Clinical Efficacy and Safety of Minimally Invasive Glaucoma Surgery on Primary Angle Closure Glaucoma

NCT ID: NCT02964676

Last Updated: 2016-11-28

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

246 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-31

Study Completion Date

2019-12-31

Brief Summary

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To evaluate the clinical efficacy (intraocular pressure reduction , success rate, the number of antiglaucoma medication) and safety of ab interno trabeculectomy (AIT) with Trabectome in Chinese PACG .

Detailed Description

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A randomized, single blind, positive parallel control study method was used.This prospective case series will recruit 246 Chinese POAG, 123 cases in the experimental group will receive AIT treatment and 123 cases in the control group will receive trabeculectomy(Trab) surgery.Measurements of intraocular pressure(IOP) , visual acuity, refraction, slit lamp examination of the anterior segment and fundus, optical coherence tomography(OCT) to detect retinal nerve fiber layer thickness, macular thickness, visual field, gonioscopy and ultrasonic biological microscopy (UBM) will be recorded.They will be followed up for 12 months. The main outcome is success rate of IOP reduction and the other outcome are the number of antiglaucoma medication and complications .

Conditions

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Glaucoma, Angle-Closure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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AIT group

PACG in AIT group will receive ab interno trabeculectomy with Trabectome and before AIT, Laser Peripheral Iridectomy (LPI) will be performed first.

Group Type EXPERIMENTAL

ab interno trabeculectomy with Trabectome

Intervention Type PROCEDURE

123 PACG will be recruited to receive ab interno trabeculectomy with Trabectome and before this surgery, laser peripheral iridectomy will be performed firstly

Trab group

PACG in AIT group will receive trabeculectomy.

Group Type ACTIVE_COMPARATOR

trabeculectomy

Intervention Type PROCEDURE

123 PACG will be recruited to receive trabeculectomy to reduce IOP

Interventions

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ab interno trabeculectomy with Trabectome

123 PACG will be recruited to receive ab interno trabeculectomy with Trabectome and before this surgery, laser peripheral iridectomy will be performed firstly

Intervention Type PROCEDURE

trabeculectomy

123 PACG will be recruited to receive trabeculectomy to reduce IOP

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Primary Angle Closure Glaucoma (PACG) with visible trabecular meshwork from 90︒ to 180︒ on gonioscopy and IOP couldn't be controlled ≤21mmHg with pilocarpine eye drop only.
* willing to accept the antiglaucoma surgery
* volunteer to participate in this study and be able to follow up on time
* previous antiglaucoma filtering surgery or laser surgery(LPI, SLT) and previous cataract surgery were not ruled out

Exclusion Criteria

* visual acuity lower than HM or central tubular visual field
* corneal edema or large pterygium affecting the observation of anterior angle
* the demarcation of the scleral process and trabecular meshwork is not clear on gonioscopy
* new vessels on the iris surface or in the anterior angle chamber
* the eye received surgery is the only eye with visual function, that is the contralateral eye is blind
* requiring long-term use of anticoagulant drugs for systemic reasons
* abnormal coagulation function
* with specific clear scar physique
* cannot participate in follow-up
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Eye Disease Prevention and Treatment Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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LING GE, M.d.

Role: PRINCIPAL_INVESTIGATOR

Shanghai Eye Disease Prevention and Treatment Center

Central Contacts

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LING GE, M.d.

Role: CONTACT

Phone: +86-21-62717733

Email: [email protected]

XIAOLING FANG, M.d.

Role: CONTACT

Phone: +86-21-62717733

Email: [email protected]

References

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Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Gordon MO. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002 Jun;120(6):701-13; discussion 829-30. doi: 10.1001/archopht.120.6.701.

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Palanca-Capistrano AM, Hall J, Cantor LB, Morgan L, Hoop J, WuDunn D. Long-term outcomes of intraoperative 5-fluorouracil versus intraoperative mitomycin C in primary trabeculectomy surgery. Ophthalmology. 2009 Feb;116(2):185-90. doi: 10.1016/j.ophtha.2008.08.009. Epub 2008 Oct 18.

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Wang M, Fang M, Bai YJ, Zhang WZ, Lin MK, Liu BQ, Hao YT, Ling YL, Zhuo YH, Ge J. Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angle-closure glaucoma. Chin Med J (Engl). 2012 Apr;125(8):1429-33.

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Reference Type BACKGROUND
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Wang M, Ge J, Lin MK, Zhuo YH, Ling YL, Fang M, Liu X, Peng SX, Yu MB. [Clinical observation of trabeculectomy for primary angle closure glaucoma]. Zhonghua Yan Ke Za Zhi. 2009 Apr;45(4):338-43. Chinese.

