Economic Evaluation of Femtosecond Laser Assisted Cataract Surgery

NCT ID: NCT01982006

Last Updated: 2018-10-04

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

PHASE3

Total Enrollment

920 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-10-09

Study Completion Date

2016-12-15

Brief Summary

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Cataract is the leading cause of blindness worldwide and cataract surgery is the most frequent surgery performed in France. A new technology, the femtosecond laser-assisted cataract surgery, has to be compared with phacoemulsification alone, the conventional cataract surgery, to determine the economic impact of femtosecond laser-assisted process for the French healthcare insurance.

Detailed Description

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An estimated 700,000 cataract procedures are performed every year in France, with this amount of surgeries predicted to climb as the population there, as well as around the world, ages. Currently, phacoemulsification alone is the conventional cataract surgery. The femtosecond laser-assisted cataract surgery has to be compared with the standard process to provide information on how it could benefit the patient population treated every year for cataract surgery. This economic study has received a grant from the French Ministry of Health to evaluate the economic impact of femtosecond laser-assisted process for the French healthcare system. For this goal, this prospective, randomized, parallel, multicenter and simple blind study will determine the incremental cost/effectiveness ratio for femtosecond laser-assisted process versus phacoemulsification surgery. Visual acuity results and intraoperative or postoperative complication rate will be compared between both groups. The learning curve of the femtosecond laser assisted cataract surgery will be also evaluated for each surgeon involved in the study.

Ethic and regulatory autority authorisations were obtained at 19/Dec/2012 and 15/Feb/2013, respectively. Date of first inclusion: 9/Oct/2013. Date of first NCT release: 13/Nov/2013. 30 patients were included between this period. French regulatory process dos not require NCT registration before first inclusion.

Conditions

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Cataract

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Phaco

Cataract surgery by phacoemulsification

Group Type ACTIVE_COMPARATOR

Cataract surgery with Phacoemulsification

Intervention Type PROCEDURE

Each patients randomized in the phaco arm will undergo a conventional cataract surgery.

Corneal incisions will be manually performed using the same calibrated blade and at the same location for all procedures of one surgeon.

Phacoemulsification machine used to perform cataract surgery in each center will be the same for all patients included in the center. The IOL (IntraOcular Lens) used in each center will be the same for all patients treated in the center.

Femto

Corneal incision, anterior capsulorhexis and lens fragmentation by femtosecond laser

Group Type EXPERIMENTAL

Femtosecond laser-assisted cataract surgery

Intervention Type DEVICE

Each patients randomized in the femto arm will undergo a femtosecond laser assisted cataract surgery.

Corneal incisions will be performed by the laser. Number, size and location of the incisions must be the same than in the phaco arm for all patients treated by one surgeon.

Phacoemulsification machine used to remove the liquefied lens will be the same than in the phaco arm The IOL used in each center will be the same than in the phaco arm

Interventions

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Cataract surgery with Phacoemulsification

Each patients randomized in the phaco arm will undergo a conventional cataract surgery.

Corneal incisions will be manually performed using the same calibrated blade and at the same location for all procedures of one surgeon.

Phacoemulsification machine used to perform cataract surgery in each center will be the same for all patients included in the center. The IOL (IntraOcular Lens) used in each center will be the same for all patients treated in the center.

Intervention Type PROCEDURE

Femtosecond laser-assisted cataract surgery

Each patients randomized in the femto arm will undergo a femtosecond laser assisted cataract surgery.

Corneal incisions will be performed by the laser. Number, size and location of the incisions must be the same than in the phaco arm for all patients treated by one surgeon.

