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Primary Tube Versus Trabeculectomy Study

Phase 4
Completed
Conditions
Glaucoma
Interventions
Procedure: Tube shunt surgery
Procedure: Trabeculectomy
Registration Number
NCT00666237
Lead Sponsor
University of Miami
Brief Summary

The purpose of the Primary Tube Versus Trabeculectomy (PTVT) Study is to compare the long-term safety and efficacy of nonvalved tube shunt surgery to trabeculectomy with mitomycin C in eyes that have not had previous ocular surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
242
Inclusion Criteria
  • Age 18-85 years
  • Glaucoma that is inadequately controlled on tolerated medical therapy with Intraocular Pressure (IOP) greater than or equal to 18 mm Hg and less than or equal to 40 mm Hg
  • No previous incisional ocular surgery
Exclusion Criteria
  • Unwilling or unable to give consent, unwilling to accept randomization, or unable to return for scheduled protocol visits
  • Pregnant or nursing women
  • No light perception vision
  • Active iris neovascularization or active proliferative retinopathy
  • Iridocorneal endothelial syndrome
  • Epithelial or fibrous ingrowth
  • Chronic or recurrent uveitis
  • Steroid-induced glaucoma
  • Severe posterior blepharitis
  • Unwilling to discontinue contact lens use after surgery
  • Previous cyclodestructive procedure
  • Conjunctival scarring from prior ocular trauma or cicatrizing disease precluding a superior trabeculectomy
  • Functionally significant cataract
  • Need for glaucoma surgery combined with other ocular procedures or anticipated need for additional ocular surgery

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Tube shunt surgery groupTube shunt surgeryParticipants in this group will receive a tube shunt surgery (Baerveldt Glaucoma implant).
Trabeculectomy with Mitomycin CTrabeculectomyParticipants in this group will receive a Trabeculectomy surgery with Mitomycin C
Trabeculectomy with Mitomycin CMitomycin CParticipants in this group will receive a Trabeculectomy surgery with Mitomycin C
Primary Outcome Measures
NameTimeMethod
Number of Participants With Surgical FailureUp to 5 years

Surgical failure is defined as:

1. Inadequate Intraocular Pressure (IOP) Reduction (IOP \> 21 mmHg or reduced \< 20% below baseline on 2 consecutive follow-up visits after 3 months)

2. Reoperation for glaucoma

3. Persistent hypotony (IOP ≤ 5 mmHg on 2 consecutive visits after 3 months)

4. Loss of light perception vision

Secondary Outcome Measures
NameTimeMethod
Visual Acuity as Measured Using EDTRS ChartAt baseline, At 5 years

Visual acuity will be reported as the number of correctly identified letters on the Early Treatment Diabetic Retinopathy Study (EDTRS) chart. Total score ranges from 0-100 with the higher score indicating better visual acuity.

Visual FieldUp to 5 years

Visual fields will be measured using standard automated perimetry.

Reoperation for GlaucomaUp to 5 years

The number of participants requiring reoperation for glaucoma will be reported

Number of Participants With Reported Postoperative ComplicationsUp to 5 years

Number of participants with early and late postoperative complications will be reported as per treating physician assessment

Intraocular PressureAt baseline, At 1 year, At 18 months, At 2 years, At 3 years, At 4 years, At 5 years

Intraocular pressure will be reported in mmHg and measured using Goldmann applanation tonometry or a Tono-Pen.

Visual Acuity Using a Snellen ChartAt Baseline, At 5 years

Visual acuity will be measured using a Snellen chart on logMAR (Logarithm of Minimal Angle of Resolution) scale. Letter-by letter results calculated the visual performance score for each chart read. logMAR scores closer to zero, or below zero, indicate a better visual acuity. A logMAR visual performance score of 0.0 is equivalent to Snellen visual acuity of 20/20.

Number of Glaucoma MedicationsAt Baseline, At 1 year, At 18 months, At 2 years, At 3 years, At 4 years, At 5 years

The need for supplemental glaucoma medications will be reported as the number of glaucoma medications used

Trial Locations

Locations (16)

St. Louis University

🇺🇸

Saint Louis, Missouri, United States

New York Eye and Ear Infirmary

🇺🇸

New York, New York, United States

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

University of Toronto

🇨🇦

Toronto, Canada

Moorfields Eye Hospital

🇬🇧

London, United Kingdom

St. Thomas' Hospital

🇬🇧

London, United Kingdom

Queen Mary's Sidcup Hospital

🇬🇧

Sidcup, United Kingdom

University of Florida

🇺🇸

Gainesville, Florida, United States

Bascom Palmer Eye Institute

🇺🇸

Miami, Florida, United States

University of Texas, Houston

🇺🇸

Houston, Texas, United States

Glaucoma Associates of Texas

🇺🇸

Dallas, Texas, United States

University of California Davis Medical Center

🇺🇸

Sacramento, California, United States

Cincinnati Eye Institute

🇺🇸

Cincinnati, Ohio, United States

Johns Hopkins

🇺🇸

Baltimore, Maryland, United States

University of Oklahoma

🇺🇸

Oklahoma City, Oklahoma, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

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