Two Second-Generation Trabecular Micro-bypass Stents to Treat Glaucoma Subjects on One Hypotensive Medication

September 2, 2022 updated by: Glaukos Corporation

A Prospective Evaluation of Open-angle Glaucoma Subjects on One Topical Hypotensive Medication (Prostaglandin) Treated With Two Trabecular Micro-bypass Stents (iStent Inject)

This study objective is to evaluate the intraocular pressure (IOP) lowering effect of two trabecular micro-bypass stents (iStent inject) in eyes of subjects with primary open-angle glaucoma on one topical hypotensive medication

Study Overview

Status

Completed

Conditions

Detailed Description

The study design is as follows:

Prospective

Subjects with medicated IOP > 18 mmHg and ≤ 30 mmHg

Subjects on one topical ocular hypotensive medication prior to stent implantation

Implantation of two iStent devices (if IOP is < 6 mmHg, at any point during the postoperative follow-up, medication will not be prescribed or will be discontinued)

IOP will be measured by two (2) observers to minimize bias; observer 1 will look through the slit lamp and turn the dial with readings being masked, and observer 2 will document the IOP

Diurnal IOP measurements

Follow-up through 60 months postoperative (but could be up to 61 months if subject needs to undergo terminal washout)

Descriptive statistics will be tabulated

Medical therapy considered necessary for the subject's welfare can be implemented at any time during the study at the investigator's discretion

Study Type

Interventional

Enrollment (Actual)

57

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Yerevan, Armenia, 375108
        • S.V. Malayan's Ophtalmology Centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

INCLUSION CRITERIA:

Screening Exam Inclusion Criteria:

  • Phakic patients or pseudophakic patients with posterior chamber intraocular lenses (PC-IOLs).
  • Primary open-angle glaucoma (including pigmentary or pseudoexfoliative).
  • Cup-to-disc ratio ≤ 0.9.
  • Visual field defects, or nerve abnormality characteristic of glaucoma.
  • One topical hypotensive medication at time of screening exam.
  • Intraocular pressure (IOP) > 18 mmHg and ≤ 30 mmHg (medicated) at screening exam.
  • Study eye BCVA 20/100 or better.
  • Normal angle anatomy as determined by gonioscopy.
  • Absence of peripheral anterior synechia (PAS), rubeosis or other angle abnormalities that could impair proper placement of stent.

Baseline Exam Inclusion Criteria:

  • Subject has completed appropriate medication washout.
  • Mean IOP > 22 mmHg and ≤ 38 mmHg after anti-glaucoma medication washout period.

EXCLUSION CRITERIA:

Screening Exam Exclusion Criteria:

  • Aphakic patients or pseudophakic patients with anterior chamber IOLs (AC-IOLs).
  • Prior stent implantations (study eye).
  • Traumatic, uveitic, neovascular, or angle-closure glaucoma; or glaucoma associated with vascular disorders.
  • Functionally significant visual field loss, including severe nerve fiber bundle defects such as Bjerrum scotoma.
  • Prior incisional glaucoma surgery.
  • Prior SLT within 90 days prior to screening.
  • Prior ALT.
  • Iridectomy or laser iridotomy.
  • Ineligibility for ocular hypotensive medication washout period as determined by the investigator such as: visual field status would be placed at risk by washout period, or unmedicated IOP after washout period would be expected to exceed upper limit of ≥ 38 mmHg.
  • Any active corneal inflammation or edema (e.g., keratitis, keratoconjunctivitis, keratouveitis).
  • Clinically significant corneal dystrophy (e.g., bullous keratopathy, Fuch's dystrophy); any guttata.
  • Corneal surgery (prior or anticipated) of any type (including LASIK, LASEK, PRK, etc.) that may interfere with IOP measurement reliability.
  • Corneal opacities or disorders that would inhibit visualization of the nasal angle.
  • Congenital or traumatic cataract.
  • Retinal or optic nerve disorders, either degenerative or evolutive, that are not associated with the existing glaucoma condition.
  • Elevated episcleral venous pressure such as associated with: active thyroid orbitopathy, cavernous sinus fistula, Sturge-Weber syndrome, orbital tumors, orbital congestive disease.
  • Clinically significant sequelae from trauma (e.g., chemical burns, blunt trauma, etc.).
  • Chronic ocular inflammatory disease or presence of active ocular inflammation (e.g., uveitis, iritis, iridocyclitis, retinitis).
  • Pregnant or nursing women.

Baseline Exam Exclusion Criteria:

  • Subject did not complete medication washout.
  • Mean IOP < 22 mmHg or > 38 mmHg after anti-glaucoma medication washout.
  • Subject did not have a 3mmHg IOP increase over screening mean diurnal IOP.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Two micro-bypass stents (iStent inject)
Standalone implantation of two trabecular micro-bypass stents (iStent inject)
Standalone implantation of two trabecular micro-bypass stents (iStent inject)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Mean intraocular pressure reduction of 20% or more vs baseline
Time Frame: 12 months post-op
12 months post-op

Secondary Outcome Measures

Outcome Measure
Time Frame
Proportion of subjects with intraocular pressure less than or equal to 18 mm Hg
Time Frame: 12 months
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Lilit Voskanyan, MD, PhD, S.V. Malayan Eye Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2013

Primary Completion (Actual)

November 8, 2019

Study Completion (Actual)

November 8, 2019

Study Registration Dates

First Submitted

August 11, 2016

First Submitted That Met QC Criteria

August 11, 2016

First Posted (Estimate)

August 16, 2016

Study Record Updates

Last Update Posted (Actual)

September 8, 2022

Last Update Submitted That Met QC Criteria

September 2, 2022

Last Verified

September 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • GCF-038

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

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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