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Doran MA, Ayintap E, Aytogan H. Evaluation of the relationship between tear meniscus changes and quality of life outcomes after external dacryocystorhinostomy. Int Ophthalmol 2024; 44:105. [PMID: 38378968 DOI: 10.1007/s10792-024-03038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE This study aims to investigate the effects of external dacryocystorhinostomy (DCR) surgery on tear meniscus parameters and assess its relationship with improvements in quality of life (QoL) in patients with nasolacrimal duct obstruction (NLDO). METHODS This prospective study included 30 patients diagnosed with NLDO who underwent external DCR surgery. Tear meniscus (TM) parameters, including height, depth and area, were measured using anterior segment optical coherence tomography. Lacrimal symptom questionnaire (LacQ), Munk scores and Glasgow benefit inventories (GBI) were collected. Statistical analysis was performed to evaluate the correlation between tear meniscus changes and improvements in QoL. RESULTS TM height, depth and area decreased from preoperative median measurements (0.09 mm2, 0.37 mm, 0.56 mm) to postoperative median measurements (0.03 mm2, 0.21 mm, 0.30 mm) (p < 0.001). Lacrimal symptom scores and Munk scores showed a significant improvement at 3-month postoperatively (p < 0.001). The GBI scores also demonstrated a significant improvement, indicating a positive impact on the patients' QoL. (p < 0.001). A statistically significant correlation was found between the change in TM parameters and LacQ lacrimal symptom scores. CONCLUSION External DCR surgery leads to significant improvements in tear meniscus parameters and quality of life outcomes in patients with NLDO. The decreased in TM height and TM area indicates improved tear film dynamics and decreased tear volume, which positively impact the patients' ocular comfort and overall well-being. This study highlights the importance of tear meniscus evaluation as a potential market for assessing the success of DCR surgery and its impact on patients' QoL.
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Affiliation(s)
- Mehmet Ali Doran
- Department of Ophthalmology, Republic of Turkey Health Sciences University Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Emre Ayintap
- Department of Ophthalmology, Republic of Turkey Health Sciences University Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hasan Aytogan
- Department of Ophthalmology, Republic of Turkey Health Sciences University Izmir Tepecik Training and Research Hospital, Izmir, Turkey
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Petzold A, Braithwaite T, van Oosten BW, Balk L, Martinez-Lapiscina EH, Wheeler R, Wiegerinck N, Waters C, Plant GT. Case for a new corticosteroid treatment trial in optic neuritis: review of updated evidence. J Neurol Neurosurg Psychiatry 2020; 91:9-14. [PMID: 31740484 PMCID: PMC6952848 DOI: 10.1136/jnnp-2019-321653] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/20/2019] [Accepted: 10/16/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Axel Petzold
- Expertise Centrum Neuro-ophthalmology, Departments of Neurology & Ophthalmology, Amsterdam UMC, Amsterdam, The Netherlands .,Moorfields Eye Hospital, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK
| | - Tasanee Braithwaite
- Neuro-ophthalmology, Moorfields Eye Hospital and The National Hospital for Neurology & Neurosurgery, London, UK
| | | | - Lisanne Balk
- Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Elena H Martinez-Lapiscina
- Center of Neuroimmunology and Service of Neurology, Clinic Barcelona Hospital University, Barcelona, Spain
| | | | - Nils Wiegerinck
- )Patient Organisation (Neuro-ophthalmology), Lisbon, Portugal
| | - Christiaan Waters
- Neuro-ophthalmologie Vereniging Nederland (KvK nummer 66260140), Amsterdam, Netherlands
| | - Gordon T Plant
- ,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, St. Thomas Hospital, Moorfields Eye Hospital, London, UK
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Braithwaite T, Calvert M, Gray A, Pesudovs K, Denniston AK. The use of patient-reported outcome research in modern ophthalmology: impact on clinical trials and routine clinical practice. PATIENT-RELATED OUTCOME MEASURES 2019; 10:9-24. [PMID: 30774489 PMCID: PMC6352858 DOI: 10.2147/prom.s162802] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This review article considers the rising demand for patient-reported outcome measures (PROMs) in modern ophthalmic research and clinical practice. We review what PROMs are, how they are developed and chosen for use, and how their quality can be critically appraised. We outline the progress made to develop PROMs in each clinical subspecialty. We highlight recent examples of the use of PROMs as secondary outcome measures in randomized controlled clinical trials and consider the impact they have had. With increasing interest in using PROMs as primary outcome measures, particularly where interventions have been found to be of equivalent efficacy by traditional outcome metrics, we highlight the importance of instrument precision in permitting smaller sample sizes to be recruited. Our review finds that while there has been considerable progress in PROM development, particularly in cataract, glaucoma, medical retina, and low vision, there is a paucity of useful tools for less common ophthalmic conditions. Development and validation of item banks, administered using computer adaptive testing, has been proposed as a solution to overcome many of the traditional limitations of PROMs, but further work will be needed to examine their acceptability to patients, clinicians, and investigators.
