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Canaloplasty versus Nonpenetrating Deep Sclerectomy: 2-Year Results and Quality of Life Assessment.

ABSTRACT: Purpose:To compare phacocanaloplasty (PC) and phaco-non-penetrating deep sclerectomy (PDS). Methods:75 patients with uncontrolled glaucoma and cataract were randomized for PC (37 eyes) or PDS (38 eyes). Intraocular pressure (IOP) and number of medications (meds) were prospectively evaluated. Follow-up examinations were performed on days 1 and 7 and after 1, 3, 6, 12, 18, and 24 months. Surgical success was calculated. Complications and postoperative interventions were noted. Quality of life (QoL) was analyzed. Results:Preoperatively, mean IOP and meds were comparable (P > 0.05). After 24 months, IOP significantly decreased in PC from 19.4?±?5.9?mmHg (2.6?±?0.9 meds) to 13.8?±?3.3?mmHg (0.5?±?0.9 meds) and in PDS from 19.7?±?5.4?mmHg (2.9?±?0.9 meds) to 15.1?±?2.9?mmHg (1.1?±?1.2 meds). Statistically lower IOP was observed in PC in the 6th month and persisted until 24 months (P < 0.05). No difference was found in meds (except for month 18, in which less drugs were used in PC (P = 0.001)) or success rates (P > 0.05). The most frequent complication in PC was transient hyphema (46%), in PDS bleb fibrosis (24%). PC patients during postoperative period required only goniopuncture (22% of subjects), whereas PDS patients required, in order to maintain subconjuctival outflow, subconjunctival 5-fluorouracil injections in 95% of cases (median?=?3), suture lysis (34%), needling (24%), and goniopuncture (37%). NEI VFQ-25 mean composite score for PC was 78.04?±?24.36 points and for PDS 74.29?±?24.45 (P = 0.136). ? Cronbach's correlation coefficient was 0.913. Conclusions:PC leads to a more effective decrease in IOP than PDS in midterm observation with similar safety profiles. PDS patients required a vast number of additional procedures in contrast to PC patients, but this fact did not influence QoL.

SUBMITTER: Byszewska A

PROVIDER: S-EPMC5845501 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Canaloplasty versus Nonpenetrating Deep Sclerectomy: 2-Year Results and Quality of Life Assessment.

Byszewska Anna A Jünemann Anselm A Rękas Marek M

Journal of ophthalmology 20180225

<h4>Purpose</h4>To compare phacocanaloplasty (PC) and phaco-non-penetrating deep sclerectomy (PDS).<h4>Methods</h4>75 patients with uncontrolled glaucoma and cataract were randomized for PC (37 eyes) or PDS (38 eyes). Intraocular pressure (IOP) and number of medications (meds) were prospectively evaluated. Follow-up examinations were performed on days 1 and 7 and after 1, 3, 6, 12, 18, and 24 months. Surgical success was calculated. Complications and postoperative interventions were noted. Quali ...[more]

PMID: 29682338

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Project description:BackgroundMedullary thyroid cancer (MTC) is a neuroendocrine tumour and a rare variant of thyroid cancer with different aetiology, presentation and treatment to differentiated thyroid cancer. Currently available thyroid cancer-specific quality of life (QoL) tools focus on issues and treatments more relevant to patients with differentiated thyroid cancer and therefore may not address issues specific to a MTC diagnosis and cancer journey.MethodThis prospective multicentre randomised study involved 204 MTC patients completing four quality of life questionnaires (QOLQ) and stating their most and least preferred. The questionnaires were a general instrument, the EORTC QLQ-C30, two disease-specific tools, the MD Anderson Symptom Inventory (MDASI) thyroid module and the City of Hope Quality of Life Scale/THYROID (amended) and the neuroendocrine questionnaire, EORTC QLQ-GINET21. Patients were randomised to complete the four questionnaires in one of 24 possible orders and then answered questions about which tool they preferred. The primary outcome measure was patients' preferred QoL instrument for describing their concerns and for facilitating communication with their healthcare professional. Secondary analyses looked at differences between preferred QOLQs amongst patient subgroups (WHO performance status [0 and 1+], disease stage: early [T1-3, N0 or N1A], metastatic [T4, any T N1b] and advanced [any T any N M1], and type of MTC [sporadic and inherited]), identification of MTC patients' least preferred questionnaire and clinicians' views on the QoL tools in terms of their ability to highlight problems not otherwise ascertained by a standard clinical review.ResultsNo evidence of a difference was observed for most preferred QOLQ (p = 0.650). There was however evidence of a difference in least preferred questionnaire in the cohort of 128 patients who stated their least preferred questionnaire (p = 0.042), with 36% (46/128) of patients choosing the EORTC QLQ-GI.NET21 questionnaire. Subgroup analyses showed that there was no evidence of a difference in patients' most preferred questionnaire in sporadic MTC patients (p = 0.637), patients with WHO PS 0 or 1+ (p = 0.844 and p = 0.423) nor when comparing patients with early, advanced local or metastatic disease (p = 0.132, p = 0.463 and p = 0.506, respectively). Similarly, subgroup analyses on patients' least preferred questionnaires showed no evidence of differences in sporadic MTC patients (p = 0.092), patients with WHO PS 0 or 1+ (p = 0.423 and p = 0.276), nor in early or metastatic disease patients (p = 0.682 and p = 0.345, respectively). There was however some evidence to suggest a difference in least preferred questionnaire in patients with advanced local stage disease (p = 0.059), with 43% (16/37) of these patients choosing the EORTC QLQ-GI.NET21 questionnaire.ConclusionsMTC patients regardless of their performance status, disease aetiology and disease burden did not express a preference for any one particular questionnaire suggesting any of the tools studied could be utilized in this patient cohort. The least preferred questionnaire being a gastrointestinal NET specific tool suggests that diarrhoea was not a significant symptom and concern for the population studied.

Dataset Information

Canaloplasty versus Nonpenetrating Deep Sclerectomy: 2-Year Results and Quality of Life Assessment.

Publications

Canaloplasty versus Nonpenetrating Deep Sclerectomy: 2-Year Results and Quality of Life Assessment.

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