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Lipiflow-behandling alene vs. Lipiflow + Dextenza-behandling for tørre øyesykdommer

18. oktober 2026 oppdatert av: Eye Surgeons of Indiana

Intrakanalikulært deksametason brukt i forbindelse med LipiFlow for behandling av meibomisk kjerteldysfunksjon hos pasienter med fordampende tørre øyne og tegn på klinisk signifikant betennelse

To evaluate the benefit of treatment with a physician administered intracanalicular dexamethasone insert in evaporative dry eye disease (DED) patients with meibomian gland disfunction (MGD) and underlying inflammation undergoing LipiFlow Thermal Pulsation.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

This prospective, open-label, single-center, non-randomized, investigator-sponsored clinical study seeks to investigate the benefit of managing patients with DED secondary to MGD with a sustained release intracanalicular dexamethasone (0.4 mg) insert in addition to LipiFlow Thermal Pulsation compared to LipiFlow Thermal Pulsation alone. In addition, this study will evaluate the ease of Dextenza insertion and the patient preference for therapy.

After screening a given patient for inclusion and exclusion criteria, and gaining informed consent, each eye will undergo LipiFlow Thermal Pulsation on the same day. The most symptomatic eye will be selected to receive DEXTENZA® insertion on the day of the procedure (study eye), while the other eye will be assigned to a receive a sham punctum dilation (control eye). If there is no obvious symptomatic difference, the right eye will receive the intracanalicular insert. Per patient, the study period will last for approximately 12 weeks after the LipiFlow procedure, consisting of one screening visit, one treatment v4isit and 3 post-procedure follow-up visits (week 1, week 4 and week 12). At week 1, week 4 and week 12, primary and secondary endpoints will be assessed alongside standard-of-care procedures. Adjusting for enrollment period, the study will last a total of approximately 4 months.

Studietype

Intervensjonell

Registrering (Faktiske)

20

Fase

  • Fase 4

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Indiana
      • Indianapolis, Indiana, Forente stater, 46040
        • Eye Surgeons of Indiana

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

A patient's study eye must meet the following criteria to be eligible for inclusion in the study:

  • 18 years of age or older
  • Evaporative DED with MGD and clinically significant inflammation
  • Willing and able to comply with clinic visits and study related procedures
  • Willing and able to sign the informed consent form

Exclusion Criteria:

A patient who meets any of the following criteria will be excluded from the study:

  • Patients under the age of 18.
  • Pregnancy (must be ruled out in women of child-bearing age with pregnancy test)
  • Active infectious systemic disease
  • Active infectious ocular or extraocular disease
  • Altered nasolacrimal flow of either acquired, induced, or congenital origin
  • Hypersensitivity to dexamethasone
  • Patient being treated with either topical, oral, or intravenous steroids
  • Patients with severe disease that warrants critical attention, deemed unsafe for the study by the investigator

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Crossover-oppdrag
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Lipiflow Only Group

Patients with dry eye disease Lipiflow only

To manage patients with dry eye disease secondary to MGD

Eksperimentell: Lipiflow + Dextenza Group

Patients with dry eye disease Lipiflow + Dextenza

to investigate the benefit of managing patients with DED secondary to MGD with a sustained release intracanalicular dexamethasone (0.4 mg) insert in addition to LipiFlow Thermal Pulsation

Andre navn:
  • Dextenza

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change From Baseline in Meibomian Gland Scores (Expressibility and Quality)
Tidsramme: Assessed at Baseline, Week 1, Week 4 and Week 12

Meibomian gland expressibility was graded at the slit lamp using the methodology of the pivotal LipiFlow trial. Fifteen glands of the lower eyelid (5 temporal, 5 central, 5 nasal) were each graded on a 0-3 scale (0 = no secretion; 1 = inspissated/toothpaste-like secretion; 2 = cloudy liquid secretion; 3 = clear liquid secretion). Grades were summed to produce a composite Meibomian Gland Expressibility Score ranging from 0 to 45. Higher scores indicate better meibomian gland function. Values shown are the mean score at each study visit.