Reference Type BACKGROUND
PMID: 19575967 (View on PubMed)

Sihota R, Gupta V, Agarwal HC. Long-term evaluation of trabeculectomy in primary open angle glaucoma and chronic primary angle closure glaucoma in an Asian population. Clin Exp Ophthalmol. 2004 Feb;32(1):23-8. doi: 10.1046/j.1442-9071.2004.00752.x.

Reference Type BACKGROUND
PMID: 14746586 (View on PubMed)

Tsai HY, Liu CJ, Cheng CY. Combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma. Br J Ophthalmol. 2009 Jul;93(7):943-8. doi: 10.1136/bjo.2008.151803. Epub 2009 Apr 20.

Reference Type BACKGROUND
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Reference Type BACKGROUND
PMID: 12967799 (View on PubMed)

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Reference Type BACKGROUND
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DeBry PW, Perkins TW, Heatley G, Kaufman P, Brumback LC. Incidence of late-onset bleb-related complications following trabeculectomy with mitomycin. Arch Ophthalmol. 2002 Mar;120(3):297-300. doi: 10.1001/archopht.120.3.297.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Ho CL, Lai JS, Aquino MV, Rojanapongpun P, Wong HT, Aquino MC, Gerber Y, Belkin M, Barkana Y. Selective laser trabeculoplasty for primary angle closure with persistently elevated intraocular pressure after iridotomy. J Glaucoma. 2009 Sep;18(7):563-6. doi: 10.1097/IJG.0b013e318193c2d1.

Reference Type BACKGROUND
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Mosaed S, Dustin L, Minckler DS. Comparative outcomes between newer and older surgeries for glaucoma. Trans Am Ophthalmol Soc. 2009 Dec;107:127-33.

Reference Type RESULT
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Minckler D, Mosaed S, Dustin L, Ms BF; Trabectome Study Group. Trabectome (trabeculectomy-internal approach): additional experience and extended follow-up. Trans Am Ophthalmol Soc. 2008;106:149-59; discussion 159-60.

Reference Type RESULT
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Vinod K, Gedde SJ. Ab interno trabeculectomy: patient selection and perspectives. Clin Ophthalmol. 2016 Aug 17;10:1557-64. doi: 10.2147/OPTH.S99746. eCollection 2016.

Reference Type RESULT
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Minckler D, Baerveldt G, Ramirez MA, Mosaed S, Wilson R, Shaarawy T, Zack B, Dustin L, Francis B. Clinical results with the Trabectome, a novel surgical device for treatment of open-angle glaucoma. Trans Am Ophthalmol Soc. 2006;104:40-50.

Reference Type RESULT
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Maeda M, Watanabe M, Ichikawa K. Evaluation of trabectome in open-angle glaucoma. J Glaucoma. 2013 Mar;22(3):205-8. doi: 10.1097/IJG.0b013e3182311b92.

Reference Type RESULT
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Werth JP, Gesser C, Klemm M. [Diverse effectiveness of the trabectome for different types of glaucoma]. Klin Monbl Augenheilkd. 2015 Jan;232(1):72-8. doi: 10.1055/s-0034-1383010. Epub 2014 Oct 1. German.

Reference Type RESULT
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Lee JWY, Yick DWF, Tsang S, Yuen CYF, Lai JSM. Efficacy and Safety of Trabectome Surgery in Chinese Open-Angle Glaucoma. Medicine (Baltimore). 2016 Apr;95(15):e3212. doi: 10.1097/MD.0000000000003212.

Reference Type RESULT
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Jea SY, Mosaed S, Vold SD, Rhee DJ. Effect of a failed trabectome on subsequent trabeculectomy. J Glaucoma. 2012 Feb;21(2):71-5. doi: 10.1097/IJG.0b013e31820bcfda.

Reference Type RESULT
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Huang P, Wang H, Wu H, Sun Y, Wang M, Cui Y, Qiu W, Yang Y, Ren Z, Zhang C, Wang N. [Preliminary investigation on the safety and efficacy of Trabectome]. Zhonghua Yan Ke Za Zhi. 2015 Feb;51(2):115-9. Chinese.

Reference Type RESULT
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Bussel II, Kaplowitz K, Schuman JS, Loewen NA; Trabectome Study Group. Outcomes of ab interno trabeculectomy with the trabectome by degree of angle opening. Br J Ophthalmol. 2015 Jul;99(7):914-9. doi: 10.1136/bjophthalmol-2014-305577. Epub 2014 Oct 21.

Reference Type RESULT
PMID: 25336577 (View on PubMed)

Other Identifiers

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YFZX2016002

Identifier Type: -

Identifier Source: org_study_id