Evaluation do Early Pars Plana Vitrectomy in Acute Endophthalmitis

NCT ID: NCT04192994

Last Updated: 2024-05-24

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

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-01

Study Completion Date

2023-12-01

Brief Summary

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Our study will evaluate the efficacy of early PPV in acute endophthalmitis and attempt to prove its greater effectiveness for combating infection when compared to eyes that received only intravitreal antibiotic therapy

Detailed Description

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Endophthalmitis, a severe inflammatory ocular condition with profound visual impairment that can lead to irreversible visual loss, requires immediate treatment.

The only multicenter randomized trial of different forms of acute endophthalmitis treatment was the Endophthalmitis Vitrectomy Study. The study concluded that intravitreal antibiotic injection improves visual prognosis, and pars plana vitrectomy (PPV) improves the final visual acuity (VA) when performed in patients with light perception or worse VA.

Our study will evaluate the efficacy of early PPV in acute endophthalmitis and attempt to prove its greater effectiveness for combating infection when compared to eyes that received only intravitreal antibiotic therapy.

Primary Endpoint: The final VA, ocular anatomy, retinal layer anatomy, and ERG response in the intravitreal injection group will be compared with the PPV group.

Secondary Endpoint: The final VA, eyeball anatomy, retinal layer anatomy, and ERG response in the group that underwent PPV will be compared with and without oral moxifloxacin therapy.

Conditions

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Endophthalmitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Group 1: Intravitreal Antibiotic: Group 1a: intravitreal antibiotic isolated; group 1b: intravitreal antibiotic isolated + oral moxifloxacin.

Group 2: PPV: Group 2a: PPV + intraoperative intravitreal antibiotic ; group 2b: PPV + oral moxifloxacin.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group 1: Antibiotic injection

A total of 0.05 ml of vancomycin 1 mg and 0.05 ml of ceftazidime 2.25 mg will be injected with a 30-gauge needle into the vitreous cavity of the affected eyes in the randomized group, as soon as the diagnosis is confirmed.

Group Type ACTIVE_COMPARATOR

Pars Plana Vitrectomy

Intervention Type PROCEDURE

Pars Plana Vitrectomy

Group 2: Pars Plana Vitrectomy

Randomized patients will undergo PPV. Briefly, a blepharostat will be placed followed by instillation of a drop of 5% iodine-povidone over the eye. Under a surgical microscope, three 23-gauge or 25-gauge sclerotomies will be performed. Vitreous core vitrectomy will be performed, and a fluid-gas exchange with balanced saline solution (BSS) or 5,000 grams of silicone oil as a vitreous substitute. At the end of surgery, all sclerotomies will be sutured with Vicryl 7.0 and a total of 0.05 ml of vancomycin 1 mg and 0.05 ml of ceftazidime 2.25 mg will be injected into the vitreous cavity. As soon as the diagnosis is confirmed.

Group Type ACTIVE_COMPARATOR

Intravitreal Antibiotic Injection

Intervention Type DRUG

Intravitreal Antibiotic Injection

Interventions

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Intravitreal Antibiotic Injection

Intravitreal Antibiotic Injection

Intervention Type DRUG

Pars Plana Vitrectomy

Pars Plana Vitrectomy

Intervention Type PROCEDURE

Other Intervention Names

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Tap Injection PPV

Eligibility Criteria

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Inclusion Criteria

* Patients with acute endophthalmitis with a history of ocular surgical procedures and a follow-up time of less than 6 weeks will be included.

Exclusion Criteria

* Patients with endophthalmitis lasting more than 6 weeks and no history of eye surgery will be excluded.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vinicius Campos Bergamo

UNKNOWN

Sponsor Role collaborator

Nilva Simeren Bueno de Moraes

UNKNOWN

Sponsor Role collaborator

Luis Filipe Nakayama

UNKNOWN

Sponsor Role collaborator

Natasha Ferreira Santos da Cruz

UNKNOWN

Sponsor Role collaborator

Murilo Ubukata Polizelli

UNKNOWN

Sponsor Role collaborator

Federal University of São Paulo

OTHER

Sponsor Role lead

Responsible Party

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Mauricio Maia

Principal Investigator, Clinical Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Dept of Ophthalmology - UNIFESP/Hospital São Paulo

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Bergamo VC, Nakayama LF, de Moraes NSB, Tavares IM, De Queiroz Campos MS, Hofling-Lima AL, Maia M. Postoperative endophthalmitis treatment with antibiotics associated or not with pars plana vitrectomy: a randomized clinical trial. Int J Retina Vitreous. 2025 Feb 18;11(1):18. doi: 10.1186/s40942-025-00640-1.

Reference Type DERIVED
PMID: 39966901 (View on PubMed)

Other Identifiers

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END_2019

Identifier Type: -

Identifier Source: org_study_id

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