A Prospective, One-center Clinical Trial to Identify the Safety and Feasibility of Sutureless Pars-plana Vitrectomy Performed in Sub-tenon Anesthesia.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Vitreoretinal Diseases
- Sponsor
- RWTH Aachen University
- Enrollment
- 67
- Locations
- 1
- Primary Endpoint
- Discomfort
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The aim of this prospective study is to investigate the feasibility of performing minimally invasive vitrectomy under sub-tenon anesthesia in terms of intraoperative patients' tolerance and the surgeon's confidence. In particular, the tolerance and pain sensation during the operation as well as the possible perception of light and colour sensations are to be recorded with the help of questionnaires. In addition, the surgeon's impressions regarding eye motility, chemosis and general feasibility will be evaluated.
Detailed Description
A prospective, one-center clinical trial to identify the safety and feasibility of sutureless pars-plana vitrectomy performed in sub-tenon anesthesia. Background: In Germany pars-plana vitrectomies are mostly performed in general anesthesia. This requires the immediate availability of a trained anesthesiology team, which is not always granted, especially in urgent eye disease (i.e. endophthalmitis, high risk retinal detachment). Furthermore, some patients are not suitable for general anesthesia due to systemic diseases (i.e. cardio-vascular diseases). There are several procedures of local ocular anesthesia (i.e. peribulbar, retrobulbar, sub-tenon anesthesia). The main advantage of sub-tenon anesthesia is the use of a blunt cannula limiting the risk of potential complications. Purpose: The purpose of this study is to investigate the safety of local sub-tenon anesthesia procedure for sutureless vitrectomy (anesthetic mixture: 2ml xylocaine and 2ml bupivacaine) in a prospective clinical study design. Objectives: Primary outcome: The evaluation of 1. sensation of pain, 2. patients' intraoperative discomfort and 3. visual sensations using the standardized questionnaires (WONG-BAKER Faces Scale, Visual Analog Scale and individual questions). Secondary Outcome: The evaluation of 1. chemosis, 2. eye movement, 3. surgeon's general feeling of comfort during surgery (rating scale).
Investigators
Antonis Koutsonas
Dr. med. Antonis Koutsonas
RWTH Aachen University
Eligibility Criteria
Inclusion Criteria
- •Age over 40 years
- •Presence of a clinical condition that requires surgical treatment with vitrectomy and does not necessarily require general anesthesia (retinal detachment, endophthalmitis, vitreous hemorrhage, after silicone oil surgery, vitreomacular traction, epiretinal gliosis, macular holes, subretinal bleeding, lens luxation).
- •The medical indication for vitrectomy is not linked to study participation. Not until the patient has consented to the vitrectomy (standardized information forms) potential study subjects will be approached to participate in the clinical trial.
- •Willingness to participate in the clinical trial
- •Understanding the objectives of the clinical trial and the study process
- •Signed informed consent form
Exclusion Criteria
- •Concomitant diseases of the eye
- •State after filtering glaucoma operations
- •Distinct corneal opacities, which make the examination considerably more difficult
- •Complicated proliferative vitreoretinopathy
- •Lack of understanding of the study, its objectives and study conduct
- •Psychiatric diseases
- •Pregnancy
- •Simultaneous participation in another clinical trial
Outcomes
Primary Outcomes
Discomfort
Time Frame: 1 Day
11-point numeric scale ranges from '0' (means "no discomfort") to '10' (means "worst discomfort imaginable"), Questionnaire
Sensation of pain
Time Frame: 1 Day
1. 11-point numeric scale ranges from '0' (means "no pain") to '10' (means "worst pain imaginable"), Questionnaire 2. Wong-Baker FACES® Scale (6 Faces, range no hurt - hurts worst), Questionnaire
Visual Sensations
Time Frame: 1 Day
4 questions, Likert scale ("yes", "no", "don't know/not sure"), Questionnaire 1. perception of details during surgery (instruments, surgeon's face) 2. perception of colors during surgery 3. perception of lights or shadows 4. no light perception at all during surgery
Secondary Outcomes
- Chemosis(1 Day)
- Eye movement(1 Day)
- Surgeon's general feeling of comfort during the surgery(1 Day)