Phacoemulsification machine used to remove the liquefied lens will be the same than in the phaco arm The IOL used in each center will be the same than in the phaco arm

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Cataract with impaired visual acuity (\> or equal +0.3 LogMAR) or with cataract-related visual symptoms (Halos, Monocular diplopia, glare)
* French healthcare insurance beneficiary

Exclusion Criteria

* Pupil size lower than 6mm
* Iris constriction
* Iris synechiae
* Preoperative zonular instability or crystalline lens subluxation
* Obstructive Corneal scars
* Obstructive pterygion
* Axial length \<20.5 mm
* Corneal astigmatism \>1.5 diopters
* Fuchs corneal dystrophy
* History of Central retinal vein or artery occlusion
* History of uveitis
* History of optic nerve head neuropathy except glaucoma
* Progressive glaucoma
* Nystagmus
* Uncontrolled diabetes mellitus
* General history of dementia or psychotic disorders
* Pregnancy, breast feeding
* General medications: Alpha-blockers, Carbonic anhydrase inhibitors
Minimum Eligible Age

22 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cédric SCHWEITZER, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital Bordeaux, France

BENARD Antoine, MD

Role: STUDY_CHAIR

University Hospital Bordeaux, France

Locations

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CHU de Bordeaux

Bordeaux, , France

Site Status

CHU de Brest

Brest, , France

Site Status

Hospices Civils de Lyon

Lyon, , France

Site Status

Hôpital Cochin

Paris, , France

Site Status

CHU de Tours

Tours, , France

Site Status

Countries

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France

References

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Abraham AG, Condon NG, West Gower E. The new epidemiology of cataract. Ophthalmol Clin North Am. 2006 Dec;19(4):415-25. doi: 10.1016/j.ohc.2006.07.008.

Reference Type BACKGROUND
PMID: 17067897 (View on PubMed)

Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004 Nov;82(11):844-51. Epub 2004 Dec 14.

Reference Type BACKGROUND
PMID: 15640920 (View on PubMed)

Lamoureux EL, Fenwick E, Pesudovs K, Tan D. The impact of cataract surgery on quality of life. Curr Opin Ophthalmol. 2011 Jan;22(1):19-27. doi: 10.1097/ICU.0b013e3283414284.

Reference Type BACKGROUND
PMID: 21088580 (View on PubMed)

Hovding G, Natvik C, Sletteberg O. The refractive error after implantation of a posterior chamber intraocular lens. The accuracy of IOL power calculation in a hospital practice. Acta Ophthalmol (Copenh). 1994 Oct;72(5):612-6. doi: 10.1111/j.1755-3768.1994.tb07188.x.

Reference Type BACKGROUND
PMID: 7887161 (View on PubMed)

Norrby S. Sources of error in intraocular lens power calculation. J Cataract Refract Surg. 2008 Mar;34(3):368-76. doi: 10.1016/j.jcrs.2007.10.031.

Reference Type BACKGROUND
PMID: 18299059 (View on PubMed)

Norregaard JC, Thoning H, Bernth-Petersen P, Andersen TF, Javitt JC, Anderson GF. Risk of endophthalmitis after cataract extraction: results from the International Cataract Surgery Outcomes study. Br J Ophthalmol. 1997 Feb;81(2):102-6. doi: 10.1136/bjo.81.2.102.

Reference Type BACKGROUND
PMID: 9059242 (View on PubMed)

Powell SK, Olson RJ. Incidence of retinal detachment after cataract surgery and neodymium: YAG laser capsulotomy. J Cataract Refract Surg. 1995 Mar;21(2):132-5. doi: 10.1016/s0886-3350(13)80499-3.

Reference Type BACKGROUND
PMID: 7791051 (View on PubMed)

Norregaard JC, Thoning H, Andersen TF, Bernth-Petersen P, Javitt JC, Anderson GF. Risk of retinal detachment following cataract extraction: results from the International Cataract Surgery Outcomes Study. Br J Ophthalmol. 1996 Aug;80(8):689-93. doi: 10.1136/bjo.80.8.689.

Reference Type BACKGROUND
PMID: 8949710 (View on PubMed)

Qatarneh D, Mathew RG, Palmer S, Bunce C, Tuft S. The economic cost of posterior capsule tear at cataract surgery. Br J Ophthalmol. 2012 Jan;96(1):114-7. doi: 10.1136/bjo.2010.200832. Epub 2011 Mar 1.

