- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02613013
Laser Peripheral Iridotomy Plus Laser Peripheral Iridoplasty for Primary Angle Closure
Laser Peripheral Iridotomy Plus Laser Peripheral Iridoplasty for Primary Angle Closure With Multi-mechanism Based on UBM: A Randomized Controlled Trial
Study Overview
Status
Conditions
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Xiulan Zhang, MD,PhD
- Email: zhangxl2@mail.sysu.edu.cn
Study Locations
-
-
Guangdong
-
Guangzhou, Guangdong, China, 510060
- Recruiting
- Zhongshan Ophthalmic Center
-
Contact:
- Xiulan Zhang, MD,PhD
- Email: zhangxl2@mail.sysu.edu.cn
-
Principal Investigator:
- Xiulan Zhang, MD,PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Clinical diagnosis of primary angle closure (PAC), with IOP≤30mmHg and PAS≤270°.
- PAC with multi-mechanism based on UBM examination (multi-mechanism is defined as primary angle closure is caused by pupil block plus at least one kind of non-pupil block factors like (relative anterior position and thick of the ciliary body, the big volume of the iris, the anterior location of the iris insertion into the ciliary body)or any two or more kinds of combination.
- Visual acuity≥ 20/40
- Age between 40-75 years old Chinese people
If both eyes of a patient are eligible for the study, the e eye had worse visual acuity will be selected. Only one eye per patient is eligible for the study.
Drug washout:
Eligible patients who are already on anti-glaucoma medications are required to have drug washout before being randomized. Various medications have different washout periods: Prostaglandin analogues 4 weeks, Beta blockers 3 weeks, Adrenergic agonist 2 weeks, Cholinergic agonist 5 days, Carbonic Anhydrase Inhibitors 5 days. Patients whose IOP>30 mm Hg during this washout period will be stopped from further washout and be withdrawn from the study.
Exclusion Criteria:
- Unwilling or unable to give consent, unwilling to accept randomization, or unable to return for scheduled protocol visits.
- Angle closure due to secondary causes (subluxed lens, neovascular, uveitic, traumatic, post-operative)
- Previous incisional intraocular surgery or ocular laser in study eye (LPI or LPIP, cyclodestructive procedure, cataract surgery)
- Primary angle closure with glaucomatous neuropathy.
- Have cataract in the studying eye and anticipated to have cataract surgery in the coming 3 years; the existing cataract affect visual field examination and fundus examination; the visual acuity <20/40 due to the existing cataract.
- Who are using IOP lowing drugs and do not have drug washout
- Need for glaucoma surgery combined with other ocular procedures (i.e. cataract surgery, penetrating keratoplasty, or retinal surgery) or anticipated need for urgent additional ocular surgery
- Coexisting other ocular diseases (i.e. cornea abnormal or cornea infection, Iridocorneal endothelial syndrome or anterior segment dysgenesis, nanophthalmos, high myopia (>6.0D), Chronic or recurrent uveitis, ocular cancer, trauma, central retinal vein occlusion, central retinal artery occlusion, retinal detachment)
- cornea endothelium counting <1000/mm2
- need local or systemic steroid long-term use
- Unwilling to discontinue contact lens use after surgery
- Who are taking parting in other drug clinical trials
- Pregnant or nursing women
- Severe systemic disease (i.e. diabetes mellitus, hypertension, the end stage of cardiac disease, nephropathy disease, respiratory disease and cancer.
- Allergic to pilocarpine or alcaine
- Contraindication to ocular laser diseases.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: single LPI
LPI was performed with a VISULAS diode laser of 532 nm (Carl Zeiss Meditec, Dublin, CA).
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia will be administered.
The treatment site was selected in the superior nasal iris or in a crypt, where present.
Treatment was initiated with a pulse of 3-5mJ, the power was increased until patency was achieved, the opening of iris >0.1mm.
and patency was determined by direct visualization of the posterior chamber.
|
a neodymium:yttrium-aluminum- garnet laser was used to perform the LPI
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia (Proparacaine) will be administered
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia (Proparacaine) will be administered
LPI was performed with a VISULAS diode laser of 532 nm (Carl Zeiss Meditec, Dublin, CA).
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia (Proparacaine) will be administered.
The treatment site was selected in the superior nasal iris or in a crypt, where present.
Treatment was initiated with a pulse of 3-5mJ, the power was increased until patency was achieved, the opening of iris >0.1mm.
and patency was determined by direct visualization of the posterior chamber.
|
Experimental: LPIP plus LPI
LPIP was applied with a VISULAS diode laser of 532 nm (Carl Zeiss Meditec, Dublin, CA).
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia will be administered.
Twenty to 30 spots of 250-300 mW power with 300-500 microns of size and duration of 400-500 ms were applied.
Power was modified arbitrarily until an effective iris contraction was obtained.
Effective iris contraction was considered as a concentric movement around the laser spot, with minimal iris pigmentation and immediate angle opening observed through the lens mirrors using a Goldmann lens.
Power was lowered if there was any bursting sound perceived, pigment dispersion, air bubbles or considerable pain.
LPI was performed after LPIP procedure
|
a neodymium:yttrium-aluminum- garnet laser was used to perform the LPI
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia (Proparacaine) will be administered
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia (Proparacaine) will be administered
a frequency-doubled Q-switched neodymium:yttrium-aluminum-garnet 532-nm laser was used to perform the LPIP
LPIP was applied with a VISULAS diode laser of 532 nm (Carl Zeiss Meditec, Dublin, CA).
30 minutes prior to the procedure, a drop of 2% pilocarpine will be instilled into the eye every 15 minutes, Topical anaesthesia will be administered.
Twenty to 30 spots of 250-300 mW power with 300-500 microns of size and duration of 400-500 ms were applied.
Power was modified arbitrarily until an effective iris contraction was obtained.
Effective iris contraction was considered as a concentric movement around the laser spot, with minimal iris pigmentation and immediate angle opening observed through the lens mirrors using a Goldmann lens.
Power was lowered if there was any bursting sound perceived, pigment dispersion, air bubbles or considerable pain.
LPI was performed after LPIP procedure.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression rate determined by number of patients who progress after laser treatment for each group.
Time Frame: 3 years
|
PAC progression defined as presence of any of the following:
|
3 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Additional medication or surgery required questionnaire
Time Frame: 3 years
|
|
3 years
|
The change of the best corrected visual acuity after the laser procedure
Time Frame: 3 years
|
3 years
|
|
The number of the cornea endothelial cells
Time Frame: 3 years
|
3 years
|
|
The change in angle width and configuration as measured by ultrasound biomicroscopy (UBM)
Time Frame: 3 years
|
3 years
|
Collaborators and Investigators
Sponsor
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Eye Diseases
- Ocular Hypertension
- Glaucoma
- Glaucoma, Angle-Closure
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Autonomic Agents
- Peripheral Nervous System Agents
- Cholinergic Agents
- Sensory System Agents
- Anesthetics
- Cholinergic Agonists
- Anesthetics, Local
- Miotics
- Muscarinic Agonists
- Proxymetacaine
- Pilocarpine
Other Study ID Numbers
- 2015019
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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