Staged and Combined Surgery for Cataract Patients With Corneal Endothelial Dysfunction

NCT ID: NCT02523950

Last Updated: 2016-04-29

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-03-31

Study Completion Date

2017-12-31

Brief Summary

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The purpose of this study is to evaluate the safety and efficacy of staged and combined phacoemulsification with intraocular lens implantation and Descemet membrane endothelial keratoplasty (DMEK) to treat cataract patients with corneal endothelial dysfunction. Surgical and postoperative complications, visual acuity and corneal endothelial cell density are evaluated.

Detailed Description

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The prospective, randomized, controlled study involves the enrollment of cataract patients with corneal endothelial dysfunction. All the patients will be randomly assigned with equal probability to the following two groups: 1. Staged group: phacoemulsification + IOL implantation is performed individually and DMEK is performed secondarily according to the corneal status of patients. During cataract surgery, viscoelastic materials and anterior lens capsule are used to protect the compromised corneal endothelium during phacoemulsification. After phacoemulsification and removal of all the lens material, a one-piece foldable IOL is implanted into the lens capsule. 2: Combined group: phacoemulsification + IOL implantation and DMEK is performed simultaneously. Standard procedures of phacoemulsification + IOL implantation are the same as in the staged group.

Patients enrolled into the study will be followed for one year and will have study visits at 1 day, 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months after each surgery.

Conditions

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Cataract Corneal Endothelial Keratopathy Phacoemulfisication+IOL Implantation Endothelial Keratopathy

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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Staged group

Procedure/Surgery: Phacoemulsification + IOL implantation is performed in the first stage and DMEK is performed secondarily.

Group Type ACTIVE_COMPARATOR

Staged phacoemulsification and DMEK

Intervention Type PROCEDURE

Stage 1. Phacoemulsification is performed individually. During phacoemulsification, viscoelastic materials and anterior lens capsule are used to protect corneal endothelial cells.

Stage 2. DMEK is performed secondarily according to the corneal status of patients.

Intraocular lens (IOL) implantation

Intervention Type DEVICE

After phacoemulsification and removal of all the lens material, a one-piece IOL is implanted into the lens capsule.

Combined group

Procedure/Surgery: Phacoemulsification + IOL implantation and DMEK are performed simultaneously.

Group Type ACTIVE_COMPARATOR

Combined phacoemulsification and DMEK

Intervention Type PROCEDURE

Routine phacoemulsification and DMEK are performed simultaneously.

Intraocular lens (IOL) implantation

Intervention Type DEVICE

After phacoemulsification and removal of all the lens material, a one-piece IOL is implanted into the lens capsule.

Interventions

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Staged phacoemulsification and DMEK

Stage 1. Phacoemulsification is performed individually. During phacoemulsification, viscoelastic materials and anterior lens capsule are used to protect corneal endothelial cells.

Stage 2. DMEK is performed secondarily according to the corneal status of patients.

Intervention Type PROCEDURE

Combined phacoemulsification and DMEK

Routine phacoemulsification and DMEK are performed simultaneously.

Intervention Type PROCEDURE

Intraocular lens (IOL) implantation

After phacoemulsification and removal of all the lens material, a one-piece IOL is implanted into the lens capsule.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subjects are older than 18 years.
2. Subjects have corneal endothelial dysfunction combined with cataract.
3. Subjects have mild to moderate cortical and/or nuclear cataract.
4. Subjects are able and willing to provide informed consent.

Exclusion Criteria

1. Subjects have corneal stromal opacity and/or neovascularization.
2. Subjects have other intraocular disease that disturbs visual rehabilitation.
3. Subjects have corneal infection, perforation or scarring.
4. Subjects are pregnant.
5. Subjects have concurrent disease that could confound the response to therapy.
6. Subjects are unlikely to comply with the protocol or likely to be lost to follow-up.
7. Subjects have known hypersensitivity or intolerance to the proposed therapy.
8. Subjects use concomitant therapy that affects either tear function or ocular surface integrity.
9. Subjects have had surgical or other manipulation of the eye that could confound the outcome parameters or interfere with the mechanism of action of the proposed intervention to be studied.
Minimum Eligible Age

19 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Haotian Lin

OTHER

Sponsor Role lead

Responsible Party

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Haotian Lin

M.D., Ph.D.

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Yizhi Liu, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Zhongshan Ophthalmic Center, Sun Yat-sen University

Locations

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Zhongshan Ophthalmic Center, Sun Yat-sen University

Guangzhou, Guangdong, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yujuan Wang, M.D., Ph.D.

Role: CONTACT

Phone: 8618620717002

Email: [email protected]

Ting Huang, M.D., Ph.D.

Role: CONTACT

Phone: 862087331540

Email: [email protected]

Facility Contacts

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Yujuan Wang, M.D., Ph.D.

Role: primary

References

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Wang Y, Xia Y, Zeng M, Liu X, Luo L, Chen B, Liu Y, Liu Y. Torsional ultrasound efficiency under different vacuum levels in different degrees of nuclear cataract. J Cataract Refract Surg. 2009 Nov;35(11):1941-5. doi: 10.1016/j.jcrs.2009.05.055.

Reference Type BACKGROUND
PMID: 19878827 (View on PubMed)

Huang T, Wang Y, Ji J, Gao N, Chen J. Deep lamellar endothelial keratoplasty for iridocorneal endothelial syndrome in phakic eyes. Arch Ophthalmol. 2009 Jan;127(1):33-6. doi: 10.1001/archophthalmol.2008.537.

Reference Type BACKGROUND
PMID: 19139335 (View on PubMed)

Luo L, Lin H, He M, Congdon N, Yang Y, Liu Y. Clinical evaluation of three incision size-dependent phacoemulsification systems. Am J Ophthalmol. 2012 May;153(5):831-839.e2. doi: 10.1016/j.ajo.2011.10.034. Epub 2012 Feb 4.

Reference Type BACKGROUND
PMID: 22310081 (View on PubMed)

Xia Y, Liu X, Luo L, Zeng Y, Cai X, Zeng M, Liu Y. Early changes in clear cornea incision after phacoemulsification: an anterior segment optical coherence tomography study. Acta Ophthalmol. 2009 Nov;87(7):764-8. doi: 10.1111/j.1755-3768.2008.01333.x. Epub 2009 Jun 22.

Reference Type BACKGROUND
PMID: 19548882 (View on PubMed)

Related Links

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http://www.gzzoc.com

Zhongshan Ophthalmic Center website

Other Identifiers

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2015MEKY047

Identifier Type: -

Identifier Source: org_study_id