Introduction

Novel agents in Diabetes Mellitus (DM)

The last several decades has seen a rapid expansion in innovations for the management of diabetes mellitus (DM). With the well-recognised risk of ocular complications of DM, it is important for those managing patients with these ocular complications to gain insight into novel management approaches to DM available in South Africa. The current review provides a brief overview of those approaches beyond insulin therapy incorporated into contemporary guidelines, and which are available for use in South Africa. The present review also highlights the role of older oral agents and the subsequent need for newer agents in the management of DM. Importantly, prior to 2008, no individual anti-hyperglycaemic agent had demonstrated a benefit with regard to cardiovascular events beyond 5 years within a clinical trial setting. In contrast, the current newer agents have been demonstrated in several major clinical trials to not only improve glucose control, but also to reduce cardiovascular and renal risk

An Update on Glaucoma Drainage Devices (and Preserflo implant): A perspective

Glaucoma surgery has undergone a paradigm shift in the last few years. With the rapidly rising numbers of glaucoma patients worldwide, it is essential to continue developing innovative therapeutic options that are effective at lowering IOP, have a good safety profile, and are well tolerated by the patients. With modern glaucoma surgery, we aim to choose the type of surgery that will be efficacious for the stage of the disease that we are treating. Another goal is to lessen the medicinal burden, for the preservative-free options are still an uphill battle. Early intervention is key to preventing end-stage disease, but we often delay due to the possible complications of the procedures. Thus modern glaucoma surgery needs to be safe with a lower complication rate. Theatre time is another financial burden. For that reason, the latest surgeries focus also on shorter theatre time and lower learning curves for the surgeons. Patients, on the other hand, expect faster postoperative recovery, while surgeons dream of the ideal glaucoma surgery that will provide universal results.

Why Ethics?

This contribution concerns two ethically-significant topics: ‘Complications vs negligence’, and ‘the second opinion’. This is an attempt to deal with some aspects of those topics but in general terms only, and no advice is proffered. The article is primarily about how rational people make ethical decisions, and if that can be applied generally, then I am hopeful that this will be of use.

Accreditation

Health Professions Council of South Africa

MDB015/1237/08/2022

2 Ethics 

Certification

Attempts allowed: 2

70% pass rate





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Ophthalmic Opinion - Vol 5 No 3 - 2022