Reference Type BACKGROUND
PMID: 21362773 (View on PubMed)

Chatoux O, Touboul D, Buestel C, Balcou P, Colin J. [Crystalline lens photodisruption using femtosecond laser: experimental study]. J Fr Ophtalmol. 2010 Sep;33(7):472-80. doi: 10.1016/j.jfo.2010.06.008. French.

Reference Type BACKGROUND
PMID: 20817344 (View on PubMed)

Friedman NJ, Palanker DV, Schuele G, Andersen D, Marcellino G, Seibel BS, Batlle J, Feliz R, Talamo JH, Blumenkranz MS, Culbertson WW. Femtosecond laser capsulotomy. J Cataract Refract Surg. 2011 Jul;37(7):1189-98. doi: 10.1016/j.jcrs.2011.04.022.

Reference Type BACKGROUND
PMID: 21700099 (View on PubMed)

Palanker DV, Blumenkranz MS, Andersen D, Wiltberger M, Marcellino G, Gooding P, Angeley D, Schuele G, Woodley B, Simoneau M, Friedman NJ, Seibel B, Batlle J, Feliz R, Talamo J, Culbertson W. Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography. Sci Transl Med. 2010 Nov 17;2(58):58ra85. doi: 10.1126/scitranslmed.3001305.

Reference Type BACKGROUND
PMID: 21084720 (View on PubMed)

Masket S, Sarayba M, Ignacio T, Fram N. Femtosecond laser-assisted cataract incisions: architectural stability and reproducibility. J Cataract Refract Surg. 2010 Jun;36(6):1048-9. doi: 10.1016/j.jcrs.2010.03.027. No abstract available.

Reference Type BACKGROUND
PMID: 20494782 (View on PubMed)

Taketani F, Matuura T, Yukawa E, Hara Y. Influence of intraocular lens tilt and decentration on wavefront aberrations. J Cataract Refract Surg. 2004 Oct;30(10):2158-62. doi: 10.1016/j.jcrs.2004.02.072.

Reference Type BACKGROUND
PMID: 15474830 (View on PubMed)

Nagy Z, Takacs A, Filkorn T, Sarayba M. Initial clinical evaluation of an intraocular femtosecond laser in cataract surgery. J Refract Surg. 2009 Dec;25(12):1053-60. doi: 10.3928/1081597X-20091117-04.

Reference Type BACKGROUND
PMID: 20000286 (View on PubMed)

Benard A, Sitta R, Brezin AP, Cochener B, Monnet D, Denis P, Pisella PJ, Hayes N, Schweitzer C; FEMCAT Study Group. Cost Utility and Value of Information Analysis of Femtosecond Laser-Assisted Cataract Surgery. JAMA Ophthalmol. 2023 Jul 1;141(7):625-629. doi: 10.1001/jamaophthalmol.2023.1716.

Reference Type DERIVED
PMID: 37200037 (View on PubMed)

Schweitzer C, Brezin A, Cochener B, Monnet D, Germain C, Roseng S, Sitta R, Maillard A, Hayes N, Denis P, Pisella PJ, Benard A; FEMCAT study group. Femtosecond laser-assisted versus phacoemulsification cataract surgery (FEMCAT): a multicentre participant-masked randomised superiority and cost-effectiveness trial. Lancet. 2020 Jan 18;395(10219):212-224. doi: 10.1016/S0140-6736(19)32481-X.

Reference Type DERIVED
PMID: 31954466 (View on PubMed)

Schweitzer C, Hayes N, Brezin A, Cochener B, Denis P, Pisella PJ, Benard A; FEMCAT study group. Re: Abell et al.: Cost-effectiveness of femtosecond laser-assisted cataract surgery versus phacoemulsification cataract surgery (Ophthalmology 2014;121:10-6). Ophthalmology. 2014 Oct;121(10):e53-4. doi: 10.1016/j.ophtha.2014.05.025. Epub 2014 Jun 26. No abstract available.

Reference Type DERIVED
PMID: 24974812 (View on PubMed)

Other Identifiers

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CHUBX 2012/23

Identifier Type: -

Identifier Source: org_study_id

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