INTRODUCTION:Radioactive iodine(I131) therapy is an established definitive treatment for Graves' hyperthyroidism.However,the optimal method of determining the radioiodine treatment dose remains controversial.
OBJECTIVE: To compare the efficacy of fixed dose versus  calculated  dose  regimen  in  the  treatment  of  Graves'  hyperthyroidism  among  Filipinos 
METHODOLOGY: Diagnosed   Graves'   disease   patients underwent  thyroid  ultrasound  to  estimate  thyroid  size. Patients  were  randomized  to  either  fixed  or  calculated dose  of  radioiodine  treatment.  For  fixed  dose  group,the  WHO  goiter  grading  was  utilized:  Grade   0   (5mCi),  Grade   1  (7mCi),  Grade2  (10mCi),  Grade  3  (15mCi).  For calculated  dose  group  the  following  formula  was  used:
                    Dose(mCi)= 160uCi/g thyroid x thyroid gland weight in grams x 100  /  24-hour RAIU(%)
Thyroid function test (TSH,FT4)  was monitored every  three  months  for  one  year. 
RESULTS: Of  the  60  patients  enrolled,  45  (fixed  dose;  n= 27,  calculated  dose;  n=  18)  completed  the  six  months follow-up  study.  Analysis  was  done  by  application  of  the  intention-to-treat  principle.  The  percentage  failure  rate  at  third  month  in  the  fixed  vs.  calculated  dose  group  was:  26  v.  28%  with  a  relative  risk  (RR)  value  of  0.93.  At  six  months  post-therapy,  there  was  a  noted  reduction  in  the  failure  rates  for  both  study  groups  (11  vs.  22%,  respectively),  with   a   further   reduction   in   the   relative   risk   value (0.67),  favoring  the  fixed  dose  group.
CONCLUSION: Fixed   dose   radioiodine   therapy   for Graves'   disease   is   observed   to   have   a   lower   risk   of   treatment   failure   (persistent   hyperthyroidism)   at   three  and  six  months  post-therapy  compared  to  the calculated  dose.

Human ; Male ; Female ; Middle Aged ; Adult ; Iodine Radioisotopes ; Iodine ; Intention To Treat Analysis ; Graves Disease ; Hyperthyroidism ; Goiter ; Thyroid Function Tests ; Treatment Failure

OBJECTIVE: To compare the visual, refractive, and patient-reported outcomes of eyes implanted with one of 3 trifocal intraocular lenses (IOLs). METHODS: This is a cross-sectional, comparative, non-interventional study wherein subjects implanted with FineVision Micro F, AT LISA tri 839MP or AcrySof IQ PanOptix trifocal IOL after phacoemulsification were recruited. Manifest refraction, uncorrected and corrected visual acuity (VA) at distance, intermediate and near vision, contrast sensitivity, modulated transfer function (MTF) values and questionnaire answers were compared among the 3 groups using analysis of variance (ANOVA). RESULTS: Fifty-seven (57) eyes were included in the study: 21 eyes with FineVision (group A), 21 eyes with LISA tri (group B), and 15 eyes with PanOptix IOL (group C). The post-operative mean manifest spherical equivalent was -0.01D, -0.07D, and 0.05D, respectively (p=0.083). Uncorrected distance VA and best-corrected distance VA were similar among the groups. Groups A and C had better uncorrected and corrected intermediate VA at 80 cm and at 60 cm compared to group B. Group A had significantly better uncorrected near visual acuity than groups B and C (p=0.032). Mesopic contrast sensitivity testing showed group C had higher contrast sensitivities without glare in at the spatial frequency of 6 CPD (p=0.038) and with glare at 3 CPD (p=0.039) and at 12 CPD (p=0.009). MTF average height analysis showed that the group A had significantly superior resolution in far targets compared to groups B and C (p=0.001). At near targets, groups A and C had better resolutions compared to group B (p=0.017). There was no significant difference in patient satisfaction for far, intermediate and near VA among the groups. CONCLUSION: Eyes implanted with any of the 3 trifocal IOL designs achieved excellent uncorrected and bestcorrected distance, intermediate and near vision. FineVision and PanOptix provided significantly better intermediate vision than LISA tri at both 80 cm and 60 cm testing distance. FineVision had better near visual outcomes than PanOptix and LISA tri. Patient satisfaction was high in all 3 trifocal IOLS
Lenses, Intraocular ; Vision, Ocular