OBJECTIVES

To evaluate and compare ectasia and pseudoectasia in post-myopic LASIK patients presenting with corneal topographic changes indicative of ectasia using the Ectasia Risk Factor Score System (ERFSS).

Single-center retrospective comparative case series of a consecutive chart review of cases in 18 years who underwent bilateral myopic-LASIK and showed topographic changes indicative of ectasia.

Four patients were included. Group 1: pseudoectasia eyes, consisting of two patients with bilateral pseudoectasia, and Group 2: ectasia eyes, consisting of two patients with unilateral ectasia. The clinical course of the cases was discussed and compared based on the ERFSS parameters: topography pattern, residual stromal bed thickness, age, preop thinnest cornea, and pre-operative spherical equivalent (SE) manifest refraction (MR). Group 1 scored zero to low risk for developing ectasia while Group 2-eyes with ectasia scored moderate risk. The predictive value of the ERFSS was 1 in this study.

The ERFSS is a good measure in deciding the suited treatment plan for patient undergoing refractive procedure. Knowing the clinical course of ectasia and pseudoectasia is helpful in the therapeutic approach since pseudoectasia is reversible when identified and managed early as seen in this study.

OBJECTIVE

To compare the refractive absolute error when axial length (AL), anterior chamber depth (ACD) and keratometry (K) are sourced from different measuring devices (IOL Master vs a combination of automated keratometer and A-scan) and inputted into the Barrett Universal II or SRK/T formula.

This was a retrospective study. Medical charts of eyes that underwent uncomplicated phacoemulsification with in-the-bag implantation of Envista or multifocal FineVision IOL were reviewed. The results of manifest refraction at 1 month after surgery were collected. The predicted refraction corresponding to the IOL power implanted was collected from 4 IOL sheets: using the SRK/T with AL, ACD, and K from IOL Master (Group A); SRK/T formula with AL and ACD from A-scan and K from the automated keratometer (Group B); Barrett formula with AL, ACD and K from IOL Master (Group C); and Barrett formula using with AL, ACD from A-scan and K from automated keratometer. For each group, the absolute error, prediction error, and variances of prediction error were computed.

A total of 132 eyes were included in the study: 56 in the monofocal group and 76 in the multifocal group. The means of manifest refraction spherical equivalent (MRSE) were 0.06 ± 0.38 D and –0.08 ± 0.31 D in the monofocal and multifocal groups, respectively. When AL and K were obtained from various sources and entered into the Barrett formula, the mean absolute error difference in both the monofocal (p = 0.70) and multifocal (p = 0.10) groups did not reach statistical significance. If the SRK/T formula was used, similar outcomes were observed (monofocal p = 0.97; multifocal p = 0.37). When compared to A-scan groups, the prediction error variances are significantly smaller in the groups that used the IOL Master as their data source. Among the four groups, the Barrett group using IOL Master as the data source showed the lowest overall variation of prediction error (monofocal F = 0.04; multifocal F = 0.03).

Though the refractive outcomes may not be statistically different, using the IOL Master as the source of AL and K makes the refractive outcomes more consistent and predictable. Combining the AL and K from the IOL Master with the Barrett Universal II formula further increases the predictability of refractive outcomes.

Objectives: To evaluate and compare ectasia and pseudoectasia in post-myopic LASIK patients presenting with corneal topographic changes indicative of ectasia using the Ectasia Risk Factor Score System (ERFSS). Methods: Single-center retrospective comparative case series of a consecutive chart review of cases in 18 years who underwent bilateral myopic-LASIK and showed topographic changes indicative of ectasia. Results: Four patients were included. Group 1: pseudoectasia eyes, consisting of two patients with bilateral pseudoectasia, and Group 2: ectasia eyes, consisting of two patients with unilateral ectasia. The clinical course of the cases was discussed and compared based on the ERFSS parameters: topography pattern, residual stromal bed thickness, age, preop thinnest cornea, and pre-operative spherical equivalent (SE) manifest refraction (MR). Group 1 scored zero to low risk for developing ectasia while Group 2-eyes with ectasia scored moderate risk. The predictive value of the ERFSS was 1 in this study. Conclusion The ERFSS is a good measure in deciding the suited treatment plan for patient undergoing refractive procedure. Knowing the clinical course of ectasia and pseudoectasia is helpful in the therapeutic approach since pseudoectasia is reversible when identified and managed early as seen in this study.
Dilatation, Pathologic

