- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05626478
Assessing eFficacy and Safety of DEXTENZA 0.4 mg inseRt, Following Cataract Surgery
February 18, 2026 updated by: Nicole Fram M.D.
Assessing eFficacy and Safety of DEXTENZA 0.4 mg inseRt in Conjunction With Topical Drop Regimen Treating Pain and inflamMation Following Cataract Surgery Compared to SOC Topical Drop Regimen
Assessing eFficacy and Safety of DEXTENZA 0.4 mg inseRt, Following Cataract Surgery
Study Overview
Status
Completed
Conditions
Detailed Description
Assessing eFficacy and Safety of DEXTENZA 0.4 mg inseRt Treating Pain, and inflamMation Following Cataract Surgery Compared to Topical Prednisolone Acetate 1%.
Study Type
Interventional
Enrollment (Actual)
50
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
-
-
California
-
Los Angeles, California, United States, 90067
- Advanced Vision Care
-
-
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
Description
Inclusion Criteria:
- Diagnosed with clinically significant cataract and are planning to undergo non-complicated Clear Cornea Incision Cataract Extraction with Posterior Capsule IntraOcular Lens in one or both eyes
- Are willing and able to comply with clinic visits and study related procedures
- Are willing and able to sign the informed consent form
Exclusion Criteria:
- Under the age of 18 at the time of signing the Informed Consent Form
- Pregnant or planning to become pregnant during the trial period
- Have visual acuity potential of less than 20/30 as recorded by a Retinal Acuity Meter or Potential Acuity Meter glare testing
- Have active infectious systemic disease
- Have active infectious ocular or extraocular disease
- Have punctal plug in the study eye
- Have obstructed nasolacrimal duct in the study eye(s) (dacryocystitus)
- Have known hypersensitivity to dexamethasone or are a known steroid responder
- Have a history of ocular inflammation or macular edema
- Has history of Laser Vision Correction (LASIK, PhotoRefractive Keratectomy) in the operated eye
- Are currently being treated with immunomodulating agents in the study eye
- Are currently being treated with immunosuppressants and/or oral steroids
- Are currently being treated with corticosteroid implant (i.e Ozurdex)
- Have a history of herpes simplex virus keratitis or present active bacterial, viral, or fungal keratitis in either eye
- Have a history of complete punctal occlusion in one or both punctum
- Currently using topical ophthalmic steroid medications
- Are unwilling or unable to comply with the study protocol
- Are determined by the Investigator to not be included for reasons not already specified (e.g., systemic, behavioral, or other ocular disease/abnormality) if the health of the subject or the validity of the study outcomes may be compromised by the subject's enrollment
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: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Active Comparator: Arm 1 - Cataract surgery gtt regimen per SOC
Following cataract surgery (without Dextenza 0.4mg insert) patients will receive: Prednisolone Acetate 1% QID X 2 Weeks, then BID x 2 weeks and stop / Prolensa 0.07% QD X 4 Weeks and stop.
|
Prednisolone Acetate 1% is a corticosteroid (to decrease inflammation) and being used as a topical drop after cataract surgery per Standard Of Care.
Prolensa 0.07% is a NSAID (to decrease inflammation, swelling and pain) and is being used as a topical drop after cataract surgery per Standard Of Care.
|
|
Experimental: Arm 2 - Cataract surgery with Dextenza and less frequency of gtt regimen
Following cataract surgery with DEXTENZA 0.4mg insert, patients will receive: Prolensa 0.07% QD X 4 Weeks and stop
|
Prolensa 0.07% is a NSAID (to decrease inflammation, swelling and pain) and is being used as a topical drop after cataract surgery per Standard Of Care.
DEXTENZA 0.4Mg Ophthalmic Insert is a corticosteroid (to decrease inflammation) intracanalicular insert placed in the punctum, a natural opening in the eye lid, and into the canaliculus and is designed to deliver dexamethasone to the ocular surface for up to 30 days without preservatives.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mean change in anterior chamber inflammation (Cell and Flare) scores
Time Frame: Assessed on Days 1,7,30,90
|
Measured by SUN (Standardization on Uveitis Nomenclature) grading scale: absence of cell to be defined as a grade of 0-0.5 and absence of flare to be defined as a grade of: 0-1.
