.

Objectives. We tested both an educational and a care coordination element of health care to examine if better disease-specific knowledge leads to successful self-management of heart failure (HF). Background.

Clinical features and management of ocular lesions after stings by hymenopteran insects.

We describe the ocular alterations and the management after stings from Hymenopteran insects. In all the five patients, the insect was identified as bee. The patients presented with significant corneal edema, which resolved dramatically in three of them after removal of stingers.

The effect of post traumatic stress disorders on rehabilitation among combat-wounded veterans.

In June 2008 the Congressionally Directed Medical Research Program provided a grant to the Research Foundation at the James A Haley Veterans Hospital in Tampa, Florida to provide care for wounded veterans from Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom (OEF/OIF). The telerehabilitation for OEF/OIF returnees with mild or moderate combat related Traumatic Brain Injury (TBI) has as its objectives 1) care coordination for wounded veterans using distance technology via the internet and 2) monitoring of physical and mental health outcomes using a variety of instruments. A total of 75 veterans were enrolled in the study.

Central nervous system and musculoskeletal medication profile of a veteran cohort with blast-related injuries.

Little is known about the utilization of central nervous system (CNS) and musculoskeletal (MS) medications in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans with blast-related injuries (BRIs). We followed prescription drug use among a cohort of 133 OIF/OEF veterans with BRIs by using the Joint Theatre Trauma Registry, the Tampa Polytrauma Registry, and electronic medical records. We extracted 12 months of national medication records from the Veterans Health Administration Decision Support System and analyzed them with descriptive statistics.

Rehabilitation outcomes for veterans with polytrauma treated at the Tampa VA.

Returning soldiers from Iraq and Afghanistan who have sustained polytrauma have a combination of complex physical and mental morbidities that require extensive therapy and rehabilitation. This study examined the effect of rehabilitation on 116 polytrauma patients with service-connected injuries treated at the Tampa VA; improvements in functional and cognitive abilities were measured using the Functional Independence Measure (FIM) scores and healthcare costs for rehabilitation treatment were also assessed. Intensive rehabilitation therapy increased functional ability in this cohort with an average improvement in total FIM scores of 23 points.

Benchmark data on the utilization and acquisition costs of central nervous system and muscular skeletal drugs among veterans with combat-related injuries.

Background: Little is known about the utilization and costs of central nervous system (CNS) and musculoskeletal medications in veterans with blast injuries.

Methods: Two years of national medication records of Operations Enduring Freedom and Iraqi Freedom veterans with blast injuries were extracted from the Veterans Health Administration Decision Support System and analyzed with descriptive statistics.

Results: Over the 2-year period, there was a total of 23,795 pharmacy claims (various drug classes) for 60 patients with blast injuries with a 2-year drug acquisition cost of $111,535 (mean per patient = $1,858; median per patient = $960).

Risk for uveitis after laser in situ keratomileusis in patients positive for human leukocyte antigen-B27.

Purpose: To assess the incidence of, risk for, and visual outcomes of acute anterior uveitis (AAU) in human leukocyte antigen (HLA)-B27 positive patients who had laser in situ keratomileusis (LASIK).

Setting: University-based center.

Methods: This study comprised 46 eyes of 23 HLA-B27 positive patients with a 5-year follow-up.

Link between safe patient handling and patient outcomes in long-term care.

This study examined the relationship between safe patient handling and quality of care measures. A comprehensive patient care ergonomics program included six elements. Using a retrospective observational design, 10 quality domains were compared before and after implementation of the program for 111 residents living on 24 units in six Veterans Administration nursing homes using a general linear regression model with repeated measures clustered within time and adjusted for age.

Under-reporting of work-related musculoskeletal disorders in the Veterans Administration.

Purpose: Work-related musculoskeletal disorders following patient contact represent a major concern for health care workers. Unfortunately, research and prevention have been hampered by difficulties ascertaining true prevalence rates owing to under-reporting of these injuries. The purpose of this study is to determine the predictors for under-reporting work-related musculoskeletal injuries and their reasons.

Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks.

Problem Statement: Nurses have one of the highest rates of work-related musculoskeletal injury of any profession. Over the past 30 years, efforts to reduce work-related musculoskeletal disorders in nurses have been largely unsuccessful.

Specific Aims: The primary goal of this program was to create safer working environments for nursing staff who provide direct patient care.

A business case for patient care ergonomic interventions.

This article provides a framework for a business case for patient ergonomic programs that accentuates the financial gains to be realized from such programs as compared to meeting safety requirements. An introduction is made to such commonly used measures as payback period, net present value analysis and internal rate of return. Financial measures on a successful patient handling project in the Veterans Health Administration are outlined and policy implications discussed.

Causes of cost inefficiency in HMOs.

Estimates a total effects cost function using a national 1994 health maintenance organization (HMO) data set to examine and update findings related to HMO efficiency. The cost function controls for ownership characteristics (profit status and ownership), size, enrollment diversity, regional location, product diversity, model type, payment characteristics, and years of operation. While not explicitly controlling for quality or acuity, measures of plan and enrollee diversity help control for aculty and quality.

Data envelopment analysis to determine efficiencies of health maintenance organizations.

We use Data Envelopment Analysis (DEA) to measure the relative technical efficiencies of 164 HMOs licensed to practice in the United States in 1995 with data collected from the American Association of Health Plans. Health care output measures used in the analysis are the number of commercial, Medicare and Medicaid lives covered in each plan. Inputs to the model are health care utilization measures such as the number of medical and surgical inpatient days, number of maternity and newborn stays in days, number of outpatient and emergency room visits and the number of non-invasive and invasive procedures performed on patients in an ambulatory setting.

Prenatal, intrapartum, and newborn care provided by health maintenance organizations: Medicaid versus commercial enrollees.

A large majority of states have adopted a policy of enrolling Medicaid and other low-income populations in managed care organizations. Analysts have raised several questions relating to whether these populations will achieve appropriate access and utilization of services, including prenatal, intrapartum, and newborn care. Data from a national survey of health maintenance organizations are used to compare access to these kinds of care for Medicaid and commercial enrollees.

Managed care organizations and mammography: opportunities to serve underserved women.

Breast cancer is one of the major causes of mortality and morbidity among women. Breast cancer screening (mammography) has been shown to be an effective preventive service. Significant proportions of women for whom mammography would be an appropriate intervention, especially older, low-income, and minority women, do not receive it.