Background: The nursing profession had recently noted a significant increase of men entering the profession. However, in countries like Canada where men comprise approximately 9% of the regulated nursing population---they were viewed as untapped human health resource due to an estimated 117,600 nurse shortage in Canada by 2030. Addressing barriers such as gender-based stigmatization, role strain, and stereotypes could improve male representation and help mitigate this workforce gap globally. The objectives of this study's literature review was to explore and to critically examine stigmatization, stereotypes, and other genderbased barriers that men face in the educational and professional setting while analyzing what influences their recruitment and retention in the nursing profession. Method: The literature review was based on related databases, such as CINAHL and PubMed, where barriers that exist for men in the nursing profession and in their undergraduate nursing education were explored. The search was restricted to international literature published in the English language with a publication date limited from 1990 to present. Key factors noted in the literature review that affected men in nursing education and the nursing profession were summarized as follows: (i) the historical feminization of nursing and (ii) stigma, role strain and stereotypes. These factors created barriers for men in nursing education and the nursing profession. Conclusion A variety of factors encompassing stress, barriers, and role strain affected the recruitment and retention of nursing students and professionals. It was discovered that there was a need to encourage men to enter the nursing profession using proactive and intentional recruitment strategies to de-gender the nursing profession and to remove the systemic barriers examined.
Nurses ; Male ; Role Strain ; Role Conflict

OBJECTIVE: Intermittent exotropia (IXT) is the most common form of strabismus that warrants standardized management for better and predictable outcomes. Currently there are no preferred practice guidelines on the non-surgical management of IXT. Among the aforementioned methods, orthoptics is the most favored by optometrists and ophthalmologists based in China and Israel. However, consensus statements on the use of such modality are yet to be established. This study aimed to identify preferred non-surgical management strategies for intermittent exotropia (IXT) among members of the Philippine Society of Pediatric Ophthalmology and Strabismus (PSPOS). METHODS: The survey collected data on respondent and patient demographics, perceived causes of IXT, clinical course, and management preferences. Incomplete responses were excluded, and data were analyzed using frequency distribution and the Fisher test. RESULTS: Forty of 54 (74%) PSPOS members participated, predominantly from urban settings (34 respondents). Most IXT cases were children aged 4 to 11 years. The proportion of pediatric patients was not significantly influenced by respondents’ age (p=0.1628) or practice region (p=0.451). Twenty-one (52.5%) respondents cited fusion defects as the primary cause of IXT. While twenty-one noted an unpredictable course, 14 identified it as a progressive course. Overminus lenses were preferred for younger patients (1-4 years), with an increasing preference for orthoptics in older age groups (5 to>18 years). Pediatric ophthalmologists aged 30 to 40 years (p=0.005) and those with 1 to 5 years of experience (p=0.020) favored overminus lenses for 5-10-year-olds. Preference for overminus lenses was stronger outside the NCR (p=0.044). Furthermore, 90% of respondents said surgery shouldn’t be performed at diagnosis, and 42.5% of respondents were against it for younger ages. CONCLUSION The findings revealed a strong preference for overminus lenses among PSPOS members, with increasing use of orthoptics for older patients. Factors influencing management decisions included respondent age, practice region, and perceptions of IXT’s cause and course. Future randomized controlled trials are essential to evaluate non-surgical interventions and develop comprehensive treatment guidelines.
Human ; ophthalmology ; strabismus ; exotropia

Introduction: Prostate cancer is the third most common cancer among Filipino males. Ga-68 PSMA PET-CT and Lu-177 PRLT have been introduced in the Philippines for the diagnostics and therapy of prostate cancer. Objective: The aim of this study is to compare treatment outcomes of standard therapy plus Lu-177 PSMA radioligand therapy and standard therapy alone among patients with prostatic cancer status-post castration using Ga-68 PET-CT as an outcome indicator. Methodology: This is an ambispective cohort study on Ga-68 PSMA PET-CT scans performed between January 1, 2018 and July 31, 2021. Serum PSA data taken within one month of the PET-CT scans were also collected when available. The PET-CT images were reviewed by a radiologist for RECIST response, and by a nuclear medicine physician for PERCIST response . Results: A total of 11 participants were included in the study. Six participants (55.5%) received standard therapy, while five participants (45.5%) received Lu-177 PSMA radioligand therapy plus standard therapy. There was no significant difference in the baseline and follow-up CT as shown by all p values > 0.05. A trend towards higher number of participants with non-complete/non-progressive RECIST response was noted in the control group than the treatment group, as well as higher number of participants with progressive or stable disease using the PERCIST response. Conclusion There were no significant differences noted in the clinical outcomes of participants who received Lu-177 PRLT and those with standard therapy alone. A trend towards decreasing serum PSA, CT and PET measurements were noted among patients given Lu-177 PRLT than those with standard therapy.
Prostatic Neoplasms

