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Comparison of Topical Ketorolac 0,4% Versus Placebo in Cataract Surgery

Primary Purpose

Cystoid Macular Edema Following Cataract Surgery, Bilateral

Status
Completed
Phase
Phase 4
Locations
Brazil
Study Type
Interventional
Intervention
Ketorolac Tromethamine
Sponsored by
University of Campinas, Brazil
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Cystoid Macular Edema Following Cataract Surgery, Bilateral focused on measuring cataract surgery, cystoid macular edema, angiography

Eligibility Criteria

50 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subjects with nuclear cataract, density 1 and 2 classified by LOCS II, scheduled to undergo phacoemulsification cataract surgery.

Exclusion Criteria:

  • Patients with:

    • Diabetes,
    • Hypertension,
    • uveitis,
    • macular disease,
    • congenital ocular abnormalities,
    • cataract density 0 and 3 by LOCS II,
    • pseudoexfoliation syndrome.

Patients under treatment with nonsteroidal antinflammatory drugs or topical eye drops were excluded.

Sites / Locations

  • Unicamp
  • Unicamp

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

ketorolac tromethamine

Dextrano 70 / Hypromellose

Arm Description

Outcomes

Primary Outcome Measures

cystoid macular edema
Angiography (Miyake's criteria)

Secondary Outcome Measures

Best corrected visual acuity
ETDRS.

Full Information

First Posted
February 7, 2012
Last Updated
December 2, 2014
Sponsor
University of Campinas, Brazil
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1. Study Identification

Unique Protocol Identification Number
NCT01542190
Brief Title
Comparison of Topical Ketorolac 0,4% Versus Placebo in Cataract Surgery
Official Title
A Randomized, Masked Comparison of Topical Ketorolac 0,4% Versus Placebo in Cataract Surgery.
Study Type
Interventional

2. Study Status

Record Verification Date
December 2014
Overall Recruitment Status
Completed
Study Start Date
February 2011 (undefined)
Primary Completion Date
December 2012 (Actual)
Study Completion Date
August 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Campinas, Brazil

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare effects of preoperative and postoperative use of topical ketorolac tromethamine 0.4% versus placebo in uncomplicated cataract surgery. Patients scheduled to undergo phacoemulsification will be randomized to receive either topical prednisolone acetate 1% 4 times daily (QID) plus dextran 70/hypromellose QID (placebo group) or topical prednisolone 1% QID plus ketorolac tromethamine 0.4% QID (ketorolac group) for three days preoperatively and four weeks postoperatively. The primary outcome 5 weeks after surgery will be angiographic cystoid macular edema.
Detailed Description
Purpose: To compare effects of preoperative and postoperative use of topical ketorolac tromethamine 0.4% versus placebo in uncomplicated cataract surgery. Methods: This will be a masked single-center, randomized clinical study comprising 80 patients undergoing phacoemulsification cataract surgery. Patients scheduled to undergo phacoemulsification and with no recognized cystoid macular edema (CME) risks (diabetic retinopathy, retinal vascular disease or macular abnormality) will be randomized to receive either topical prednisolone acetate 1% 4 times daily (QID) plus dextran 70/hypromellose QID (placebo group;n=40) or topical prednisolone 1% QID plus ketorolac tromethamine 0.4% QID (ketorolac group;n=40) for three days preoperatively and four weeks postoperatively. In both groups topical gatifloxacin will be administered to the treated eye QID, starting three days before surgery and continuing for seven days. The primary outcome 5 weeks after surgery will be angiographic cystoid macular edema. Other included outcomes will be best corrected visual acuity (BCVA), intraocular pressure (IOP), CME incidence, retinal thickness as measured by spectral-domain optical coherence tomography (OCT).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystoid Macular Edema Following Cataract Surgery, Bilateral
Keywords
cataract surgery, cystoid macular edema, angiography

