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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04557527
Other study ID # 283518
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date February 7, 2022
Est. completion date December 31, 2024

Study information

Verified date July 2023
Source King's College Hospital NHS Trust
Contact Riti Desai
Phone 020 3299 1297
Email ritidesai@nhs.net
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The study compares standard surgery for retinal detachment (RD) (vitrectomy, cryotherapy and gas) with a surgical variation that replaces the intraocular gas tamponade with suprachoroidal injection of viscoelastic underneath the break that caused the retinal detachment.


Description:

After being informed about the study and the potential risks, the eligible patients who have given written consent to the treatment will be randomized into treatment (vitrectomy, cryo and gas) or control (viscobuckle vitrectomy) group.


Recruitment information / eligibility

Status Recruiting
Enrollment 50
Est. completion date December 31, 2024
Est. primary completion date December 31, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: Patients requiring pars plana vitrectomy for the treatment of primary rhegmatogenous retinal detachment (RD) caused by a single break, or multiple breaks within one clock hour. The final determination of qualifying breaks is made at the time of surgery following 360-degree, internal, indented search using a wide-angle viewing system. Exclusion Criteria: - Hypersensitivity to hyaluronate or. HEALON5® PRO OVD - Participation in another interventional study within 8 weeks of enrolment or planned to occur during this study. - Bleeding disorders or the use of anticoagulants (such as warfarin, rivaroxaban) or dual anti-platelet drugs such as aspirin with clopidogrel. Monotherapy with low dose (=100 mg) aspirin is permitted, and if clinically appropriate this should be stopped prior to surgery and recommenced only after satisfactory day 1 post-operative review. - Unwilling, unable, or unlikely to return for scheduled follow-up for the duration of the trial. - Any other condition that, in the opinion of the investigator, would prevent the participant from granting informed consent or complying with the protocol, such as dementia, mental illness, or serious systemic medical disease. Study eye: - Presence of proliferative vitreoretinopathy (PVR) or any tractional RD - Previous vitreoretinal surgery, open-globe injury or endophthalmitis - Aphakia - Previous or current congenital cataract - Previous or current suprachoroidal haemorrhage - Congenital or acquired ocular, orbital or periocular abnormality that, in the opinion of the attending vitreoretinal surgeon, would preclude the safe delivery of Healon 5 into the suprachoroidal space (detail the specific reason for exclusion in the source documents) - Presence of other ocular co-morbidity that, in the opinion of the investigator, is likely to prevent an accurate assessment of retinal attachment - Current intraocular inflammation other than mild cellular activity thought to be secondary to RD - Current ocular or periocular infection other than blepharitis

Study Design


Intervention

Procedure:
Pars plana vitrectomy, laser or cryo retinopexy and intraocular gas tamponade
Conventional pars plana vitrectomy procedure is used to treat rhegmatogenous retinal detachment- laser or cryo retinopexy intraocular gas tamponade (SF6, C2F6 or C3F8) are chosen according to the number and size of the causative retinal break(s) and surgeons clinical judgement
Device:
Suprachoroidal viscobuckle with 2.3% Sodium hyaluronate (Healon 5 Ophthalmic viscoelastic device)
After drainage of subretinal fluid, approximately 0.5 ml of Healon 5 is injected in to the suprachoroidal space underlying the retinal break. Laser retinopexy is applied around the break .

Locations

Country Name City State
United Kingdom Guy's & St. Thomas' Hospital NHS Foundatrion Trust London
United Kingdom King's College Hospital NHS Foundation Trust London
United Kingdom Moorfields Eye Hospital London
United Kingdom Norfolk and Norwich University Foundation Trust Norwich
United Kingdom Southend University Hospital NHS Foundation Trust Southend
United Kingdom Sunderland Eye Infimary Sunderland Tyne And Wear

Sponsors (7)

Lead Sponsor Collaborator
King's College Hospital NHS Trust Mid and South Essex NHS Foundation Trust, Moorfields Eye Hospital NHS Foundation Trust, Norfolk and Norwich University Trust Foundation, Sheffield Teaching Hospitals NHS Foundation Trust, St Thomas' Hospital, London, University of Sunderland

Country where clinical trial is conducted

United Kingdom, 

References & Publications (7)

Boden KT, Januschowski K, Szurman P. [Suprachoroidal Hydrogel Buckle - a New Minimal-Invasive Technique in Treatment of Rhegmatogenous Retinal Detachment]. Klin Monbl Augenheilkd. 2019 Mar;236(3):308-312. doi: 10.1055/s-0043-102947. Epub 2017 Apr 4. German. — View Citation

El Rayes EN, Mikhail M, El Cheweiky H, Elsawah K, Maia A. SUPRACHOROIDAL BUCKLING FOR THE MANAGEMENT OF RHEGMATOGENOUS RETINAL DETACHMENTS SECONDARY TO PERIPHERAL RETINAL BREAKS. Retina. 2017 Apr;37(4):622-629. doi: 10.1097/IAE.0000000000001214. — View Citation

Jackson TL, Donachie PH, Sallam A, Sparrow JM, Johnston RL. United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 3, retinal detachment. Ophthalmology. 2014 Mar;121(3):643-8. doi: 10.1016/j.ophtha.2013.07.015. Epub 2013 Aug 23. — View Citation

Mikhail M, El-Rayes EN, Kojima K, Ajlan R, Rezende F. Catheter-guided suprachoroidal buckling of rhegmatogenous retinal detachments secondary to peripheral retinal breaks. Graefes Arch Clin Exp Ophthalmol. 2017 Jan;255(1):17-23. doi: 10.1007/s00417-016-3530-8. Epub 2016 Nov 16. — View Citation

Mitry D, Awan MA, Borooah S, Siddiqui MA, Brogan K, Fleck BW, Wright A, Campbell H, Singh J, Charteris DG, Yorston D. Surgical outcome and risk stratification for primary retinal detachment repair: results from the Scottish Retinal Detachment study. Br J Ophthalmol. 2012 May;96(5):730-4. doi: 10.1136/bjophthalmol-2011-300581. Epub 2012 Jan 18. — View Citation

Mohamed YH, Ono K, Kinoshita H, Uematsu M, Tsuiki E, Fujikawa A, Kitaoka T. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment. J Ophthalmol. 2016;2016:2193518. doi: 10.1155/2016/2193518. Epub 2016 Jul 13. — View Citation

Poole TA, Sudarsky RD. Suprachoroidal implantation for the treatment of retinal detachment. Ophthalmology. 1986 Nov;93(11):1408-12. doi: 10.1016/s0161-6420(86)33553-x. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary To establish if it is feasible to recruit, retain, and evaluate patients with RD into a larger randomised controlled trial of vitrectomy and suprachoroidal viscobuckle. feasibility trial 2 years
Primary To make a preliminary assessment of safety and efficacy of suprachoroidal viscobuckle. feasibility trial 2 years