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Capsular Tension Ring With Hydrophilic Versus Hydrophobic Intraocular Lenses (CTR-IOL-3ARM)

21 września 2026 zaktualizowane przez: Ehab Mohamed Elsayed Mohamed Saad, Benha University

Outcomes of Hydrophilic Intraocular Lens Implantation With and Without a Capsular Tension Ring Versus Hydrophobic Intraocular Lens Implantation Alone: A Randomized Controlled Trial

This study compares three approaches to cataract surgery. Cataract surgery involves removing the eye's cloudy natural lens and replacing it with an artificial intraocular lens (IOL) to restore clear vision. IOLs are made from different materials, most commonly a "hydrophilic" (water-attracting) acrylic or a "hydrophobic" (water-repelling) acrylic. Hydrophilic lenses are generally easier and less expensive to use, but have been linked in past research to a higher chance of the lens capsule becoming cloudy again after surgery (posterior capsule opacification, or PCO), sometimes requiring a follow-up laser treatment. Hydrophobic lenses tend to have lower rates of this problem but can cost more.

A capsular tension ring (CTR) is a small flexible ring that can be placed inside the eye at the time of surgery to help hold the lens capsule in a stable, round shape. This study asks whether adding a CTR when a hydrophilic lens is used can reduce the disadvantages usually seen with that lens material.

600 adult patients (ages 50-80) undergoing cataract surgery at three hospitals in Egypt were randomly assigned to one of three groups: (1) a hydrophilic lens plus a CTR, (2) a hydrophobic lens alone (the common comparison approach), or (3) a hydrophilic lens alone without a CTR. Patients were followed for 24 months, and researchers compared vision, glasses prescription accuracy, lens position, capsule clouding, need for laser treatment, and surgical complications between the groups.

The results showed that adding a CTR to a hydrophilic lens produced results very similar to using a hydrophobic lens alone. In contrast, using a hydrophilic lens without a CTR resulted in worse vision, less accurate glasses prescriptions, more lens shifting or tilting, more capsule clouding, a higher need for laser treatment, and more complications compared with the hydrophobic lens. These findings suggest that adding a CTR may be a simple, low-cost way to improve outcomes when a hydrophilic lens is used for cataract surgery.

Przegląd badań

Status

Zakończony

Warunki

Interwencja / Leczenie

Szczegółowy opis

Background and rationale: Phacoemulsification with intraocular lens (IOL) implantation is the standard treatment for age-related cataract. IOL material (hydrophilic versus hydrophobic acrylic) is a recognized determinant of long-term capsular biocompatibility, with hydrophobic acrylic lenses generally associated with lower rates of posterior capsule opacification (PCO) and reduced need for neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy compared with hydrophilic acrylic lenses. Capsular tension rings (CTRs) are polymethyl methacrylate devices that stabilize the capsular bag equator and have been proposed to mitigate capsular contraction, lens decentration, and PCO, independent of IOL material. Prior comparative work has generally examined either IOL material effects or CTR effects in isolation, or has compared a composite intervention (hydrophilic IOL plus CTR) against a hydrophobic IOL alone, without a design capable of isolating the CTR's independent contribution.

Objectives: To compare visual, refractive, anatomical (IOL position and posterior capsule opacification), and safety outcomes among three approaches to routine cataract surgery: (1) hydrophilic acrylic IOL implantation combined with a CTR (Group A); (2) hydrophobic acrylic IOL implantation alone (Group B); and (3) hydrophilic acrylic IOL implantation alone, without a CTR (Group C). The inclusion of Group C, using the same hydrophilic IOL model as Group A but without CTR insertion, was designed specifically to allow assessment of the CTR's independent contribution when compared against Group A, in addition to the material-based comparisons of Groups A and C against Group B.

Design: Prospective, randomized, parallel-group, three-arm controlled trial conducted at three tertiary ophthalmology centers in Egypt (Zagazig University Hospital, Benha University Hospital, and Al-Azhar University Hospital). Eligible adults aged 50-80 years with visually significant age-related cataract (LOCS III grade >=3) were randomized 1:1:1 using a computer-generated allocation sequence, with allocation concealment via sealed opaque envelopes opened intraoperatively. Outcome assessors and data analysts were blinded to treatment allocation; operating surgeons were not blinded due to the nature of the intervention.

Interventions: All participants underwent standardized phacoemulsification via a 2.2 mm clear corneal incision with a ~5.5 mm continuous curvilinear capsulorhexis. Group A received a hydrophilic acrylic IOL (Eyecryl, Biotech Healthcare, India) plus a polymethyl methacrylate CTR (Auroring CTR 11, Aurolab, India). Group B received a hydrophobic acrylic IOL (AcrySof IQ, Alcon Laboratories, USA) without a CTR. Group C received the same hydrophilic acrylic IOL as Group A, without CTR insertion.