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ketorolac tromethamine
Arm Type
Active Comparator
Arm Title
Dextrano 70 / Hypromellose
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Ketorolac Tromethamine
Other Intervention Name(s)
Acular LS (Allergan), Lacribell (Latinofarma)
Intervention Description
ketorolac tromethamine 0.4%
Primary Outcome Measure Information:
Title
cystoid macular edema
Description
Angiography (Miyake's criteria)
Time Frame
1 month
Secondary Outcome Measure Information:
Title
Best corrected visual acuity
Description
ETDRS.
Time Frame
1 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects with nuclear cataract, density 1 and 2 classified by LOCS II, scheduled to undergo phacoemulsification cataract surgery. Exclusion Criteria: Patients with: Diabetes, Hypertension, uveitis, macular disease, congenital ocular abnormalities, cataract density 0 and 3 by LOCS II, pseudoexfoliation syndrome. Patients under treatment with nonsteroidal antinflammatory drugs or topical eye drops were excluded.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rodrigo PC Lira
Organizational Affiliation
University of Campinas, Brazil
Official's Role
Study Chair
Facility Information:
Facility Name
Unicamp
City
Campinas
State/Province
Sao Paulo
ZIP/Postal Code
13083970
Country
Brazil
Facility Name
Unicamp
City
Campinas
State/Province
Sao Paulo
Country
Brazil

12. IPD Sharing Statement

Citations:
PubMed Identifier
10698027
Citation
Miyake K, Masuda K, Shirato S, Oshika T, Eguchi K, Hoshi H, Majima Y, Kimura W, Hayashi F. Comparison of diclofenac and fluorometholone in preventing cystoid macular edema after small incision cataract surgery: a multicentered prospective trial. Jpn J Ophthalmol. 2000 Jan-Feb;44(1):58-67. doi: 10.1016/s0021-5155(99)00176-8.
Results Reference
background
PubMed Identifier
12204717
Citation
Miyake K, Ibaraki N. Prostaglandins and cystoid macular edema. Surv Ophthalmol. 2002 Aug;47 Suppl 1:S203-18. doi: 10.1016/s0039-6257(02)00294-1.
Results Reference
background
PubMed Identifier
18804560
Citation
Kim A, Stark WJ. Are topical NSAIDs needed for routine cataract surgery? Am J Ophthalmol. 2008 Oct;146(4):483-5. doi: 10.1016/j.ajo.2008.07.027. No abstract available.
Results Reference
background
PubMed Identifier
5955948
Citation
Gass JD, Norton EW. Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch Ophthalmol. 1966 Nov;76(5):646-61. doi: 10.1001/archopht.1966.03850010648005. No abstract available.
Results Reference
background
PubMed Identifier
303062
Citation
Miyake K. Prevention of cystoid macular edema after lens extraction by topical indomethacin (I). A preliminary report. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1977 Aug 8;203(2):81-8. doi: 10.1007/BF00413399.
Results Reference
background
PubMed Identifier
21855758
Citation
Miyake K, Ota I, Miyake G, Numaga J. Nepafenac 0.1% versus fluorometholone 0.1% for preventing cystoid macular edema after cataract surgery. J Cataract Refract Surg. 2011 Sep;37(9):1581-8. doi: 10.1016/j.jcrs.2011.03.052.
Results Reference
background
PubMed Identifier
9499767
Citation
Rossetti L, Chaudhuri J, Dickersin K. Medical prophylaxis and treatment of cystoid macular edema after cataract surgery. The results of a meta-analysis. Ophthalmology. 1998 Mar;105(3):397-405. doi: 10.1016/S0161-6420(98)93018-4.
Results Reference
background
PubMed Identifier
18599019
Citation
Wittpenn JR, Silverstein S, Heier J, Kenyon KR, Hunkeler JD, Earl M; Acular LS for Cystoid Macular Edema (ACME) Study Group. A randomized, masked comparison of topical ketorolac 0.4% plus steroid vs steroid alone in low-risk cataract surgery patients. Am J Ophthalmol. 2008 Oct;146(4):554-560. doi: 10.1016/j.ajo.2008.04.036. Epub 2008 Jul 2.
Results Reference
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Links:
URL
http://www.fcm.unicamp.br
Description
Estate University of Campinas

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Comparison of Topical Ketorolac 0,4% Versus Placebo in Cataract Surgery

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