Clinical trial NCT00597181: A Clinical Study Comparing the Inflammatory Response of the Ex-Press Mini Shunt to Trabeculectomy
Official title: A Clinical Study Comparing the Inflammatory Response of the Ex-Press Mini Glaucoma Shunt to Trabeculectomy in Subjects With Open-Angle Glaucoma
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE4
Conditions: Glaucoma
Keywords: Inflammatory response
Lead sponsor: Indiana University
Sponsor class: OTHER
Collaborators: name: Optonol
First posted: 2008-01-17
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The less invasive nature of the Ex-Press Mini shunt with mitomycin C induces less post-operative inflammation than trabeculectomy with mitomycin c.

Detailed description: The purpose of this study is to quantify the degree of post-operative inflammation in eyes which have undergone either trabeculectomy filtering surgery or Ex-Press mini shunt insertion. Early intraocular pressure control and postoperative complications will also be noted.

Eligibility criteria: Inclusion Criteria:

All subjects must:

1. Be willing and able to provide written Informed Consent.
2. Be able and willing to follow instructions on the use of post- operative medication and likely to complete the entire course of the study.
3. Be male or female of any race at least 18 years of age.
4. Have medically uncontrolled glaucoma for which they have elected to undergo surgery.
5. Diagnosed with primary open angle glaucoma, pigmentary or pseudoexfoliation glaucoma.

Exclusion Criteria:

No subject may:

1. Have any contraindication to intraocular surgery.
2. Diagnosed with: primary angle closure glaucoma, normal tension glaucoma, secondary glaucoma, neovascular glaucoma.
3. Have any active ocular disease other than glaucoma that would interfere with study parameters (such as: uveitis, ocular infection, or severe dry eye). Subjects with mild chronic blepharitis, age-related macular degeneration and background diabetic retinopathy may be enrolled at the discretion of the investigator.
4. Have laser ALT or SLT within the past 3 months or cataract surgery within the last six months.
5. Require use of ocular NSAID or systemic steroids.
6. Have known allergy or sensitivity to mitomycin C
7. Have corneal abnormalities that would interfere with the ability to obtain an adequate laser flare measurement.
8. Be concurrently enrolled in an investigational drug or device study or participation within the last 30 days in any investigational drug or device study.
9. Be pregnant, nursing, planning a pregnancy, or be of childbearing potential and not using a reliable form of contraception (a woman is considered of childbearing potential unless she is postmenopausal, has had a uterus and/or both ovaries removed, or has had a bilateral tubal ligation).
10. Have a situation or condition that in the investigator's opinion may put the subject at significant risk, may confound the study results, or may interfere significantly with participation in the study.

Primary outcomes:
measure: Aqueous humor flare
timeFrame: 2 months
Secondary outcomes:
measure: Aqueous humor cell
timeFrame: 2 months
Other outcomes:
Locations:
city: Indianapolis
country: United States
facility: IU Eye at Carmel
state: Indiana
Study officials:
affiliation: Indiana University School of Medicine
name: Louis B Cantor, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Hille K, Hans J, Manderscheid T, Spang S, Ruprecht KW. [Laser flare in combined cataract and glaucoma surgery]. Ophthalmologe. 2001 Jan;98(1):47-53. doi: 10.1007/s003470170199. German.
citation: Maris PJ Jr, Ishida K, Netland PA. Comparison of trabeculectomy with Ex-PRESS miniature glaucoma device implanted under scleral flap. J Glaucoma. 2007 Jan;16(1):14-9. doi: 10.1097/01.ijg.0000243479.90403.cd.
citation: Shah SM, Spalton DJ, Allen RJ, Smith SE. A comparison of the laser flare cell meter and fluorophotometry in assessment of the blood-aqueous barrier. Invest Ophthalmol Vis Sci. 1993 Oct;34(11):3124-30.
citation: Dahan E, Carmichael TR. Implantation of a miniature glaucoma device under a scleral flap. J Glaucoma. 2005 Apr;14(2):98-102. doi: 10.1097/01.ijg.0000151688.34904.b7.
citation: Shields, MB Textbook of Glaucoma. Fourth Edition; Williams & Wilkins, Baltimore, 1998.
citation: Guyer DR, Yannuzzi LA, Chang S, Shields JA, Green WR Retina-Vitreous-Macula. W.B. Saunders Company, Philadelphia, 1999.