Intraocular Pressure Control Following One Site Versus Two Site Combined Phacoemulsification/IOL And Trabeculectomy

NCT ID: NCT00695747

Last Updated: 2009-01-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

95 participants

Study Classification

INTERVENTIONAL

Study Start Date

1998-01-31

Study Completion Date

2009-01-31

Brief Summary

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The purpose of this study is to compare the safety \& effectiveness of the two types of cataract and glaucoma surgeries. Results from this study may improve the surgical and post surgical management and long term management of patients with these conditions in the future

Detailed Description

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The purpose of this study is to determine whether a Two-Site Technique for the Combined Procedure for subjects with coexisting visually significant glaucoma \& cataracts will result in an improvement in IOP control in both the immediate and longer term postoperative period as compared with the currently Standard One Site surgical technique for both glaucoma and cataracts.

Research and data indicate that the success rate of the glaucoma part of this operation may be improved if the incision for the cataract part of the operation is separated from the drainage hole created for the glaucoma part, the constant drainage through this hole is what lowers the intraocular pressure after surgery. Using the Two-Site Combined procedure the glaucoma incision(drainage hole) will still be created superiorly, under the upper lid. The cataract incision will be moved to the temporal side of the eye ball, away from the drainage hole for the glaucoma.

Conditions

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Glaucoma Cataracts

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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1

Standard 1 site Procedure using a fornix based incision, performed superiorly

Group Type NO_INTERVENTION

No interventions assigned to this group

2

2 Site Combined Procedure

Group Type EXPERIMENTAL

2 Site procedure- Phacoemulsification/IOL and Trabeculectomy

Intervention Type PROCEDURE

2 Site Combined Procedure: in which a temporal clear cornea approach would be used for the cataract/IOL part of the procedure, and immediately thereafter the superior limbus would be employed for a limbus-based trabeculectomy

Interventions

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2 Site procedure- Phacoemulsification/IOL and Trabeculectomy

2 Site Combined Procedure: in which a temporal clear cornea approach would be used for the cataract/IOL part of the procedure, and immediately thereafter the superior limbus would be employed for a limbus-based trabeculectomy

Intervention Type PROCEDURE

Other Intervention Names

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Coexisting Cataract and glaucoma Cateract Glaucoma Phacoemulsification/IOL Trabeculectomy

Eligibility Criteria

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Inclusion Criteria

* Meet the current criteria for combined procedure surgery:
* A visually significant cataract(ie: an opacification of the crystalline lens resulting in a reduction of visual performance affecting daily living
* Open angle or mixed mechanism glaucoma inadequately controlled on current therapy, or requiring two or more medications for control, or with advanced visual field and optic nerve damage.

Exclusion Criteria

* Subjects with normal tension glaucoma(defined as those subjects in whom no IOPs greater than 21 mm Hg\[preceding or during therapy\]have been recorded)
* Subjects with uveitis
* Subjects with neovascular glaucoma
* Severe conjunctival inflammation or scarring
* Subjects who have had previous incisional ocular surgery in the same eye
* No subjects will have second eye operated on within 8 weeks of the first eye
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Lahey Clinic

OTHER

Sponsor Role lead

Responsible Party

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Lahey Clinic, Inc.

Principal Investigators

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Paul R. Cotran, M.D.

Role: PRINCIPAL_INVESTIGATOR

Lahey Clinic, Inc.

Locations

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Lahey Clinic, Inc.

Burlington, Massachusetts, United States

Site Status

Countries

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United States

References

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Palmer SS. Mitomycin as adjunct chemotherapy with trabeculectomy. Ophthalmology. 1991 Mar;98(3):317-21. doi: 10.1016/s0161-6420(91)32293-0.

Reference Type BACKGROUND
PMID: 2023752 (View on PubMed)

Shingleton BJ, Jacobson LM, Kuperwaser MC. Comparison of combined cataract and glaucoma surgery using planned extracapsular and phacoemulsification techniques. Ophthalmic Surg Lasers. 1995 Sep-Oct;26(5):414-9.

Reference Type BACKGROUND
PMID: 8963855 (View on PubMed)

Gandolfi SA, Vecchi M. 5-fluorouracil in combined trabeculectomy and clear-cornea phacoemulsification with posterior chamber intraocular lens implantation. A one-year randomized, controlled clinical trial. Ophthalmology. 1997 Feb;104(2):181-6. doi: 10.1016/s0161-6420(97)30336-4.

Reference Type BACKGROUND
PMID: 9052620 (View on PubMed)

Shin DH, Simone PA, Song MS, Reed SY, Juzych MS, Kim C, Hughes BA. Adjunctive subconjunctival mitomycin C in glaucoma triple procedure. Ophthalmology. 1995 Oct;102(10):1550-8. doi: 10.1016/s0161-6420(95)30832-9.

Reference Type BACKGROUND
PMID: 9097805 (View on PubMed)

Joos KM, Bueche MJ, Palmberg PF, Feuer WJ, Grajewski AL. One-year follow-up results of combined mitomycin C trabeculectomy and extracapsular cataract extraction. Ophthalmology. 1995 Jan;102(1):76-83. doi: 10.1016/s0161-6420(95)31050-0.

Reference Type BACKGROUND
PMID: 7831046 (View on PubMed)

Berestka JS, Brown SV. Limbus- versus fornix-based conjunctival flaps in combined phacoemulsification and mitomycin C trabeculectomy surgery. Ophthalmology. 1997 Feb;104(2):187-96. doi: 10.1016/s0161-6420(97)30335-2.

Reference Type BACKGROUND
PMID: 9052621 (View on PubMed)

Scott IU, Greenfield DS, Schiffman J, Nicolela MT, Rueda JC, Tsai JC, Palmberg PF. Outcomes of primary trabeculectomy with the use of adjunctive mitomycin. Arch Ophthalmol. 1998 Mar;116(3):286-91. doi: 10.1001/archopht.116.3.286.

Reference Type BACKGROUND
PMID: 9514480 (View on PubMed)

Parrish RK II, Folberg R. Wound healing in glaucoma surgery: In: Ritch R. Shields MB, Krupin T, eds. The Glaucomas 2nd ed. St. Louis: CV Mosby 1989, vol III, chap. 81

Reference Type BACKGROUND

Other Identifiers

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98-067

Identifier Type: -

Identifier Source: org_study_id

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