Modified Müller's Muscle-conjunctival Resection Internal Ptosis Repair Using Fibrin Glue

NCT ID: NCT03392272

Last Updated: 2018-01-05

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-01

Study Completion Date

2020-02-01

Brief Summary

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Fibrin glue is widely used in ophthalmology for homeostasis and tissue recovery. It is commonly used in ocular surface surgeries such as pterygium removal and conjunctival lesions excisions. In Müller's muscle-conjunctival resection (MMCR), sutures are used to reconnect the conjunctiva and Muller muscle, which causes discomfort and pain for the patient. The investigators' goal is to explore using fibrin glue instead of sutures in MMCR surgeries to shorten the procedure's length and alleviate patients discomfort and pain. This is especially important in the management of children suffering ptosis, where sedation and even general anaesthesia is required for sutured removal as a secondary procedure.

Detailed Description

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Fibrin glue is widely used in ophthalmology for homeostasis and tissue recovery. It is commonly used in ocular surface surgeries such as pterygium removal and conjunctival lesions excisions.

Müller's muscle-conjunctival resection (MMCR) is the most common surgery for ptosis correction and is normally performed under local anaesthesia. In MMCR, a portion of the Muller and conjunctiva is resected, and sutures are used to reconnect the remaining edges. The suturing process requires several minutes and causes discomfort to the patient. In addition, many patients experience post operative discomfort due to the touch of the sutures in the superior ocular surface until their removal about 7-14 days post op. Moreover, the sutures removal process is commonly unpleasant, and in the pediatric patients requires sedation or general anaesthesia.

The investigators' goal is to explore using fibrin glue instead of sutures in MMCR surgeries to shorten the procedure's length and alleviate patients discomfort and pain. This is especially important in the management of children suffering ptosis, where sedation and even general anaesthesia is required for sutured removal as a secondary procedure.

Methods:

A prospective randomized study. Patients will be randomized into traditional MMCR using sutures, vs. MMCR using tisseel glue. Follow up will take place 1 day, 7 days, 1 month and 3 months post op. Main outcome measures included patient reported outcome such as pain grade and discomfort, and success of ptosis repair surgery defined by improvement in margin reflex distance, symmetry of upper eyelid position, and incidence of complications.

Conditions

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Ptosis, Eyelid Ptosis; Eyelid, Congenital Surgical Procedure, Unspecified

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A prospective randomized study
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers
The physician will randomly assign the patient into the tisseel group or the sutures group

Study Groups

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Tisseel

Müller's Muscle-Conjunctival Resection (MMCR) using glue instead of sutures

Group Type EXPERIMENTAL

Using of Tisseel fibrin glue

Intervention Type DEVICE

Using of Tisseel fibrin glue instead of sutures in Müller's Muscle-Conjunctival Resection (MMCR) surgeries

Sutures

Müller's Muscle-Conjunctival Resection (MMCR) using the usual procedure

Group Type ACTIVE_COMPARATOR

Using sutures

Intervention Type OTHER

Using sutures in Müller's Muscle-Conjunctival Resection (MMCR) surgeries

Interventions

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Using of Tisseel fibrin glue

Using of Tisseel fibrin glue instead of sutures in Müller's Muscle-Conjunctival Resection (MMCR) surgeries

Intervention Type DEVICE

Using sutures

Using sutures in Müller's Muscle-Conjunctival Resection (MMCR) surgeries

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Patients with ptosis referred to Müller's Muscle-Conjunctival Resection (MMCR)

Exclusion Criteria

Previous eyelid surgery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sheba Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Dr. Guy Ben-Simon, MD

Head, oculoplastic unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sheba_Medical_Center

Ramat Gan, , Israel

Site Status

Countries

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Israel

References

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Putterman AM, Urist MJ. Muller muscle-conjunctiva resection. Technique for treatment of blepharoptosis. Arch Ophthalmol. 1975 Aug;93(8):619-23. doi: 10.1001/archopht.1975.01010020595007.

Reference Type BACKGROUND
PMID: 1156223 (View on PubMed)

Liu MT, Totonchi A, Katira K, Daggett J, Guyuron B. Outcomes of mild to moderate upper eyelid ptosis correction using Muller's muscle-conjunctival resection. Plast Reconstr Surg. 2012 Dec;130(6):799e-809e. doi: 10.1097/PRS.0b013e31826d9cb0.

Reference Type BACKGROUND
PMID: 23190831 (View on PubMed)

Mercandetti M, Putterman AM, Cohen ME, Mirante JP, Cohen AJ. Internal levator advancement by Muller's muscle-conjunctival resection: technique and review. Arch Facial Plast Surg. 2001 Apr-Jun;3(2):104-10. doi: 10.1001/archfaci.3.2.104.

Reference Type BACKGROUND
PMID: 11368662 (View on PubMed)

Carruth BP, Meyer DR. Simplified Muller's muscle-conjunctival resection internal ptosis repair. Ophthalmic Plast Reconstr Surg. 2013 Jan-Feb;29(1):11-4. doi: 10.1097/IOP.0b013e31826afb6b.

Reference Type BACKGROUND
PMID: 23034694 (View on PubMed)

Zloto O, Greenbaum E, Fabian ID, Ben Simon GJ. Evicel versus Tisseel versus Sutures for Attaching Conjunctival Autograft in Pterygium Surgery: A Prospective Comparative Clinical Study. Ophthalmology. 2017 Jan;124(1):61-65. doi: 10.1016/j.ophtha.2016.09.010. Epub 2016 Nov 3.

Reference Type BACKGROUND
PMID: 27817915 (View on PubMed)

Other Identifiers

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SHEBA-17-4383-GBS

Identifier Type: -

Identifier Source: org_study_id

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