0-4 score scale, higher scores mean a worse outcome.
0-1 Absent, 1-2 Mild, 2-3 Moderate, 4 Severe.
|
Assessed on Days 1,7,30,90
|
|
Mean change in pain score
Time Frame: Assessed on Day 1,7, 30 and 90
|
Measured with the visual analog scale (VAS); between 0 and 100; 0 meaning no pain and 100 meaning worst pain possible, higher scores mean a worse outcome.
0-10 Absent, 11-30 Mild, 31-70 Moderate, 71-100 Severe.
|
Assessed on Day 1,7, 30 and 90
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Visual outcome (Best Corrected Visual Acuity)
Time Frame: Assessed on Day 1,7, 30 and 90
|
Measured by ETDRS (Early Treatment Diabetic Retinopathy Study) chart.
0-70 letter read score, higher scores mean a better outcome.
|
Assessed on Day 1,7, 30 and 90
|
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Absence of CME (Cystoid Macular Edema)
Time Frame: Assessed on Day 90
|
Macular thickness measured by OCT (Optical Coherence Tomography) and compared to the preop measurements, higher scores (>over 50 microns) mean a worse outcome.
|
Assessed on Day 90
|
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Mean change in corneal staining
Time Frame: Assessed on Day 7, 30 and 90
|
measured by the National Eye Institute 0-4 score scale, higher scores mean a worse outcome.
0-1 Mild, 2-3 Moderate, 4 Severe.
Total score 0-5 Mild, 6-15 Moderate, 16-20 Severe.
|
Assessed on Day 7, 30 and 90
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Safety endpoint: Change in IOP (IntraOcular Pressure) initiating rescue medications
Time Frame: Assessed throughout 90-day study period
|
Measured by Applanation in millimeter Hg(Mercury), higher then 22mm Hg or lower then 10mm Hg mean a worse outcome and a need for rescue.
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Assessed throughout 90-day study period
|
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Safety endpoint: corneal or retinal edema
Time Frame: Assessed throughout 90-day study period
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Measured by slit lamp examination and supporting imaging and testing such as Pachymetry measured in micrometer (μm) or Macular OCT (Optical Coherence Tomography) measured in microns (μ).
Higher scores (in comparison to preop measurements) mean a worse outcome.
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Assessed throughout 90-day study period
|
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Safety endpoint: Signs of Rebound Iritis
Time Frame: Assessed throughout 90-day study period
|
Measured by slit lamp examination and scored by SUN (Standardization on Uveitis Nomenclature) grading scale of Anterior chamber Cell and Flare presence.
0-4 score scale.
Cell: 0-0.5 Absence, 1-2 Mild, 2-3 Moderate 4 Severe.
Flare: 0-1 Absence, 2 Mild, 3 Moderate, 4 Severe.
Higher scores mean a worse outcome.
(specifically sub-grouped Blue vs. Brown eyed subjects)
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Assessed throughout 90-day study period
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Nicole R Fram, M.D., Advanced Vision Care
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.
General Publications
- Jabs DA, Nussenblatt RB, Rosenbaum JT; Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005 Sep;140(3):509-16. doi: 10.1016/j.ajo.2005.03.057.
- ARMALY MF. EFFECT OF CORTICOSTEROIDS ON INTRAOCULAR PRESSURE AND FLUID DYNAMICS. II. THE EFFECT OF DEXAMETHASONE IN THE GLAUCOMATOUS EYE. Arch Ophthalmol. 1963 Oct;70:492-9. doi: 10.1001/archopht.1963.00960050494011. No abstract available.
- Pande MV, Spalton DJ, Kerr-Muir MG, Marshall J. Postoperative inflammatory response to phacoemulsification and extracapsular cataract surgery: aqueous flare and cells. J Cataract Refract Surg. 1996;22 Suppl 1:770-4. doi: 10.1016/s0886-3350(96)80160-x.
- An JA, Kasner O, Samek DA, Levesque V. Evaluation of eyedrop administration by inexperienced patients after cataract surgery. J Cataract Refract Surg. 2014 Nov;40(11):1857-61. doi: 10.1016/j.jcrs.2014.02.037. Epub 2014 Sep 22.
