Study for Optimizing Anti-inflammatory Prophylaxis

NCT ID: NCT03383328

Last Updated: 2019-12-20

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

PHASE4

Total Enrollment

470 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-01

Study Completion Date

2019-12-18

Brief Summary

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The purpose of this study is to investigate which anti-inflammatory treatment is best at preventing postoperative inflammation following cataract surgery. We want to compare topical prophylaxis with NSAID eye drops to topical prophylaxis with a combination of NSAID and prednisolone. We also want to compare topical prophylaxis with eye drops to drop-less surgery where the anti-inflammatory drug is administered to the subtenonal space at the conclusion of the surgical procedure. In addition, we want to investigate if topical anti-inflammatory prophylaxis should be initiated preoperatively or postoperatively. The primary outcome is change in central macular thickness, measured by optical coherence tomography, 3 months after surgery.

Detailed Description

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Conditions

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Postoperative Cystoid Macular Edema Irvine-Gass Syndrome

Keywords

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Cataract Cataract Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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NSAID + prednisolone, preoperative

Combination of NSAID- and prednisolone eye drops. Treatment is initiated 3 days prior to surgery and administered 3 times pr. day for 3 weeks.

Ketorolactrometamol 5 mg/ml, eye drops, 1 drop 3 times pr. day Prednisolone acetate 1% w/v, eye drops, 1 drop 3 times pr. day

Group Type ACTIVE_COMPARATOR

NSAID + prednisolone, preoperative

Intervention Type DRUG

Ketorolactrometamol 5 mg/ml and prednisolone acetate 1% w/v eye drops are administered 3 times pr. day, starting 3 days prior to surgery and until 3 weeks after surgery.

NSAID + prednisolone, postoperative

Combination of NSAID- and prednisolone eye drops. Treatment is initiated on the day of surgery and administered 3 times pr. day for 3 weeks.

Ketorolactrometamol 5 mg/ml, eye drops, 1 drop 3 times pr. day Prednisolone acetate 1% w/v, eye drops, 1 drop 3 times pr. day

Group Type ACTIVE_COMPARATOR

NSAID + prednisolone, postoperative

Intervention Type DRUG

Ketorolactrometamol 5 mg/ml and prednisolone acetate 1% w/v eye drops are administered 3 times pr. day, starting on the day of surgery and until 3 weeks after surgery.

NSAID, preoperative

NSAID eye drops as monotherapy. Treatment is initiated 3 days prior to surgery and administered 3 times pr. day for 3 weeks.

Ketorolactrometamol 5 mg/ml, eye drops, 1 drop 3 times pr. day

Group Type EXPERIMENTAL

NSAID, preoperative

Intervention Type DRUG

Ketorolactrometamol 5 mg/ml eye drops are administered 3 times pr. day, starting 3 days prior to surgery and until 3 weeks after surgery.

NSAID, postoperative

NSAID eye drops as monotherapy. Treatment is initiated on the day of surgery and administered 3 times pr. day for 3 weeks.

Ketorolactrometamol 5 mg/ml, eye drops, 1 drop 3 times pr. day

Group Type EXPERIMENTAL

NSAID, postoperative

Intervention Type DRUG

Ketorolactrometamol 5 mg/ml eye drops are administered 3 times pr. day, starting on the day of surgery and until 3 weeks after surgery.

Drop-less surgery

A depot of dexamethasone is administered subtenonally during surgery.

Dexamethason Krka 4 mg/ml solution for injection/infusion. 0,5 ml equivalent to 2 mg of dexamethasone is administered once.

Group Type EXPERIMENTAL

Drop-less surgery

Intervention Type DRUG

A depot of 0.5 ml Dexamethason Krka 4 mg/ml solution for injection/infusion is administered during cataract surgery.

Interventions

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NSAID + prednisolone, preoperative

Ketorolactrometamol 5 mg/ml and prednisolone acetate 1% w/v eye drops are administered 3 times pr. day, starting 3 days prior to surgery and until 3 weeks after surgery.

Intervention Type DRUG

NSAID + prednisolone, postoperative

Ketorolactrometamol 5 mg/ml and prednisolone acetate 1% w/v eye drops are administered 3 times pr. day, starting on the day of surgery and until 3 weeks after surgery.

Intervention Type DRUG

NSAID, preoperative

Ketorolactrometamol 5 mg/ml eye drops are administered 3 times pr. day, starting 3 days prior to surgery and until 3 weeks after surgery.

Intervention Type DRUG

NSAID, postoperative

Ketorolactrometamol 5 mg/ml eye drops are administered 3 times pr. day, starting on the day of surgery and until 3 weeks after surgery.

Intervention Type DRUG

Drop-less surgery

A depot of 0.5 ml Dexamethason Krka 4 mg/ml solution for injection/infusion is administered during cataract surgery.

Intervention Type DRUG

Other Intervention Names

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Group a1 Group a2 Group b1 Group b2 Group c

Eligibility Criteria

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Inclusion Criteria

* Patients with age-related cataracts
* Older than 18 years
* Women must be postmenopausal. Women are asked if they have menstruated within the preceding 12 months.
* Capacity to consent
* Scheduled to undergo cataract surgery at the ophthalmic department at Rigshospitalet-Glostrup, Denmark
* The surgeon must be experienced, defined by a minimum of 1000 cataract extractions completed
* Only 1 eye can be included for each participant, but there are no restrictions as to whether it is the eye that undergoes surgery first or last. If both eyes of a participant are eligible, it will be decided by randomization which eye to be included in the study
* Informed consent to participation

Exclusion Criteria

* Known allergy to any of the contents of the pharmaceuticals (active and in-active ingredients) used in the study
* Medical history of epiretinal membrane, retinal vein occlusion, retinal detachment, uveitis, glaucoma, diabetes mellitus, exudative age-related macular degeneration (AMD) or AMD with geographical atrophy
* Significant complications to surgery such as posterior capsule rupture/vitreous loss, choroidal hemorrhage, and dislocated lens material
* Pregnancy
* Fertile women, i.e. women who are not menopausal.
* Women who breastfeed
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Line Kessel

OTHER

Sponsor Role lead

Responsible Party

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Line Kessel

Consultant ophthalmologist, Associate Professor, MD, Ph.D., FEBO

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Line Kessel, MD, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Dpt. of Ophthalmology, Rigshospitalet-Glostrup

Locations

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Department of Ophthalmology

Glostrup Municipality, Capital Region, Denmark

Site Status

Countries

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Denmark

References

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Erichsen JH, Holm LM, Forslund Jacobsen M, Forman JL, Kessel L. Prednisolone and Ketorolac vs Ketorolac Monotherapy or Sub-Tenon Prophylaxis for Macular Thickening in Cataract Surgery: A Randomized Clinical Trial. JAMA Ophthalmol. 2021 Oct 1;139(10):1062-1070. doi: 10.1001/jamaophthalmol.2021.2976.

Reference Type DERIVED
PMID: 34383010 (View on PubMed)

Erichsen JH, Forman JL, Holm LM, Kessel L. Effect of anti-inflammatory regimen on early postoperative inflammation after cataract surgery. J Cataract Refract Surg. 2021 Mar 1;47(3):323-330. doi: 10.1097/j.jcrs.0000000000000455.

Reference Type DERIVED
PMID: 33086290 (View on PubMed)

Other Identifiers

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SOAP1

Identifier Type: -

Identifier Source: org_study_id