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Study Title and Description

Phacoemulsification and intraocular lens implantation for angle closure glaucoma after the relief of pupillary block.



Key Questions Addressed
1 What is the effect of lens extraction for chronic angle-closure glaucoma?
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Primary Publication Information
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TitleData
Title Phacoemulsification and intraocular lens implantation for angle closure glaucoma after the relief of pupillary block.
Author Kubota T., Toguri I., Onizuka N., Matsuura T.
Country Department of Ophthalmology, National Nagasaki Medical Center, Omura City, Nagasaki 856-8562, Japan. kubota@nmc.hosp.go.jp
Year 2003
Numbers Pubmed ID: 12913321

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Lens extraction for chronic angle-closure glaucoma 2009
Arms
Number Title Description Comments
1 Phacoemulsification and intraocular lens replacement
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2 Phacoemulsification and intraocular lens replacement and goniosynechialysis
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Design Details
Question... Follow Up Answer Follow-up Answer
Type of study retrospective cohort study.
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Was the control group representative of the underlying population? Unclear.
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Losses to follow-up and reasons for loss to follow-up controls - none reported, but not clear if sample was consecutive. Cases - none reported, but not clear if sample was consecutive.
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Country Japan.
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Cases or Intervention 1 phacoemulsification and intraocular lens replacement.
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Control or Intervention 2 phacoemulsification and intraocular lens replacement and goniosynechialysis.
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Primary outcome as defined in the study no primary outcome was specified a priori. IOP was reported.
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Study period April 1998 to March 2001.
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Age Mean (SD) age of all patients was 67.7 (8.8) years.
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Gender 67% of all patients were women.
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Inclusion criteria PACG was defined as GON, reproducible VF defect, closed angle on indentation. Also write "patients with a closed angle who had a history of raised IOP were included in the study." Not sure if this means patients without VF defect and GON were included.
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Exclusion criteria secondary angle-closure glaucoma.
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Equivalence of baseline characteristics unclear.
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Number of participants (eyes) in Intervention 1 group 9 (11)
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Number of participants (eyes) in Intervention 2 group 2 (2)
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Length of follow up planned: Not stated. Actual: 13.8 (7.2) months, range 6 to 36 months.
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Measurement of primary outcome in the study not reported.
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Secondary outcomes as defined in the study number of postoperative medications, visual acuity, complications.
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Measurement of secondary outcomes in the study visual acuity measured using Snellen charts.
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Intervals at which outcome assessed during routine follow-up for surgery , 1 week, 2 weeks, 1 month, 2 months, 3 months and 6 months postoperatively.
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Reported information on cost of interventions none.
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Reported information on quality of life none.
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Were the criteria for allocation of participants to the treatment and control groups explicitly reported? ... Yes ... those with broad PAS in two or more quadrants had combined procedures.
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Can the above criteria be explicitly related to the outcome? ... Yes ... the presence of PAS may be associated with worse IOP outcome.
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Was there evidence of a consecutive sample or a clearly defined patient population or some other method to minimize the chance that clinicians preferentially selected patients with favorable outcomes or that patients with better outcomes volunteered? No.
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How were the controls selected? The indication for an additional goniosynechialysis procedure was a broad peripheral synechiae of more than 2 quadrants observed by intraoperative Swan gonioscopy.
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Were appropriate statistical/ case-mix methods used to adjust for confounding factors? No factors adjusted for in the analysis.
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Were the factors adjusted for in the analyses, specified a priori? None adjusted for.
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Was the measurement of the confounding factors in the participants consistently adequate? Unclear.
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Was consistency achieved in allocation, administration of treatments and recording of the treatments? Unclear.
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Was the treatment/intervention confirmed in an objective way and not determined exclusively by self reports? Yes, treatment was surgery.
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Was outcome assessment conducted in a masked fashion (if the study was prospective)? No attempt at masking outcome assessment described.
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Were criteria/protocols for outcome assessment standardized and/or pre-specified? Were there deviations from the protocol? No criteria described.
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Was the method of outcome assessment valid? Unclear, method of measurement of outcomes including IOP not described.
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Was outcome assessed in the same way in both groups? Unclear.
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Results & Comparisons


Results Data
Outcome: Proportion of participants with evidence of progression of visual field loss      Population: All Participants
Time Point Measure Phacoemulsification and intraocular lens replacement Phacoemulsification and intraocular lens replacement and goniosynechialysis


6-36 months

N Analyzed data on participants without past history of acute attacks of angle closure were not available data on participants without past history of acute attacks of angle closure were not available

Adverse Events
Arm or Total Title Description Proportion of adverse events Comments
Phacoemulsification and intraocular lens replacement Posterior capsule rupture unit = eyes
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Phacoemulsification and intraocular lens replacement and goniosynechialysis
Total 1/11