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Efficacy and Necessity of Anti-inflammatory Drops After Laser Peripheral Iridotomy

Not Applicable
Conditions
Glaucoma, Closed-Angle
Glaucoma, Narrow-Angle
Glaucoma, Angle-Closure
Interventions
Registration Number
NCT02955641
Lead Sponsor
Sheba Medical Center
Brief Summary

The purpose of this study is to evaluate the efficacy and need for prescribing anti-inflammatory topical drops to patients undergoing laser peripheral iridotomy.

Detailed Description

Primary closed angle glaucoma is responsible to almost half glaucoma related blindness around the world. Laser peripheral iridotomy (LPI) is a common and simple treatment used for both treatment and prevention of acute angle closure event.

Anti-inflammatory drops are commonly prescribed to patients undergoing LPI in order to prevent or reduce post-treatment discomfort. However, to date, there are no specific guidelines for post LPI anti-inflammatory treatment, nor sufficient clinical evidence regarding the efficacy of such treatment.

In the current study, the investigators aim to evaluate the effect of topical steroids and non-steroidal anti-inflammatory drugs (NSAIDs) on post LPI symptoms and inflammation markers.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Diagnosis of primary narrow/closed angle by gonioscopy
  • Able to give consent
  • Ability to attend follow-up visits
Exclusion Criteria
  • Corneal disease preventing sufficient evaluation of the angle
  • Secondary closed angle (e.g. uveitis related)
  • Pregnant women
  • Previous eye surgery other than laser refractive correction

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Steroid-PlaceboDexamethasone Disodium Phosphate 0.1%Will receive Dexamethasone Disodium Phosphate 0.1% in the first eye, and Hydroxyethylcellulose 0.19% in the second eye
Placebo-SteroidsDexamethasone Disodium Phosphate 0.1%Will receive Hydroxyethylcellulose 0.19%in the first eye, and Dexamethasone Disodium Phosphate 0.1%in the second eye
Placebo-SteroidsHydroxyethylcellulose 0.19%Will receive Hydroxyethylcellulose 0.19%in the first eye, and Dexamethasone Disodium Phosphate 0.1%in the second eye
Placebo-NSAIDsHydroxyethylcellulose 0.19%Will receive Hydroxyethylcellulose 0.19% in the first eye, and Nepafenac 0.1%in the second eye
Steroid-PlaceboHydroxyethylcellulose 0.19%Will receive Dexamethasone Disodium Phosphate 0.1% in the first eye, and Hydroxyethylcellulose 0.19% in the second eye
NSAIDs-PlaceboNepafenac 0.1%Will receive Nepafenac 0.1%in the first eye, and Hydroxyethylcellulose 0.19% in the second eye
NSAIDs-PlaceboHydroxyethylcellulose 0.19%Will receive Nepafenac 0.1%in the first eye, and Hydroxyethylcellulose 0.19% in the second eye
Placebo-NSAIDsNepafenac 0.1%Will receive Hydroxyethylcellulose 0.19% in the first eye, and Nepafenac 0.1%in the second eye
Primary Outcome Measures
NameTimeMethod
Pain scoreAt four days post LPI treatment

Using VAS pain scale

Symptoms scoreAt four days post LPI treatment

Using a modified questionnaire based on the ocular surface disease index.

Secondary Outcome Measures
NameTimeMethod
Grading of cells in the anterior chamberAt four days post LPI treatment

Assessed by counting the number of cells in the anterior chamber and applying the SUN working group grading scheme for anterior chamber cells

Patency of LPI by visualisationup to 30 days post LPI treatment

Assessed on slit-lamp examination using transilumination and visualising the site of LPI treatment for the presence (patent) or obsence (closed) of transilumination defect

Grading of flare in anterior chamberAt four days post LPI treatment

Assessed by counting the number of cells in the anterior chamber and applying the SUN working group grading scheme for anterior chamber flare

Trial Locations

Locations (1)

Sheba Medical Center

🇮🇱

Tel HaShomer, Israel

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