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Comparison of Traditional Cataract Surgery and Traditional Surgery Combined Triamcinolone Staining

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StatusRecruiting
Sponsors
Sun Yat-sen University

Keywords

Abstract

Previously, the investigators have developed a surgical technique to reduce inflammatory response after congenital cataract surgery. This prospective, randomized controlled study aims to compare the prognosis of traditional cataract surgery with traditional surgery combined triamcinolone staining of the anterior vitreous in treating congenital cataracts.

Description

Surgical technique for congenital cataract is now more and more mature, but many young patients still have obvious postoperative inflammatory response, which might cause visual axial opacification, posterior synechiae and secondary glaucoma. Triamcinolone is used in intraocular injection for its anti-inflammatory effect However, the application of Triamcinolone was reported to be associated with high intraocular pressure. It is necessary to evaluate the safety and effectiveness of using triamcinolone in congenital cataract surgery.

In this randomized clinical trial, children with equal degree of congenital cataract in both eyesare enrolled. Patients receive cataract surgery on both eyes on the same day. For each patient, one eye is randomly assigned to undergo traditional surgical procedure, while the fellow eye is undergoing new surgical procedure. The traditional surgical procedure include anterior continuous curvilinear capsulorhexis (ACCC), irrigation/aspiration (I/A), posterior continuous curvilinear capsulorhexis (PCCC), and anterior vitrectomy(A-VIT). Primary intraocular lens implantation (IOL) is performed in children older than age of two. The new surgical procedure is to combine triamcinolone staining of the anterior vitreous on the basis of the traditional surgical procedure. Investigators then compare the incidence of high intraocular pressure, visual axis opacification, uveitis, iris/pupil abnormality, and macular edema between two groups

Dates

Last Verified: 05/31/2020
First Submitted: 03/24/2020
Estimated Enrollment Submitted: 03/25/2020
First Posted: 03/26/2020
Last Update Submitted: 06/01/2020
Last Update Posted: 06/03/2020
Actual Study Start Date: 03/26/2020
Estimated Primary Completion Date: 03/24/2021
Estimated Study Completion Date: 03/24/2021

Condition or disease

Congenital Cataract

Intervention/treatment

Procedure: New Cataract Surgery

Procedure: Traditional Cataract Surgery

Phase

-

Arm Groups

ArmIntervention/treatment
Experimental: New Cataract Surgery
Traditional surgery combined triamcinolone staining of the anterior vitreous (TA)
Procedure: New Cataract Surgery
(ACCC + I / A + PCCC + TA+ A-vit) or (ACCC + I / A + PCCC + IOL + TA + A-vit)
Active Comparator: Traditional Cataract Surgery
For patients younger than 2 years of age: anterior continuous capsulorhexis + irrigation/aspiration + posterior capsulorhexis + anterior vitrectomy (ACCC+ I/A + PCCC + A-vit) For patients older than 2years of age: anterior continuous capsulorhexis + irrigation/aspiration + posterior capsulorhexis + primary intraocular lens implantation + anterior vitrectomy (ACCC+ I/A + PCCC + IOL + A-vit)
Procedure: Traditional Cataract Surgery
(ACCC + I / A + PCCC + A-vit) or (ACCC + I / A + PCCC + IOL + A-vit)

Eligibility Criteria

Ages Eligible for Study 3 Months To 3 Months
Sexes Eligible for StudyAll
Accepts Healthy VolunteersYes
Criteria

Inclusion Criteria:

1. Age between 3 months and 13 years

2. Uncomplicated bilateral same degree of congenital cataract (≥ 3 mm central dense opacity)

3. Informed consent signed by a parent or legal guardian

Exclusion Criteria:

1. Intraocular pressure >21 mmHg

2. Preterm birth (<28 weeks)

3. Presence of other ocular diseases (keratitis, keratoleukoma, aniridia, glaucoma, microcornea, persistent hyperplastic primary vitreous) or systemic disease (congenital heart disease, ischemic encephalopathy)

4. History of ocular trauma

5. Previous intraocular surgery

Outcome

Primary Outcome Measures

1. incidence of high intraocular pressure [5 years]

Determined with the Tono-pen.

2. incidence of visual axis opacification [5 years]

Visual axis obscuration will be evaluated based on the retroillumination.

3. incidence of uveitis and iris/pupil abnormality [5 years]

Uveitis and iris/pupil abnormality will be evaluated based on the slip lamp examination.

Secondary Outcome Measures

1. Best corrected visual acuity [5 years]

Determined with the Teller's acuity card, the Lea symbol visual acuity chart or the ETDRS chart according the patient's age.

2. Central corneal thickness [5 years]

Determined with the pentacam.

3. Central macular thickness [5 years]

Determined with the optical coherence tomography.

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