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Posterior Capsulotomy in Cataract Complicated With Primary Posterior Capsule Opacification.

Not Applicable
Conditions
Cataract
Posterior Capsule Opacification
Interventions
Procedure: laser capsulotomy
Procedure: posterior capsulotomy
Registration Number
NCT03701139
Lead Sponsor
Zhongshan Ophthalmic Center, Sun Yat-sen University
Brief Summary

This is a two-arm, parallel group, open-label, randomized controlled trial to compare the visual acuity, visual quality, operative complications and the satisfaction of patients between primary posterior capsulorhexis group and laser capsulotomy group of cataract patients combined with primary posterior capsular opacification (PPCO).

Detailed Description

Primary posterior capsular opacification (PPCO) refers to the posterior capsule opacification which cannot be removed by polishing or vacuuming during cataract surgery. The surgeon may have to decide on primary posterior capsulorhexis or early neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy in these cases. The aim of this study is to compare the visual acuity, visual quality, operative complications and the satisfaction of patients between primary posterior capsulorhexis group and laser capsulotomy group of cataract patients combined with primary posterior capsular opacification (PPCO).

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  1. Cataract patients with primary posterior capsular opacification, which involves the central posterior capsular and interferes with visual axis;
  2. Aged 18 years or over;
  3. With best corrected visual acuity (BCVA) less than 0.3.
Exclusion Criteria
  1. History of other eye disease that contributes to visual impairment, including keratopathy, uveitis, glaucoma, retinopathy, ocular trauma, or intraocular surgery.
  2. Cases with operative complications, including anterior or posterior capsular rupture, lens suspensory ligament rupture, the falling of lens nucleus into vitreous cavity.
  3. Unwillingness to participate in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Nd:YAG laser capsulotomylaser capsulotomyNd:YAG laser capsulotomy will be performed 1 month postoperative to remove the primary posterior capsule opacification.
posterior capsulotomyposterior capsulotomyPrimary posterior capsulotomy will be performed to remove the primary posterior capsule opacification after posterior capsule polishing during phacoemulsification.
Primary Outcome Measures
NameTimeMethod
LogMAR visual acuity 1 month postoperatively1 month

Best corrected visual acuity (LogMAR) will be measured 1 month postoperatively.

Secondary Outcome Measures
NameTimeMethod
Modulation transfer function cut off (MTF cut off)3 months

Modulation transfer function cut off (MTF cut off) relates directly to retinal image quality and is a useful indicator of visual performance in cataract eyes. MTF cut off will be measured by OQAS.

Rate of intraocular lens damage3 months

The rate of intraocular lens damage by Nd:YAG laser is documented.

Object scatter index (OSI)3 months

Object scatter index (OSI) is a ratio of 12 and 20 points from the perspective of the annular region of the light and the central 1 point perspective peak. OSI can objectively evaluate the amount of intraocular scattering and is an important index of optical quality. OSI is a score ranged from 0 to 10 and will be measured by Optical Quality Analysis System (OQAS).

Predicted visual acuity (PVA) with contrasts of 100%, 20% and 10%3 months

Predicted visual acuity (PVA) with contrasts of 100%, 20% and 10% correspond to three specific frequencies of the MTF that describe the eye's optical quality for the contrast values mentioned. In general, PVAs higher than 1 are associated to very high retinal image quality. PVA will be measured by OQAS.

Rate of retinal detachment3 months

Retinal detachment following surgical or laser posterior capsulotomy is documented and the rate of Retinal detachment is calculated.

Rate of ocular hypertension3 months

Diagnosis of ocular hypertension is based on IOP greater than 21 mm Hg and the rate of ocular hypertension is calculated.

Dysfunctional lens index (DLI)3 months

The dysfunctional lens index (DLI) is an objective lens performance metric derived from internal higher order aberrations (HOAs), pupil size, and contrast sensitivity data. DLI is a score ranged from 0 to 10. DLI will be measured by iTrace aberrometer.

Internal higher order aberration (HOAs)3 months

TInternal higher order aberration (HOAs) in micrometer can quantify the intraocular optical quality and will be measured by iTrace aberrometer.

Rate of ocular macular edema3 months

The central macular thickness in micrometer is measured by optical coherence tomography (OCT) and the rate of ocular macular edema is calculated.

Strehl ratio (SR)3 months

Strehl ratio (SR) is computed as the ratio between the areas under the MTF curve of the measured eye and that of the aberration-free eye, and therefore it provides more global information on the optical quality. SR is a score ranged from 0 to 1 and will be measured by OQAS.

Visual-functioning index 7 score3 months

Subjective satisfaction of patients is investigated by visual-functioning index 7 (VF-7) questionnaire. The VF-7 questionnaire comprises 7 questions for performing daily-life activities (1= a great deal of difficulty; 2= a moderate amount difficulty; 3= a little difficulty; 4= no difficulty). The VF-7 score is the average score of these 7 activities multiplied by 25, to give a final score between 0 and 100.

1. nighttime driving;

2. reading small print;

3. watching television;

4. seeing steps, stairs, or curbs;

5. reading traffic, street, or store signs;

6. cooking;

7. doing fine handwork

Trial Locations

Locations (1)

Zhongshan Ophthalmic Center, Sun Yat-sen University

🇨🇳

Guangzhou, Guangdong, China

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