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Affiliation(s)
- Tasanee Braithwaite
- Centre for Patient Reported Outcomes Research and NIHR Birmingham Biomedical Research Centre, University of Birmingham, Edgbaston, Birmingham, UK, .,Moorfields Eye Hospital, London, UK,
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research and NIHR Birmingham Biomedical Research Centre, University of Birmingham, Edgbaston, Birmingham, UK, .,Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Alastair K Denniston
- Centre for Patient Reported Outcomes Research and NIHR Birmingham Biomedical Research Centre, University of Birmingham, Edgbaston, Birmingham, UK, .,Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHSFT, Birmingham, UK.,Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Biomedical Research Centre (Moorfields Eye Hospital/UCL), London, UK
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Sipkova Z, Vonica O, Olurin O, Obi EE, Pearson AR. Assessment of patient-reported outcome and quality of life improvement following surgery for epiphora. Eye (Lond) 2017. [PMID: 28622317 DOI: 10.1038/eye.2017.120] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PurposeTo assess and compare the subjective improvement in symptoms and quality of life in adult patients who underwent commonly performed oculoplastic surgical interventions to treat epiphora.Materials and methodsA prospective study was undertaken involving all adult patients undergoing dacryocystorhinostomy (DCR), lid tightening (lateral tarsal strip or lateral wedge resection), and punctoplasty surgery at our institution. We assessed severity of epiphora preoperatively using the Munk score. At 3 months postoperatively, all patients were sent postal questionnaires comprising of Munk score, 'social impact score' from validated Lac-Q questionnaire ranging from 0 (no impact) to 5 (maximal negative impact) and Glasgow Benefit Inventory (GBI) score, ranging from -100 (maximal detriment) to +100 (maximal benefit).ResultsA total of 134 questionnaires were sent with an overall response rate of 74.6%. For the purpose of data analysis, patients were divided into four groups: DCR, lid tightening, punctoplasty, and combined group (lid tightening plus punctoplasty). There was statistically significant improvement in subjective epiphora postoperatively, as assessed by Munk score (P<0.001) in all groups. The total GBI scores were +42.67 (95% CI: 33.42-51.91) for DCR, +19.65 (95% CI: 10.33-28.97) for lid tightening, +16.06 (95% CI: 2.65-29.48) for punctoplasty, and +26.53 (95% CI: 13.15-39.90) for the combined group, demonstrating a positive change in health status for all groups. There was negative correlation between total GBI and post-operative Munk scores (r=-0.58, P<0.001), and positive correlation between Lac-Q and Munk scores (r=0.65, P<0.001).ConclusionPatients derived significant improvement in symptoms and health-related quality of life benefit following all surgical interventions for epiphora.
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Affiliation(s)
- Z Sipkova
- Department of Ophthalmology, Royal Berkshire Hospital, Reading, UK.,Department of Ophthalmology, King Edward VII Hospital, Windsor, UK
| | - O Vonica
- Department of Ophthalmology, Royal Berkshire Hospital, Reading, UK.,Department of Ophthalmology, King Edward VII Hospital, Windsor, UK
| | - O Olurin
- Department of Ophthalmology, King Edward VII Hospital, Windsor, UK
| | - E E Obi
- Department of Ophthalmology, Royal Berkshire Hospital, Reading, UK.,Department of Ophthalmology, King Edward VII Hospital, Windsor, UK
| | - A R Pearson
- Department of Ophthalmology, Royal Berkshire Hospital, Reading, UK.,Department of Ophthalmology, King Edward VII Hospital, Windsor, UK
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In pursuit of empirically supported assessment for use in medical settings. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016. [DOI: 10.1111/cpsp.12176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Ptosis repair was performed in patients with ocular myasthenia gravis by a posterior approach (Fasanella-Servat, 12 eyelids of nine patients) or levator advancement (eight eyelids of five patients) techniques. There were eight males and five females. Median age was 73 years and range 30-86 years. The median duration of myasthenia was 10 years and range 2 to 28 years. Pyridostigmine and prednisone were widely used prior to surgical referral, but ineffective or intolerable in all. The mean preoperative upper margin-reflex distance (MRD) was 0.55 mm (range -1 to 2 mm). The levator excursion range was 10 to 16 mm and mean 12.4 mm. Mean follow-up was 9.1 months. Postoperatively, the MRD ranged from 0.5 to 4 mm, with a mean of 2.3 mm. Two patients had lagophthalmos postoperatively (one posterior approach, one levator advancement) that did not require correction. Three of five patients who underwent levator advancement required repeat ptosis repair.
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Affiliation(s)
- Michel J Belliveau
- a Department of Ophthalmology and Vision Sciences , University of Toronto , Toronto , Canada
| | - James H Oestreicher
- a Department of Ophthalmology and Vision Sciences , University of Toronto , Toronto , Canada
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