Triamcinolone vs. Laser for Diabetic Macular Edema

NCT ID: NCT00229931

Last Updated: 2023-12-28

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

11 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-11-30

Study Completion Date

2013-05-31

Brief Summary

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The purpose of this study is to determine if intravitreal triamcinolone acetonide (IVTA) injection at the time of cataract surgery will improve visual acuity and decrease post-operative swelling in diabetic patients requiring cataract extraction as compared to the conventional treatment of laser following cataract surgery.

The subjects will be followed for 11 visits over 3 year. Visits will occur at screening,1, 3,6,9,12,18,24,30 and 36 months post surgery.

Detailed Description

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Protocol Summary:

This is a randomized, prospective study comparing diabetic patients with pre-operative macular edema undergoing cataract surgery treated with either 4 mg of intravitreal triamcinolone at the time of cataract surgery or focal laser treatment 1 month following cataract surgery.

Disease State:

The conventional treatment for clinically significant macular edema is focal laser photocoagulation. In some diabetic patients however, the cataract often impedes fundus visualization for optimal laser treatment. In these patients focal laser treatment is deferred until after cataract surgery.

Study aim:

The purpose of this study is to determine if intravitreal triamcinolone acetonide (IVTA) injection at the time of cataract surgery will improve visual acuity and decrease post-operative macular edema in diabetic patients with pre-operative macular edema requiring cataract extraction as compared to the conventional treatment of focal laser photocoagulation following cataract surgery.

Hypothesis:

We propose that by injecting triamcinolone intravitreally at the time of cataract surgery in patients who have pre-operative macular edema, we will not only reduce the risk of exacerbating macular edema but also possibly improve the final visual outcome.

Study Procedures:

After informed consent is obtained each patient will be placed, based on a randomization scheme, into either the control group receiving the conventional focal laser treatment one month following cataract extraction or into the study group receiving the IVTA injection at the time of surgery.

Conditions

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DIABETIC MACULAR EDEMA

Keywords

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CATARACT EXTRACTION MACULAR EDEMA DIABETES FOCAL LASER TRIAMCINOLONE

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Laser therapy

If randomized to laser therapy at time of cataract surgery, laser therapy will be performed one month after cataract surgery. If macular edema does not respond an additional laser therapy will be performed. If macular edema persists after 2 lasers, then IVTA will be administered as per standard of care.

Group Type ACTIVE_COMPARATOR

laser

Intervention Type PROCEDURE

Laser treatment 1 month after cataract surgery with option to repeat once if no improvement.

Triamcinolone therapy

At time of cataract surgery, will have IVTA injection. If macular edema does not show improvement at 1 month, then can have repeat IVTA injection. If the macular edema is stil not improved after 2nd injection, participant will be considered "treatment failure" and will be given the option to have laser therapy.

Group Type ACTIVE_COMPARATOR

Triamcinolone acetonide

Intervention Type DRUG

4mg of intravitreal triamcinolone at time of cataract surgery with option to repeat at one month if no response

Interventions

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Triamcinolone acetonide

4mg of intravitreal triamcinolone at time of cataract surgery with option to repeat at one month if no response

Intervention Type DRUG

laser

Laser treatment 1 month after cataract surgery with option to repeat once if no improvement.

Intervention Type PROCEDURE

Other Intervention Names

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Kenalog focal laser photocoagulation

Eligibility Criteria

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Inclusion Criteria

* visually significant cataracts
* pre-operative visual acuity 20/50 or worse
* pre-operative optical coherence tomography (OCT) showing at least 250 microns central foveal thickness.

Exclusion Criteria

* macular ischemia
* vitreomacular traction
* macular hole
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oklahoma

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robert E Leonard, MD

Role: PRINCIPAL_INVESTIGATOR

Dean A. McGee Eye Institute

Locations

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Dean A. McGee Eye Institute

Oklahoma City, Oklahoma, United States

Site Status

Countries

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United States

Related Links

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http://www.dmei.org

Dean McGee Eye Institute

Other Identifiers

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2746

Identifier Type: -

Identifier Source: org_study_id