Assessed at Baseline, Week 1, Week 4 and Week 12
Patient Preference
Tidsramme: Assessed at Week 12

As measured by COMTOL Survey

Assessed at Week 12

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
The Rate of Positive MMP-9
Tidsramme: Assessed at Baseline, Week 1, Week 4 and Week 12 Visit

Meibomian gland inflammation was assessed using the InflammaDry point-of-care immunoassay, which detects elevated matrix metalloproteinase-9 (MMP-9) levels in tear fluid. Results are reported as positive or negative based on a predefined assay threshold. The outcome represents the proportion of eyes testing positive for MMP-9 at each study visit.

Assessed at Baseline, Week 1, Week 4 and Week 12 Visit
Mean Change in Ocular Surface Staining
Tidsramme: Assessed at Baseline, Week 1, Week 4 and Week 12 Visit

Corneal fluorescein staining was graded on a 0-3 scale (none to heavy) in 5 corneal regions (superior, inferior, nasal, temporal, central) and summed for a corneal score (range 0-15). Conjunctival lissamine green staining was graded on the same 0-3 scale in 6 conjunctival regions (3 nasal, 3 temporal) and summed for a conjunctival score (range 0-18). Corneal and conjunctival scores were summed to produce a total Ocular Surface Staining Score ranging from 0 to 33. Higher scores indicate greater ocular surface damage (worse outcome). Values shown are the mean score at each study visit.

Assessed at Baseline, Week 1, Week 4 and Week 12 Visit
Mean Change in Tear Break-up Time (TBUT)
Tidsramme: Assessed at Baseline, Week 1, Week 4 and Week 12 Visit

Tear break-up time (TBUT) was measured in seconds following fluorescein instillation as the interval between a complete blink and the first appearance of tear film disruption. Higher TBUT values indicate greater tear film stability. Values shown are the mean TBUT at each study visit.

Assessed at Baseline, Week 1, Week 4 and Week 12 Visit
Mean Change in Tear Osmolarity (mOsm/L)
Tidsramme: Assessed at Baseline, Week 1, Week 4 and Week 12 Visit

Tear osmolarity was measured using a point-of-care tear osmolarity system and reported in milliosmoles per liter (mOsm/L). Higher values indicate greater tear film hyperosmolarity and ocular surface stress. Values shown are the mean tear osmolarity at each study visit.

Assessed at Baseline, Week 1, Week 4 and Week 12 Visit
Mean Change in DEQ-5
Tidsramme: Assessed at Baseline, Week 1, Week 4 and Week 12 Visit

Dry eye symptoms were assessed using the Dry Eye Questionnaire-5 (DEQ-5), a validated patient-reported outcome instrument with scores ranging from 0 to 22. Higher DEQ-5 scores indicate greater severity of dry eye symptoms. The outcome represents the mean change in DEQ-5 score from baseline at each study visit.

Assessed at Baseline, Week 1, Week 4 and Week 12 Visit
Mean Change in Best-corrected Visual Acuity (BCVA)
Tidsramme: Assessed at Baseline, Week 1, Week 4 and Week 12 Visit

Best-corrected visual acuity (BCVA) was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart and recorded as the number of letters read correctly (range 0 to 100 letters). Higher letter scores indicate better visual acuity. Values shown are the mean BCVA letter score at each study visit.

Assessed at Baseline, Week 1, Week 4 and Week 12 Visit

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Samarbeidspartnere

Etterforskere

  • Hovedetterforsker: Damon Dierker, OD, FAAO, Eye Surgeons of Indiana

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. august 2020

Primær fullføring (Faktiske)

1. juli 2021

Studiet fullført (Faktiske)

1. juli 2021

Datoer for studieregistrering

Først innsendt

28. mai 2020

Først innsendt som oppfylte QC-kriteriene

28. mai 2020

Først lagt ut (Faktiske)

2. juni 2020

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

10. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

18. oktober 2026

Sist bekreftet

1. oktober 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • The DIERKER Study

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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