Telemedicine Follow-up for Routine, Low-Risk Oculoplastic Surgery

NCT ID: NCT04235803

Last Updated: 2020-11-04

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-01

Study Completion Date

2021-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The investigators propose utilizing a simple telemedical protocol to allow patients to substitute the first post-operative visit with a remote survey that includes essential post-operative history, vision measurement, and photographs, all of which can be provided using a personal computer, tablet, or smart phone. The investigators have selected for this purpose a subset of oculoplastic procedures involving the eyelid and lacrimal system that have well-reported low rates of serious complications, since high-risk procedures will likely always require close, in-person care. The investigators hypothesize that telemedicine follow-up for the first post-operative week after low-risk oculoplastic surgery will decrease the time burden on patients without compromising their satisfaction or increase the risk of late post-operative complications.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Eyelid Diseases Ptosis, Eyelid Blepharoptosis Dermatochalasis Ectropion Entropion Eyelid Tumor Skin Cancer, Eyelid Floppy Eyelid Syndrome

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomization to telemedicine follow-up versus routine in-person follow-up for the 1 week assessment after low-risk oculoplastic surgery.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Telemedicine

Patients in the telemedicine arm will have their post-operative week one visit via a telemedicine portal.

Group Type EXPERIMENTAL

Telemedicine follow-up

Intervention Type OTHER

A telemedicine follow-up form based in REDCap that collects information from the patient including: history, photographs, vision measurement, and questions.

Routine

Patient in the routine arm will have their post-operative week one visit in clinic.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Telemedicine follow-up

A telemedicine follow-up form based in REDCap that collects information from the patient including: history, photographs, vision measurement, and questions.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Are age 18 years or older
* Are fluent in English
* Own or have ready access to a smart phone, tablet, or personal computer with high speed internet
* Participate in an informed consent process with the surgeon(s) including documentation of written informed consent
* Are undergoing a low-risk\* eyelid procedure in a clinic, ambulatory surgery center, or hospital operating room setting, including but not limited to:

* upper eyelid blepharoplasty repair
* ectropion repair
* entropion repair
* external levator resection
* internal levator resection
* eyelid lesion removal and/or biopsy
* eyelid reconstruction and defect repair including after Mohs' surgery
* eyelid tightening procedures for Floppy Eyelid Syndrome
* tarsorrhaphy
* dacryocystorhinostomy

(\*)These listed procedures have a low reported rate of serious complications including vision loss, infection, severe bleeding, or death; however, surgical risk is ultimately determined by the surgeon on a per-patient basis, except in those cases specifically excluded in the subsequent section.

Exclusion Criteria

* Are under the age of 18 years
* Are incarcerated
* Are pregnant or plan to become pregnant during the period of surgery and 3 month recovery (however these patients are not eligible for elective eyelid surgery)
* Are not fluent in English
* Do not have access to or do not feel comfortable using a smart phone, tablet, or personal computer
* Lack personal capacity for consent (i.e. those patients requiring consent for the surgery by a legal representative are excluded)
* Experience a serious intra-operative complication (this criterion is assessed after initial consent)
* Are undergoing eyelid or other oculoplastic procedures that are deemed greater than low-risk for serious complications, including but not limited to:

* orbital surgery
* lower eyelid blepharoplasty
* repair of extensive eyelid defects following Mohs' surgery (roughly \>33%)
* procedures requiring skin grafting
* procedures requiring extensive tissue rearrangement
* procedures involving an implant (e.g. frontalis sling, gold weight implantation; except dacryocystorhinostomy due to the low-risk nature of the lacrimal stent)
* procedures requiring in-person care at the first post-operative week (e.g. suture removal, bolster removal, patch removal)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Davin C Ashraf, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of California, San Francisco

San Francisco, California, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Davin C Ashraf, MD

Role: CONTACT

415-353-2800

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Davin C Ashraf, MD

Role: primary

415-353-2800

References

Explore related publications, articles, or registry entries linked to this study.

Vyas KS, Hambrick HR, Shakir A, Morrison SD, Tran DC, Pearson K, Vasconez HC, Mardini S, Gosman AA, Dobke M, Granick MS. A Systematic Review of the Use of Telemedicine in Plastic and Reconstructive Surgery and Dermatology. Ann Plast Surg. 2017 Jun;78(6):736-768. doi: 10.1097/SAP.0000000000001044.

Reference Type BACKGROUND
PMID: 28328635 (View on PubMed)

Hwa K, Wren SM. Telehealth follow-up in lieu of postoperative clinic visit for ambulatory surgery: results of a pilot program. JAMA Surg. 2013 Sep;148(9):823-7. doi: 10.1001/jamasurg.2013.2672.

Reference Type BACKGROUND
PMID: 23842982 (View on PubMed)

Kummerow Broman K, Roumie CL, Stewart MK, Castellanos JA, Tarpley JL, Dittus RS, Pierce RA. Implementation of a Telephone Postoperative Clinic in an Integrated Health System. J Am Coll Surg. 2016 Oct;223(4):644-51. doi: 10.1016/j.jamcollsurg.2016.07.010. Epub 2016 Aug 18.

Reference Type BACKGROUND
PMID: 27545100 (View on PubMed)

Robaldo A, Rousas N, Pane B, Spinella G, Palombo D. Telemedicine in vascular surgery: clinical experience in a single centre. J Telemed Telecare. 2010;16(7):374-7. doi: 10.1258/jtt.2010.091011. Epub 2010 Aug 2.

Reference Type BACKGROUND
PMID: 20679407 (View on PubMed)

Williams AM, Bhatti UF, Alam HB, Nikolian VC. The role of telemedicine in postoperative care. Mhealth. 2018 May 2;4:11. doi: 10.21037/mhealth.2018.04.03. eCollection 2018.

Reference Type BACKGROUND
PMID: 29963556 (View on PubMed)

Carter SR, Stewart JM, Khan J, Archer KF, Holds JB, Seiff SR, Dailey RA. Infection after blepharoplasty with and without carbon dioxide laser resurfacing. Ophthalmology. 2003 Jul;110(7):1430-2. doi: 10.1016/S0161-6420(03)00447-0.

Reference Type BACKGROUND
PMID: 12867404 (View on PubMed)

Chang S, Lehrman C, Itani K, Rohrich RJ. A systematic review of comparison of upper eyelid involutional ptosis repair techniques: efficacy and complication rates. Plast Reconstr Surg. 2012 Jan;129(1):149-157. doi: 10.1097/PRS.0b013e318230a1c7.

Reference Type BACKGROUND
PMID: 22186506 (View on PubMed)

Lee EW, Holtebeck AC, Harrison AR. Infection rates in outpatient eyelid surgery. Ophthalmic Plast Reconstr Surg. 2009 Mar-Apr;25(2):109-10. doi: 10.1097/IOP.0b013e3181994124.

Reference Type BACKGROUND
PMID: 19300151 (View on PubMed)

Mejia JD, Egro FM, Nahai F. Visual loss after blepharoplasty: incidence, management, and preventive measures. Aesthet Surg J. 2011 Jan;31(1):21-9. doi: 10.1177/1090820X10391212.

Reference Type BACKGROUND
PMID: 21239669 (View on PubMed)

Kam KY, Cole CJ, Bunce C, Watson MP, Kamal D, Olver JM. The lateral tarsal strip in ectropion surgery: is it effective when performed in isolation? Eye (Lond). 2012 Jun;26(6):827-32. doi: 10.1038/eye.2012.34. Epub 2012 Mar 9.

Reference Type BACKGROUND
PMID: 22402697 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

Eye plastic telemedicine

Identifier Type: -

Identifier Source: org_study_id