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Efficacy Comparison Study of Steroids to Control Post-operative Inflammation

Phase 4
Conditions
Inflammation
Intraocular Pressure
Interventions
Registration Number
NCT01801774
Lead Sponsor
Mahidol University
Brief Summary

Phacoemulsification is a quick method with less complication for cataract surgery. Due to the use of ultrasonic energy, it produced more post-operative inflammation than other methods. Many routes of steroid had been used to control post-operative inflammation. The investigators here compare the efficacy of single depot steroid subtenon injection (20-mg triamcinolone) with four-time-a-day steroid eye drop (0.1% dexamethasone) in controlling inflammation after uneventful phacoemulsification.

Detailed Description

Cataract is one of the most common causes of blindness in the world. Surgical removal of lens is the only treatment for cataract, which now shifts from extracapsular cataract extraction to phacoemulsification. Although phacoemulsification provides faster operating time and gives better optical result and rapid recovery to the patient, it causes more inflammation post-operatively compare with extracapsular cataract extraction. Corticosteroids eye drops are mainly use to control intraocular inflammation after the surgery.

Other routes of corticosteroids have been introduced to increase the intraocular level and to increase the patient's compliance. Subtenon triamcinolone injection is easy and safe. Antiinflammatory effect of single subtenon triamcinolone injection lasts about 4-6 weeks. This method has been used in combination with corticosteroid eye drop to control the inflammation after cataract surgery in uveitic patients. It shows potency in controlling of intraocular inflammation with lower rate of increasing the intraocular pressure. The investigators here quantitatively compare the efficacy of subtenon 20-mg triamcinolone injection with 0.1% dexamethasone eye drop in controlling intraocular inflammation after uneventful phacoemulsification.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
140
Inclusion Criteria
  • Age older than 18 years old
  • Uncomplicated cataract patient scheduled for phacoemulsification and posterior chamber intraocular lens implantation
  • No History of prior intraocular procedures or any eye diseases such as uveitis, glaucoma, diabetic retinopathy
  • No History of systemic autoimmune diseases
  • No History of allergy to corticosteroids or to any component of the study medications
  • No History of using corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), or immunomodulating agents within 3 months prior to surgery
Exclusion Criteria
  • Complications occurred during cataract surgery such as ruptured posterior capsule, vitreous loss, or dropped nucleus
  • Pregnant and lactating women

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DexamethasonePlaceboDexamethasone 0.1%/Tobramycin 0.3% eye drop 4 times per day for 28 days
TriamcinoloneSubtenon 20-mg triamcinolone injectionSubtenon 20-mg Triamcinolone injection
Primary Outcome Measures
NameTimeMethod
Anterior chamber reactionpostoperative day 28

proportion of anterior chamber reaction grade 0 measured by anterior chamber inflammation score at postoperative day 28+/-5

Secondary Outcome Measures
NameTimeMethod
rate of increased intraocular pressure over 21 mmHgpreoperative, postoperative day 1,7,14,28,90

rate of increased intraocular pressure over 21 mmHg by Goldman applanation tonometer

Changes of anterior chamber reaction over timepreoperative, postoperative day1, 7, 14, 28, 90

repeated measure in changes of anterior chamber reaction over time from preoperative state to postoperative day 90

Trial Locations

Locations (1)

Siriraj Hospital

🇹🇭

Bangkok-Noi, Bangkok, Thailand

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