Rates of glaucomatous visual field change before and after transscleral cyclophotocoagulation: a retrospective case series

BACKGROUND: The primary goal of glaucoma treatment is to lower and control intraocular pressure (IOP) and thereby prevent functional deterioration. For glaucomas that are refractory to medical and incisional surgical therapies, transscleral diode cyclophotocoagulation (TCP) is a well-established procedure to effectively decrease IOP. This study investigated rates of visual field (VF) change in patients with glaucoma before and after TCP. METHODS: This retrospective case series investigated rates of VF changes in glaucoma patients before and after they underwent TCP. At least four VF examinations were required, two before and two after surgery. VF examinations were performed using standard automated perimetry and rates of change were calculated by linear regression analysis of mean deviation (MD) values measured over time. RESULTS: A total of 46 eyes of 43 patients were included and followed on average 3.6 years before and 2.1 years after TCP. 67 % of the eyes showed further progression of glaucoma following surgery. Mean preoperative MD change was -0.21 dB/year (SE = 0.08, 95 % CI [-0.06, -0.37]). Postoperatively the mean change was -0.26 dB/year (SE = 0.22 95 % CI [0.38, -0.48]) which results in a difference between pre- and postoperative MD rate of 0.05 dB/year (p = 0.824). The mean MD value was worse after surgery and dropped by 1.73 dB (SE = 0.58, 95 % CI [-0.59, -2.87], p = 0.003). Intraocular pressure (IOP) decreased from 23.2 mmHg (SD = 4.67) before TCP to 14.3 mmHg (SD = 3.17) after TCP (p < 0.001). For each 1 mmHg of IOP reduction after surgery, postoperative rate of VF loss decreased by 0.15 dB/year. CONCLUSION: Rates of glaucomatous visual field loss did not significantly change after TCP and the majority of the eyes showed further progression of glaucoma after surgery. Mean MD value was considerably lower after TCP

Representations and concepts of professional ethos among Swiss religious education teacher trainers

Over the past two decades, the organisation of religious education classes in Switzerland has undergone profound reforms. Amid the increasing secularisation and pluralisation of the religious landscape, many cantons have introduced a compulsory course that falls under the responsibility of the state and is aimed at teaching basic knowledge about a variety of religions. These reforms have enabled a harmonisation of the syllabi for religious education across the country and have prompted the adaptation of teacher training programmes. Because of the many diverse social expectations surrounding these new courses and the diverse academic tra- ditions in the field of religious education, however, a unified conception of these courses is still absent. In this article, we discuss the ongoing construction of religious education teachers’ professional ethos within this fluid context. In particular, we discuss the perspective of teacher trainers on pragmatic questions concerning religious plurality and the place of teachers’ and pupils’ personal (religious) experiences in the classroom, and pay attention to different representations of ‘religion’ and distinct ideas regarding the purpose of these courses as they have a major impact on the professional attitudes expected from teachers. Keywords: professional ethos; teacher trainers; Switzerland; concepts of religion; impartialit