Outcomes: Primary outcomes were best-corrected visual acuity (logMAR) and manifest spherical equivalent refractive error at 24 months, with longitudinal assessment at 1, 3, 6, 12, 18, and 24 months. Secondary outcomes included posterior capsule opacification grade (slit-lamp retroillumination, graded per Aslam et al.), Nd:YAG capsulotomy rate, IOL centration and tilt (anterior segment optical coherence tomography), and intraoperative and postoperative complications (posterior capsule rupture, zonular dialysis, vitreous loss, iris trauma, cystoid macular edema, intraocular pressure elevation, corneal edema, and endophthalmitis).

Follow-up: Scheduled visits at day 1, week 1, and months 1, 3, 6, 12, 18, and 24 postoperatively, with the 24-month visit representing the final prespecified assessment.

Statistical analysis: Continuous variables were compared across groups using one-way ANOVA or Kruskal-Wallis testing as appropriate, with post-hoc pairwise comparisons for Group A vs. Group B and Group C vs. Group B. Categorical variables were compared using chi-square or Fisher's exact test. Repeated-measures ANOVA assessed longitudinal group x time interactions for visual and refractive outcomes.

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

600

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

    • Benha
      • Banhā, Benha, Egipt, 13111
        • Benha University

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat i starsze (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  • Age 50-80 years
  • Visually significant age-related cataract, defined as nuclear opacity grade >=3 according to the Lens Opacities Classification System III (LOCS III), graded preoperatively under standardized mydriasis via slit-lamp biomicroscopy
  • Clear cornea
  • Adequate pupillary dilation
  • Anatomically normal capsular bag with no evidence of zonular weakness
  • No ocular comorbidities expected to affect visual or refractive outcomes

Exclusion Criteria:

  • Previous intraocular surgery
  • Ocular trauma
  • Pseudoexfoliation syndrome
  • Posterior polar cataract
  • Zonular instability
  • Complicated cataract
  • Active intraocular inflammation
  • Retinal or optic nerve pathology
  • Anticipated need for additional capsular support devices beyond the study protocol

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Pojedynczy

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: U.S. flag An official website of the United States government Here's how you know Skip to main page

Phacoemulsification with implantation of a hydrophilic acrylic intraocular lens (Eyecryl, Biotech Healthcare, India) combined with insertion of a polymethyl methacrylate capsular tension ring (Auroring CTR 11, Aurolab, India).

Foldable hydrophilic acrylic intraocular lens implanted in the capsular bag following phacoemulsification.

Polymethyl methacrylate capsular tension ring (overall diameter 13.0 mm, compressed diameter 11.0 mm) inserted into the capsular bag to distribute equatorial zonular forces and maintain capsular bag contour.

Aktywny komparator: Group B: Hydrophobic IOL alone

Phacoemulsification with implantation of a hydrophobic acrylic intraocular lens (AcrySof IQ, Alcon Laboratories, USA), without a capsular tension ring.

Foldable hydrophobic acrylic intraocular lens implanted in the capsular bag following phacoemulsification.

Eksperymentalny: Group C: Hydrophilic IOL alone

Phacoemulsification with implantation of the same hydrophilic acrylic intraocular lens used in Group A (Eyecryl, Biotech Healthcare, India), without capsular tension ring insertion.

Foldable hydrophilic acrylic intraocular lens implanted in the capsular bag following phacoemulsification.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Best-corrected visual acuity (BCVA)
Ramy czasowe: 24 months postoperatively

Best-corrected visual acuity measured in logMAR units, assessed longitudinally at 1, 3, 6, 12, 18, and 24 months, with between-group comparison at 24 months as the primary efficacy endpoint.

24 months postoperatively

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Manifest spherical equivalent refractive error
Ramy czasowe: 24 months postoperatively

Manifest spherical equivalent refractive error (diopters), assessed longitudinally at 1, 3, 6, 12, 18, and 24 months, with between-group comparison at 24 months as the primary efficacy endpoint. Proportion of eyes within +/-0.5 D and +/-1.0 D of target refraction was also assessed at 24 months.

24 months postoperatively

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

15 grudnia 2022

Zakończenie podstawowe (Rzeczywisty)

15 maja 2026

Ukończenie studiów (Rzeczywisty)

15 maja 2026

Daty rejestracji na studia

Pierwszy przesłany

21 września 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

21 września 2026

Pierwszy wysłany (Rzeczywisty)

25 września 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

25 września 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

21 września 2026

Ostatnia weryfikacja

1 września 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • ZU-BU-AU-CTR-IOL-3ARM-2023

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .