The Effect of Punctal Plugs on Ocular Surface After Povidone-Iodine Preparation of Intravitreal Injection

NCT ID: NCT03945071

Last Updated: 2023-12-07

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

NA

Total Enrollment

126 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-06-01

Study Completion Date

2020-10-18

Brief Summary

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The aim of this study is to evaluate the effectiveness of punctal plugs in reducing ocular surface (eye surface) irritation after intravitreal injections prepared by povidone-iodine 5% solution.

Detailed Description

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Intravitreal injection is a shot of medication into the eye. Many retinal diseases, such as diabetic retinopathy, neovascular age-related macular degeneration, and retinal vein occlusions require regular, periodic injections. Patients often reports eye surface irritation post intravitreal injection. One of the reasons for such discomfort is attributed to povidone-iodine solution used to clean the eye surface to reduce sight-threatening infections. Patients who already experience symptoms of dry eye are at increased risk of discomfort after povidone-iodine prepped intravitreal injections.

Povidone-iodine is known to be corrosive to the corneal epithelium and delay eye surface healing. Human tears contain proteins and chemicals that lubricate, heal, and protect the eye surface from infections and irritants. Adequate tear film therefore not only dilutes povidone-iodine, but also promotes corneal healing post povidone-iodine prepping.

The primary long-term objective of the present study is to investigate whether punctal plugs will reduce eye discomfort post intravitreal injections as reported by the Ocular Surface Disease Index (OSDI) and other relevant surveys. The secondary outcome is to describe any other risk and protective factors associated with eye surface discomfort after intravitreal injections.

Conditions

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Dry Eye Syndromes Dry Eye Ocular Surface Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators

Study Groups

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Puntal plug

Subjects will receive temporary punctal plug after intravitreal injection

Group Type ACTIVE_COMPARATOR

Punctal plug

Intervention Type DEVICE

Punctal plug will be given to subjects after intravitreal injection in half of the study subjects

Non-Punctual plug

Subjects will not receive temporary punctal plug after intravitreal injection

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Punctal plug

Punctal plug will be given to subjects after intravitreal injection in half of the study subjects

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of age-related macula degeneration
* Clinical diagnosis of diabetic retinopathy
* Clinical diagnosis of retinal vein occlusion

Exclusion Criteria

* Currently wearing punctal plugs
* History of punctal cautery,
* Active ocular infection
* History of ocular infection
* Eyelid trauma
* Eyelid surgery
* Graft versus host disease
* Thyroid eye disease.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oklahoma

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vinay Shah, MD

Role: PRINCIPAL_INVESTIGATOR

University of Oklahoma

Locations

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Dean McGee Eye Institute

Oklahoma City, Oklahoma, United States

Site Status

Countries

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United States

References

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Goldberg RA. How to prevent endophthalmitis after intravitreal injections. Int J Retina Vitreous. 2015 Aug 11;1:12. doi: 10.1186/s40942-015-0012-9. eCollection 2015.

Reference Type BACKGROUND
PMID: 27847605 (View on PubMed)

Laude A, Lim JW, Srinagesh V, Tong L. The effect of intravitreal injections on dry eye, and proposed management strategies. Clin Ophthalmol. 2017 Aug 16;11:1491-1497. doi: 10.2147/OPTH.S136500. eCollection 2017.

Reference Type BACKGROUND
PMID: 28860698 (View on PubMed)

Marcet MM, Shtein RM, Bradley EA, Deng SX, Meyer DR, Bilyk JR, Yen MT, Lee WB, Mawn LA. Safety and Efficacy of Lacrimal Drainage System Plugs for Dry Eye Syndrome: A Report by the American Academy of Ophthalmology. Ophthalmology. 2015 Aug;122(8):1681-7. doi: 10.1016/j.ophtha.2015.04.034. Epub 2015 May 30.

Reference Type BACKGROUND
PMID: 26038339 (View on PubMed)

Ridder WH 3rd, Oquindo C, Dhamdhere K, Burke J. Effect of Povidone Iodine 5% on the Cornea, Vision, and Subjective Comfort. Optom Vis Sci. 2017 Jul;94(7):732-741. doi: 10.1097/OPX.0000000000001091.

Reference Type BACKGROUND
PMID: 28609415 (View on PubMed)

Saedon H, Nosek J, Phillips J, Narendran N, Yang YC. Ocular surface effects of repeated application of povidone iodine in patients receiving frequent intravitreal injections. Cutan Ocul Toxicol. 2017 Dec;36(4):343-346. doi: 10.1080/15569527.2017.1291665. Epub 2017 Feb 28.

Reference Type BACKGROUND
PMID: 28166657 (View on PubMed)

Other Identifiers

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9810

Identifier Type: -

Identifier Source: org_study_id