Objective: To compare the visual performance and patient-reported outcomes of three types of monofocal intraocular lenses (IOL) with different asphericities. Methods: This cross-sectional, comparative study comprised of 62 pseudophakic eyes divided into three groups corresponding to the IOL that they were previously implanted with (Tecnis ZCB00 negative aspheric IOL, EnVista MX60 neutral aspheric IOL and Akreos Adapt spheric IOL). Mean refractive spherical equivalent (MRSE), best-corrected far visual acuity (BCVA), spherical aberration (SA), contrast sensitivity (SC), halo and starburst, and responses to a qualitative questionnaire (NEI-RQL) were measured. Results: There was no significant difference in MRSE (P=0.74) and BCVA (P=0.52) among the three groups. There was a statistically significant difference (P=0.00) in mean internal (lens) SA, measured through a 5mm pupil, among Tecnis (-0.150 μm), EnVista (+0.022 μm) and Akreos Adapt (+0.094 μm). Compared to the Akreos Adapt, the Tecnis and EnVista groups had significantly better CS at 6 CPD and 12 CPD under mesopic testing without glare (P= 0.01) and at 6 CPD mesopic testing with glare (P=0.04). Halo scores were insignificant among the three groups. However, starburst scores were significantly worse in the Akreos Adapt IOL than the Tecnis and EnVista (P=0.01). There was no difference in questionnaire responses among the three groups. Conclusion The negative aspheric and neutral aspheric lenses showed significantly lower SA resulting in better CS in mesopic conditions and better starburst scores. MRSE, BCVA and subjective satisfaction were statistically similar regardless of the type of monofocal intraocular lens
Contrast Sensitivity

OBJECTIVE: To compare the visual, refractive, and patient-reported outcomes of eyes implanted with one of 3 trifocal intraocular lenses (IOLs). METHODS: This is a cross-sectional, comparative, non-interventional study wherein subjects implanted with FineVision Micro F, AT LISA tri 839MP or AcrySof IQ PanOptix trifocal IOL after phacoemulsification were recruited. Manifest refraction, uncorrected and corrected visual acuity (VA) at distance, intermediate and near vision, contrast sensitivity, modulated transfer function (MTF) values and questionnaire answers were compared among the 3 groups using analysis of variance (ANOVA). RESULTS: Fifty-seven (57) eyes were included in the study: 21 eyes with FineVision (group A), 21 eyes with LISA tri (group B), and 15 eyes with PanOptix IOL (group C). The post-operative mean manifest spherical equivalent was -0.01D, -0.07D, and 0.05D, respectively (p=0.083). Uncorrected distance VA and best-corrected distance VA were similar among the groups. Groups A and C had better uncorrected and corrected intermediate VA at 80 cm and at 60 cm compared to group B. Group A had significantly better uncorrected near visual acuity than groups B and C (p=0.032). Mesopic contrast sensitivity testing showed group C had higher contrast sensitivities without glare in at the spatial frequency of 6 CPD (p=0.038) and with glare at 3 CPD (p=0.039) and at 12 CPD (p=0.009). MTF average height analysis showed that the group A had significantly superior resolution in far targets compared to groups B and C (p=0.001). At near targets, groups A and C had better resolutions compared to group B (p=0.017). There was no significant difference in patient satisfaction for far, intermediate and near VA among the groups. CONCLUSION: Eyes implanted with any of the 3 trifocal IOL designs achieved excellent uncorrected and bestcorrected distance, intermediate and near vision. FineVision and PanOptix provided significantly better intermediate vision than LISA tri at both 80 cm and 60 cm testing distance. FineVision had better near visual outcomes than PanOptix and LISA tri. Patient satisfaction was high in all 3 trifocal IOLS
Lenses, Intraocular ; Vision, Ocular

This paper explores the issues surrounding international nurse migration to Canada. Within the context of Karl Marx's idea of a "disposable industrial reserve army [of labor]" (Magdoff & Magdoff, p. 20; Marx, 1887, p. 438), this paper posits that internationally educated nurses (IENs) are viewed as disposable labour who have the potential to assume different labour requirements needed by the receiving nation state (Magdoff & Magdoff, p. 26). This paper provides a brief background of international nurse migration in history and literature. It proceeds to explore the issue of gendered and racialized labour, and a more focused discussion of the current state and pathways of IEN migration to, and the plight of IENs in Canada.

OBJECTIVE: To  report  a  case  of  tumoral  calcinosis  from  secondary hyperparathyroidism  and  to describe its surgical management.
METHODS:
 Design: Case Report
 Setting: Tertiary Public University Hospital
 Patient: One
RESULTS: A 34-year-old woman presented with progressively-enlarging bilateral upper extremity masses. Diagnostic tests revealed hyperfunctioning parathyroid glands. The patient underwent subtotal  parathyroidectomy,  right  thyroid  lobectomy  with  isthmusectomy,  and  transcervical thymectomy.    Follow-up  revealed  marked  decrease  in  parathyroid  hormone,  and  progressive resolution of the tumoral calcinosis.
CONCLUSION: Subtotal  parathyroidectomy  and  transcervical  thymectomy  have  a  role  in  the management  of  tumoral  calcinosis,  and  in  this  case  led  to  excellent  post-operative  results. The rare  presentation  of  secondary  hyperparathyroidism  and  intervention  in  this  patient  may  have potential lessons for future management of similar cases.