- Tyson SL, Bafna S, Gira JP, Goldberg DF, Jones JJ, Jones MP, Kim JK, Martel JM, Nordlund ML, Piovanetti-Perez IK, Singh IP, Metzinger JL, Mulani D, Sane S, Talamo JH, Goldstein MH; Dextenza Study Group. Multicenter randomized phase 3 study of a sustained-release intracanalicular dexamethasone insert for treatment of ocular inflammation and pain after cataract surgery. J Cataract Refract Surg. 2019 Feb;45(2):204-212. doi: 10.1016/j.jcrs.2018.09.023. Epub 2018 Oct 24.
- Patel SB, Reddy NK, He YG. TOXIC POSTERIOR SEGMENT SYNDROME AFTER DROPLESS CATARACT SURGERY WITH COMPOUNDED TRIAMCINOLONE-MOXIFLOXACIN. Retina. 2020 Mar;40(3):446-455. doi: 10.1097/IAE.0000000000002450.
- Freire FS, Lang R, Abalem MF, Johnson MW. RETINAL DEPOSITS OF TRIAMCINOLONE-MOXIFLOXACIN AFTER DROPLESS CATARACT SURGERY. Retin Cases Brief Rep. 2023 Sep 1;17(5):577-580. doi: 10.1097/ICB.0000000000001243.
- Ibach MJ, Zimprich L, Wallin DD, Olevson C, Puls-Boever K, Thompson V. In Clinic Optometrist Insertion of Dextenza (Dexamethasone Ophthalmic Insert 0.4mg) Prior to Cataract Surgery: The PREPARE Study. Clin Ophthalmol. 2022 Aug 13;16:2609-2615. doi: 10.2147/OPTH.S374405. eCollection 2022.
- Ibach MJ, Shafer BM, Wallin DD, Puls-Boever KR, Thompson VM, Berdahl JP. The Effectiveness and Safety of Dextenza 0.4 mg for the Treatment of Postoperative Inflammation and Pain in Patients After Photorefractive Keratectomy: The RESTORE Trial. J Refract Surg. 2021 Sep;37(9):590-594. doi: 10.3928/1081597X-20210610-05. Epub 2021 Sep 1.
- Alsetri H, Fram N, Shiler O. Evaluating a Sustained-Release Dexamethasone Insert as Adjunctive Therapy for Inflammation and Pain Post-Corneal Transplantation. Clin Ophthalmol. 2024 Jul 16;18:2083-2091. doi: 10.2147/OPTH.S466118. eCollection 2024.
- Fram N, Alsetri H, Shiler O, Paterno PJ, Cabang J. Retrospective Study of a Sustained-Release Intracanalicular Dexamethasone Insert for Treatment of Ocular Inflammation After Cataract and Corneal Surgery. Clin Ophthalmol. 2022 Dec 10;16:4065-4074. doi: 10.2147/OPTH.S386702. eCollection 2022.
- Shapiro JN, Armenti ST, Levine H, Hood CT, Mian SI. Dexamethasone Intracanalicular Insert versus Standard Topical Steroids for the Prophylaxis of Inflammation after Cataract Surgery. Am J Ophthalmol. 2024 Dec;268:174-180. doi: 10.1016/j.ajo.2024.07.030. Epub 2024 Jul 31.
- Walters T, Endl M, Elmer TR, Levenson J, Majmudar P, Masket S. Sustained-release dexamethasone for the treatment of ocular inflammation and pain after cataract surgery. J Cataract Refract Surg. 2015 Oct;41(10):2049-59. doi: 10.1016/j.jcrs.2015.11.005.
- Donnenfeld ED, Hovanesian JA, Malik AG, Wong A. A Randomized, Prospective, Observer-Masked Study Comparing Dropless Treatment Regimen Using Intracanalicular Dexamethasone Insert, Intracameral Ketorolac, and Intracameral Moxifloxacin versus Conventional Topical Therapy to Control Postoperative Pain and Inflammation in Cataract Surgery. Clin Ophthalmol. 2023 Aug 15;17:2349-2356. doi: 10.2147/OPTH.S422502. eCollection 2023.
