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NCT Number: NCT06681688

Study of Complication Rates in Cataract Surgery Patients Treated With Combined Pre-operative NSAID, OMIDRIA, and Subconjunctival Triamcinolone Acetonide Compared With Peri-operative SOC

This is a multicenter, 2-arm, randomized, prospective study of patients slated for bilateral cataract extraction. One eye will be randomized to the Study Arm, and the fellow eye will be randomized to the Control Arm.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

The Eye Associates - Venice, Venice, Florida, United States

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About this study

For the control arm interventions:

Preoperatively, the Control Arm (control eye) will self-administer a regimen of ketorolac four times daily (QID) x 1 day and moxifloxacin drops three times daily (TID) x 1 day before surgery. On the Day of Surgery, eyes in the Control Arm will receive in-office drops administered by study staff according to the following schedule:

  • In pre-operative holding: 1 drop ketorolac, 1 drop moxifloxacin
  • Immediately prior to surgery: 1 drop ketorolac, 1 drop moxifloxacin
  • At the conclusion of surgery while still in the operating room: 1 drop ketorolac, 1 drop moxifloxacin, 1 drop prednisolone acetate
  • Any time in postoperative recovery: 1 drop ketorolac, 1 drop moxifloxacin, 1 drop prednisolone acetate

Eyes in the Control Arm will then self-administer the following postoperative interventions: ketorolac drops QID x 1 month, prednisolone acetate tapering QID x1 week, TID x 1 week, twice daily (BID) x 1 week, and once daily (QD) x 1 week; and moxifloxacin drops TID x 1 week.

For the study arm interventions:

Eyes will receive in-office drops on the Day of Surgery administered by study staff according to the following schedule:

  • In pre-operative holding: 1 drop ketorolac, 1 drop moxifloxacin
  • Immediately prior to surgery: 1 drop ketorolac, 1 drop moxifloxacin
  • At the conclusion of surgery while still in the operating room: 1 drop ketorolac, 1 drop moxifloxacin, 1 drop prednisolone acetate
  • Any time in postoperative recovery: 1 drop ketorolac, 1 drop moxifloxacin, 1 drop prednisolone acetate.

Eyes in the Study Arm will be treated with the following intraoperative interventions: intracameral phenylephrine 1.0%/ketorolac 0.3%, intracameral moxifloxacin, and subconjunctival triamcinolone acetonide.

The following study assessments will take place for all subjects:

Visual acuity measured by the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart (pinhole visual acuity [VA] or best corrected visual acuity [BCVA])

  • Slit lamp examination, including intraocular pressure (IOP) measurement
  • Grading of inflammation
  • Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire
  • Pain assessment on a 0-4 scale
  • Overall participant satisfaction on a 0-10 scale
  • Optical coherence tomography (OCT) imaging

Eyes in the Study Arm will also receive in-office drops administered by study staff at the end of the 1-day visit: 1 drop ketorolac, 1 drop moxifloxacin, 1 drop prednisolone acetate.

Rescue therapy for postoperative inflammation will be allowed for Study Arm participants, if necessary, at the discretion of the evaluating physician and will consist of prednisolone acetate QID (taper also at the discretion of the evaluating physician).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult participants > 18 years of age undergoing bilateral cataract surgery
  • Able to provide written informed consent prior to any study related procedure
  • Able and willing, as assessed by the Investigator, to follow study instructions, complete study assessments, comply with the protocol, and attend study visits for the duration of the study
  • Patients deemed to be "higher risk" for postoperative complications (e.g., well-controlled diabetes (HbA1c ≤7.0), history of uveitis, history of retinal vein occlusion, history of epiretinal membrane, history of vitreomacular traction, evidence of posterior synechiae, etc.) MAY be enrolled provided there has been no evidence of active disease or treatment in the prior 12 months
  • Participants who do not meet the exclusion criteria may be enrolled.

Exclusion criteria

  • Cataract surgery combined with any other procedure (e.g., glaucoma, retina, etc.)
  • Glaucoma patients or known steroid responders
  • Oral anti-inflammatory medications to treat a systemic disease (exceptions to this include 81 mg aspirin, ibuprofen for headache, etc.)
  • Intraocular injection within 6 months
  • Any prior ocular implant
  • Diagnosis of retinal thickening in the study eye within 12 months of enrollment
  • Inability to provide informed consent
  • Participation in another clinical trial

Treatment and study plan

Omidria, {0.3%-1% Intraocular Solution}, VIGAMOX {0.5% moxifloxacin hydrochloride}, Kenalog {0.4 ml, 10mg/ml, triamcinolone acetonide}

Drug

Eyes in the Study Arm will be treated with the following intraoperative interventions: Intracameral (OMIDRIA) phenylephrine 1.0%/ketorolac 0.3%, intracameral moxifloxacin (0.5%), and subconjunctival triamcinolone acetonide (0.4 mL, 10mgs/mL).

Other names: (OMIDRIA), Phenylephrine (1%) and Ketorolac (0.3%) intraocular solution

Ketorolac (0.5%) {Toradol}, moxifloxacin (0.5%) {VIGAMOX}, prednisolone acetate (1%) {Pred Forte}

Drug

On the Day of Surgery, eyes in the Control Arm will receive in-office drops administered by study staff according to the following schedule:

  • In pre-operative holding: 1 drop ketorolac (0.5%), 1 drop moxifloxacin (0.5%)
  • Immediately prior to surgery: 1 drop ketorolac (0.5%), 1 drop moxifloxacin (0.5%)
  • At the conclusion of surgery while still in the operating room: 1 drop ketorolac (0.5%), 1 drop moxifloxacin (0.5%), 1 drop prednisolone acetate (1%)
  • Any time in postoperative recovery: 1 drop ketorolac (0.5%), 1 drop moxifloxacin (0.5%), 1 drop prednisolone acetate (1%)

Other names: TORADOL (Generic), Vigamox, Avalox, Pred Forte, Prelone, Omnipred

Primary outcomes

  1. inflammation

    Time frame: 8 days

    The proportion of participants with inflammation on Day 8. (Participants will be considered to have no inflammation (Grade 0) if they have ≤ 2 anterior chamber cells and are asymptomatic.) {Anterior Inflammation Scale, 0-4 with 4 being the worst or most severe score}

Secondary outcomes

  1. SPEED Questionnaire

    Time frame: 30 days

    Mean change in SPEED Questionnaire from baseline to Day 8 and baseline to Day 30

Study contacts

Contact information is provided by the study sponsor or research team.

Cathleen McCabe, MD

CONTACT

[email protected]

941-493-3763

Paul Singh, MD

CONTACT

[email protected]

262-637-0500

Sponsors and collaborators

Lead sponsor

Inder Paul Singh, M.D.

Other

Collaborators

  • The Eye Associates

Registry information

Official study title

Prospective Study of Complication Rates in Cataract Surgery Patients Treated With Combined Pre-operative NSAID, OMIDRIA, and Subconjunctival Triamcinolone Acetonide Compared With Peri-operative Standard of Care

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Nov 8, 2024
Registry last updated
Nov 29, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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