Patient Reported Visual Satisfaction Following Same Day or Delayed Bilateral Cataract Surgery

NCT ID: NCT05069753

Last Updated: 2021-10-21

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

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-01

Study Completion Date

2022-08-31

Brief Summary

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Cataract is currently the leading cause of visual impairment worldwide with age being the most common cause of lenticular opacification. As cataract surgery is the most commonly performed elective surgery worldwide, forecasts of an increasing number of elderly individuals make it clear that efficient and evidence based models for managing cataract in the future need to be implemented to manage the broadening gap between intervention and available resources.

Bilateral cataract is currently treated using same day separate surgical procedures (immediate sequential bilateral cataract surgery (ISBCS) or on separate days (delayed sequential bilateral cataract surgery (DSBCS). Whether one approach is more ideal than the other is an ongoing debate. There is, however, a clear advantage of same day surgery on resource management.

The primary purpose of this clinical study is to measure the patient reported satisfaction regarding vision in a group of 300 participants following either same day or delayed bilateral cataract surgery.

Detailed Description

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In this study, patient reported satisfaction in regards to vision is measured using a questionnaire based on the validated Catquest-7SF questionnaire. This is a 7-item self-report scale with both general questions related to difficulties in performing daily activities and satisfaction with vision, as well as questions assessing performance in specific daily activities. Each question has multiple predefined response categories ranging from "very great difficulty" to "no difficulty". One question has response categories ranging from "very dissatisfied" to "very satisfied". All questions have a "can't say"-response category. Each response will be translated to a numerical value used to score the participants.

In addition to the Catquest-7SF, the questionnaire used will also include questions related to satisfaction with the surgical approach (same day or delayed) and experiences with and knowledge of complex visual hallucinations.

The additional questions about complex visual hallucinations are used to measure prevalence and knowledge of Charles Bonnet Syndrome among participants referred to elective cataract surgery.

The study is a prospective, randomized cohort study and will include 300 consecutive patients referred to our department for elective bilateral cataract surgery. Eligible patients who provide consent will be randomly allocated in a group of either same day bilateral surgery or surgery on two days separated by one week. In case of serious surgical complications in the same day group, surgery of the second eye will be postponed and the participant will be placed in a new, separate group.

During a preoperative visit to the department, participants will fill out the questionnaire regarding vision and be subjected to the routine clinical ophthalmic examination which includes biometry and refraction status. One day post-surgery, participants will be contacted by phone regarding their vision. One-week post-surgery, participants will undergo a check-up visit that includes the same examinations as the preoperative visit, except for biometry. Three months post-surgery, participants will once again be contacted by phone or letter and asked to fill out the questionnaire again.

Conditions

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Bilateral Cataract Charles Bonnet Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly allocated to one of two groups using a digital coin toss. Thus they will either undergo same day-surgery of both eyes or have the two surgical procedures separated by one week.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

No masking: The patients will be informed of the type of procedure they will undergo.

Study Groups

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Immediate sequential bilateral cataract surgery (ISBCS)

Group Type ACTIVE_COMPARATOR

Immediate sequential bilateral cataract surgery (ISBCS)

Intervention Type PROCEDURE

Surgery on both eyes will be performed on the same day as separate procedures: Once surgery on the first eye is completed, a new sterile procedure on the second eye will commence.

Delayed sequential bilateral cataract surgery (DSBCS)

Group Type ACTIVE_COMPARATOR

Delayed sequential bilateral cataract surgery (DSBCS)

Intervention Type PROCEDURE

The group will undergo bilateral cataract surgery on two separate days with a time period of one week between the two procedures.

Interventions

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Immediate sequential bilateral cataract surgery (ISBCS)

Surgery on both eyes will be performed on the same day as separate procedures: Once surgery on the first eye is completed, a new sterile procedure on the second eye will commence.

Intervention Type PROCEDURE

Delayed sequential bilateral cataract surgery (DSBCS)

The group will undergo bilateral cataract surgery on two separate days with a time period of one week between the two procedures.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients planned for bilateral cataract surgery with monofocal intraocular lens implantation in the bag.
* Patients who agree to be randomly allocated to either ISBCS or DSBCS

Exclusion Criteria

* Patients at risk of intra- og postoperative complications or where delayed visual rehabilitation is expected (e.g. glaucoma, anterior chamber depth 2,3 or less, corneal endothelial dystrophy)
* Patients with axial lengths \< 21 mm or \> 27 mm
* Patients in need of immediate surgery
* Patients only eligible to one group, e.g. those requiring general anesthesia where ISBCS is the preferred approach
* Patients unable to read, understand or fill out the questionnaire
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rigshospitalet, Denmark

OTHER

Sponsor Role lead

Responsible Party

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Mads Assenholt Nielsen

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Amardeep Singh, MD, PhD

Role: STUDY_DIRECTOR

Dpt. of Ophthalmology, Rigshospitalet-Glostrup; University of Copenhagen

Mads Assenholt Nielsen

Role: PRINCIPAL_INVESTIGATOR

Dpt. of Ophthalmology, Rigshospitalet-Glostrup; University of Copenhagen

Locations

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Department of Ophthalmology, Rigshospitalet-Glostrup

Glostrup Municipality, Capital Region, Denmark

Site Status

Countries

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Denmark

Central Contacts

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Amardeep Singh, MD, PhD

Role: CONTACT

+45 20 93 09 49

References

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Arshinoff SA, Odorcic S. Same-day sequential cataract surgery. Curr Opin Ophthalmol. 2009 Jan;20(1):3-12. doi: 10.1097/ICU.0b013e32831b6daf.

Reference Type BACKGROUND
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Arshinoff SA. Same-day cataract surgery should be the standard of care for patients with bilateral visually significant cataract. Surv Ophthalmol. 2012 Nov;57(6):574-9. doi: 10.1016/j.survophthal.2012.05.002. Epub 2012 Sep 18.

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Arshinoff SA, Claoue C, Mehta C, Johanssen B, Mota SH. Bilateral Pseudomonas endophthalmitis after immediately sequential bilateral cataract surgery: primum non nocere. Arq Bras Oftalmol. 2020 Aug;83(4):346-349. doi: 10.5935/0004-2749.20200073. Epub 2020 Jul 29. No abstract available.

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
PMID: 18786128 (View on PubMed)

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Other Identifiers

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CatQuestCBS

Identifier Type: -

Identifier Source: org_study_id