- Nassiri S, Hwang FS, Kim J, LeClair B, Yoon E, Pham M, Rauser ME. Comparative analysis of intravitreal triamcinolone acetonide-moxifloxacin versus standard perioperative eyedrops in cataract surgery. J Cataract Refract Surg. 2019 Jun;45(6):760-765. doi: 10.1016/j.jcrs.2018.12.019. Epub 2019 Mar 6.
- Chang DT, Herceg MC, Bilonick RA, Camejo L, Schuman JS, Noecker RJ. Intracameral dexamethasone reduces inflammation on the first postoperative day after cataract surgery in eyes with and without glaucoma. Clin Ophthalmol. 2009;3:345-55. doi: 10.2147/opth.s5730. Epub 2009 Jun 2.
- Kuriakose RK, Cho S, Nassiri S, Hwang FS. Comparative Outcomes of Standard Perioperative Eye Drops, Intravitreal Triamcinolone Acetonide-Moxifloxacin, and Intracameral Dexamethasone-Moxifloxacin-Ketorolac in Cataract Surgery. J Ophthalmol. 2022 Jul 19;2022:4857696. doi: 10.1155/2022/4857696. eCollection 2022.
- Miura M, Inomata T, Nakamura M, Sung J, Nagino K, Midorikawa-Inomata A, Zhu J, Fujimoto K, Okumura Y, Fujio K, Hirosawa K, Akasaki Y, Kuwahara M, Eguchi A, Shokirova H, Murakami A. Prevalence and Characteristics of Dry Eye Disease After Cataract Surgery: A Systematic Review and Meta-Analysis. Ophthalmol Ther. 2022 Aug;11(4):1309-1332. doi: 10.1007/s40123-022-00513-y. Epub 2022 May 9.
- Quintana NE, Allocco AR, Ponce JA, Magurno MG. Non steroidal anti-inflammatory drugs in the prevention of cystoid macular edema after uneventful cataract surgery. Clin Ophthalmol. 2014 Jun 25;8:1209-12. doi: 10.2147/OPTH.S61604. eCollection 2014.
- Belair ML, Kim SJ, Thorne JE, Dunn JP, Kedhar SR, Brown DM, Jabs DA. Incidence of cystoid macular edema after cataract surgery in patients with and without uveitis using optical coherence tomography. Am J Ophthalmol. 2009 Jul;148(1):128-35.e2. doi: 10.1016/j.ajo.2009.02.029. Epub 2009 Apr 29.
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)
June 1, 2023
Primary Completion (Actual)
February 5, 2025
Study Completion (Actual)
February 5, 2025
Study Registration Dates
First Submitted
November 8, 2022
First Submitted That Met QC Criteria
November 15, 2022
First Posted (Actual)
November 23, 2022
Study Record Updates
Last Update Posted (Actual)
February 20, 2026
Last Update Submitted That Met QC Criteria
February 18, 2026
Last Verified
February 1, 2026
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Eye Diseases
- Corneal Diseases
- Retinal Diseases
- Retinal Degeneration
- Macular Degeneration
- Eye Manifestations
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Macular Edema
- Eye Pain
- Corneal Edema
- Pharmaceutical Solutions
- Sulfur Compounds
- Organic Chemicals
- Pharmaceutical Preparations
- Pharmacologic Actions
- Chemical Actions and Uses
- Therapeutic Uses
- Hydrocarbons
- Hydrocarbons, Cyclic
- Hydrocarbons, Aromatic
- Polycyclic Compounds
- Pregnadienes
- Pregnanes
- Steroids
- Fused-Ring Compounds
- Steroids, Fluorinated
- Benzene Derivatives
- Solutions
- Specialty Uses of Chemicals
- Sulfonic Acids
- Sulfur Acids
- Pregnadienetriols
- Benzenesulfonates
- Arylsulfonates
- Arylsulfonic Acids
- Dexamethasone
- Ophthalmic Solutions
- Calcium Dobesilate
- prednisolone acetate
- bromfenac
Other Study ID Numbers
- AVC-003
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
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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