- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04174924
Molecular Background of Endothelial Cell Loss in Patients With Phakic Intraocular Lenses: a Tear and Aqueous Humour Analysis Study (MoBack)
Molecular Background of Endothelial Cell Loss in Patients With Phakic Intraocular Lenses (MoBack-ECL): a Tear and Aqueous Humour Analysis Study
Rationale: The number of highly myopic patients is increasing. Especially in East and Southeast Asia, up to 90% of adolescents are currently myopic. Long-term treatment of high myopia can be obtained by three types of surgery: laser refractive surgery, phakic intraocular lens (pIOL) implantation, and refractive lens exchange Implantation with a pIOL is the preferred treatment for high myopes, resulting in increasing patient numbers implanted due to the increasing numbers of patients with high myopia.
Long-term results show that implantation of a pIOL induces an accelerated decrease in corneal endothelial cells (EC). Although some risk factors for increase EC loss have been identified, the underlying mechanism is currently unknown. It is hypothesized that the aqueous flow in the anterior segment of the eye (i.e. anterior chamber) is disturbed, causing an altered nutritional flow in the anterior chamber. Another hypothesis is that the pIOL causes chronic subclinical inflammation in the anterior chamber resulting in increased EC loss. Currently there is insufficient proof to confirm or reject either hypothesis. If one of these hypotheses can be confirmed, it is likely to induces significant changes in clinical practice.
Objective: The primary objective of the study is to explore the role of inflammation in the anterior chamber on endothelial cell loss in patients implanted with iris-fixated pIOLs. The secondary objective is to identify whether there is a correlation between biomarkers in aqueous humour and biomarkers in tears, both related to the accelerated progression of EC loss.
Study design: Two strategies are incorporated in the design of this study. The first part will retrospectively evaluate EC loss in patients with iris-fixated (IF) phakic intraocular lenses (pIOLs). The second part is prospective and will compare EC measurements, cytokines in aqueous humour and in tears from patients scheduled for IF-pIOLs explantation and compare them to patients with routine cataract surgery.
Study population: Patients over 18 years of age, undergoing regular cataract surgery, and patients undergoing pIOL explantation in combination with cataract surgery. A total number of 126 patients is needed, equally divided over two groups.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Christian Bertens
- Phone Number: +31 (0)43 388 1847
- Email: christian.bertens@mumc.nl
Study Contact Backup
- Name: Frank van den Biggelaar, PhD
- Phone Number: +31 (0)43 387 5342
- Email: f.vanden.biggelaar@mumc.nl
Study Locations
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Limburg
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Maastricht, Limburg, Netherlands, 6202 AZ
- Recruiting
- Maastricht University Medical Centre
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Contact:
- Frank van den Biggelaar, PhD
- Phone Number: 0031433877377
- Email: f.vanden.biggelaar@mumc.nl
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age over 18
- Cataract in one or both eyes, or indication for pIOL explantation
- Informed and having given informed consent.
Exclusion Criteria:
- Insufficient understanding of the Dutch language to comply with study procedures
- Inability to complete follow-up or comply with study procedures
- Non-routine cataract surgery
- Cognitive or behavioral conditions that might interfere with surgery
- Patients with ocular comorbidities such as
- Women who are pregnant or nursing their child
- Immune-compromised patients (e.g., systemic corticosteroid use, leukaemia)
- Factors that increase the risk of complicated surgery
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Phakic intraocular lens (pIOL) explantation
Patients with pIOLs where a combined pIOL explantation and cataract surgery is needed.
|
Phakic intraocular lens (pIOL) explantation is a surgical procedure to remove the pIOL which needs to be done after cataract formation. Cataract extraction is a surgical procedure to remove a lens in the eye that has become cloudy over time, affecting vision in that eye.
Other Names:
|
Cataract extraction
Healthy control group of patients scheduled for regular cataract surgery without comorbidities affecting an immune response.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Difference in pro- inflammatory cytokine levels between patients undergoing a pIOL explantation in combination with a cataract surgery compared to patients only undergoing cataract surgery in aqueous humour.
Time Frame: up to 12 months after surgery
|
Cytokines of interest are IFN-γ, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, TNF-α, MMP9.
Detection will be in pg/mL.
|
up to 12 months after surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Correlation between inflammatory biomarkers (cytokines) in the aqueous humour and in tears
Time Frame: up to 12 months after surgery
|
The following assay will be used: MSD multiplex pro-inflamatory kit.
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up to 12 months after surgery
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Progress of EC loss after combined IF-pIOL explantation and cataract surgery compared to cataract surgery as a single procedure.
Time Frame: up to 12 months after surgery
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Progress will be measured with non-contact specular microscopy which will be the same for all patients.
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up to 12 months after surgery
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
Other Study ID Numbers
- NL70342.068.19
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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