Glaucoma Drainage Device and Endothelial Cell Loss Compare Trial

NCT ID: NCT05924477

Last Updated: 2025-06-27

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

RECRUITING

Clinical Phase

NA

Total Enrollment

226 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-11

Study Completion Date

2027-12-31

Brief Summary

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Glaucoma Drainage Device and Endothelial Cell Loss Compare Trial (DECLARE) is a multi-center, outcome-masked, randomized clinical trial. The purpose of this study is to compare glaucoma drainage device implantation in the anterior chamber (front part of the eye) and sulcus (small space between iris and front chamber of the eye) in efforts to minimize cell loss in the eye.

Detailed Description

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The DECLARE Trial is a prospective 1:1 randomized, parallel design, double-masked clinical trial to compare endothelial cell density (ECD), intraocular pressure (IOP) and metagenomic RNA deep sequencing (MDS) between sulcus and anterior chamber (AC) tube placement after glaucoma drainage device (GDD) implantation.

The trial has fixed sample size with 12 months follow-up for primary outcome assessment and trial participants will continue to be followed to the end of grant cycle with a total of 24 months follow-up.

Patients will be randomized to 2 tube locations for GDD implantation:

* Tube placed in the AC
* Tube placed in ciliary sulcus
* Stratification: by clinical center and type of surgery (GDD alone vs GDD combined with phacoemulsification). Stratified randomization by clinical center is to ensure that a similar number of subjects will be randomized to either sulcus tube or AC tube placement for a specific clinical center. Because eyes undergoing a combined phacoemulsification with GDD implantation may be associate with larger ECL from phacoemulsification, stratified by surgery type is to ensure two tube location groups similar number of study eyes that will undergo a combined phacoemulsification with GDD implantation.

Conditions

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Glaucoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A prospective 1:1 randomized, parallel design, double-masked clinical trial. Stratification is by clinical center and type of surgery (GDD alone vs GDD combined with phacoemulsification).
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
All trial participants will be masked to their tube locations. The primary outcome accessors who grade specular microscopy images at the PRC, perform IOP measurements at each clinical center, or conduct the MDS analysis at the Metagenomic RNA Deep Sequencing (RNA-seq) Center will also be masked to tube locations. Due to the nature of the surgical intervention, the surgeon, the technician taking specular microscopy and AS-OCT images, and the graders at the PRC who will perform AS-OCT measurements will not be masked to the tube locations. However, the graders of AS-OCT images will be masked to the purpose of the study and will be different from the graders of specular microscopy images.

Study Groups

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Sulcus tube placement

Glaucoma drainage device (GDD) implantation with tube placement in the ciliary sulcus

Group Type ACTIVE_COMPARATOR

Sulcus tube placement

Intervention Type PROCEDURE

GDD implantation surgery with tube placement in the ciliary sulcus

Anterior chamber (AC) tube placement

Glaucoma drainage device (GDD) implantation with tube placement in the anterior chamber

Group Type ACTIVE_COMPARATOR

Anterior chamber (AC) tube placement

Intervention Type PROCEDURE

GDD implantation surgery with tube placement in the anterior chamber

Interventions

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Sulcus tube placement

GDD implantation surgery with tube placement in the ciliary sulcus

Intervention Type PROCEDURE

Anterior chamber (AC) tube placement

GDD implantation surgery with tube placement in the anterior chamber

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Medically uncontrolled glaucoma requiring GDD or GDD combined with phacoemulsification as the planned surgical procedure
* Candidate for GDD implantation for ciliary sulcus and AC tube
* Age greater than or equal to 18 years old

Exclusion Criteria

* Preexisting corneal condition that would affect the corneal endothelium or previous corneal transplant
* Presence or history of Cypass Micro-Stent
* Previous GDD, Xen Gel Stent or Preserflo MicroShunt removed less than 6 months before surgery
* Presence of GDD implantation, Xen Gel Stent, of Preserflo MicroShunt
* Previous trabeculectomy and/or minimally invasive glaucoma surgery within the past 6 months
* AC intraocular lens
* Presence of nanophthalmos, uncontrolled uveitis, silicone oil, Sturge-Weber syndrome or other conditions associated with elevated episcleral venous pressure
* Unwilling or unable to give consent, unwilling to accept randomization, or unable to return for scheduled protocol visits
* No light perception vision in the study eye or fellow eye visual acuity \< 20/200
* Need for glaucoma surgery combined with other ocular procedures (i.e. corneal transplant, or retinal surgery) or anticipated need for additional ocular surgery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Eye Institute (NEI)

NIH

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ying Han, MD, PhD

Role: STUDY_CHAIR

University of California, San Francisco

Jennifer Rose-Nussbaumer, MD

Role: STUDY_DIRECTOR

Stanford University

Thuy Doan, MD, PhD

Role: STUDY_DIRECTOR

University of California San Fransicso

Locations

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University of California San Francisco

San Francisco, California, United States

Site Status RECRUITING

Diablo Eye Associates

Walnut Creek, California, United States

Site Status RECRUITING

Bascom Palmer Eye Institute

Miami, Florida, United States

Site Status RECRUITING

Wilmer Eye Institute, Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

Massachusetts Eye and Ear

Boston, Massachusetts, United States

Site Status RECRUITING

University of Buffalo/State University of New York

Buffalo, New York, United States

Site Status RECRUITING

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Prism Eye Institute, University of Toronto

Toronto, , Canada

Site Status RECRUITING

Countries

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United States Canada

Central Contacts

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Gui-shuang Ying, PhD

Role: CONTACT

215-615-1514

Facility Contacts

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Ying Han, MD, PhD

Role: primary

Yen Cheng Hsia, MD

Role: primary

Steven Gedde, MD

Role: primary

Pradeep Yammanuru Ramulu, MD, PhD

Role: primary

Teresa Chen, MD

Role: primary

Asher Weiner, MD

Role: primary

Donald Budenz, MD

Role: primary

Iqbal Ike Ahmed, MD, PhD

Role: primary

Other Identifiers

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UG1EY033703

Identifier Type: NIH

Identifier Source: secondary_id

View Link

853474

Identifier Type: -

Identifier Source: org_study_id

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