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Comparing Nd:YAG Laser and Sequential Double Frequency YAG-Nd:YAG Laser Iridotomy

Primary Purpose

Angle Closure Glaucoma

Status
Completed
Phase
Not Applicable
Locations
Thailand
Study Type
Interventional
Intervention
The sequential technique
The pure Nd:YAG laser technique
Sponsored by
Prince of Songkla University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Angle Closure Glaucoma focused on measuring Iridotomy

Eligibility Criteria

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

Inclusion Criteria:

  • Patient in need to have a laser iridotomy

    • primary angle closure glaucoma or
    • primary angle closure or
    • primary angle closure suspect (needed repeated pupil dilation) or
    • fellow eyes of acute angle closure crisis, and
  • Age of at least 18 years, and
  • Dark iris patients (only black and dark brown color)

Exclusion Criteria:

  • Eye with acute angle closure crisis
  • Active conjunctiva or corneal infection or inflammation
  • Active anterior uveitis
  • History of any prior laser treatment
  • History intraocular surgery
  • Eye with corneal scar
  • Corneal haziness obscure iridotomy site
  • Endothelial cell count less than 1000 cells/mm2 (pre-laser)
  • Iris color other than black or dark brown
  • Inability to sit at the slit lamp to have laser done

Sites / Locations

  • Weerawat Kiddee

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

The sequential technique

The pure Nd:YAG laser technique

Arm Description

By using the double frequency YAG laser to make the initial bore and the Nd:YAG laser to complete the perforation on iris.

By using the pure Nd:YAG to make a complete perforation on iris.

Outcomes

Primary Outcome Measures

Laser energy
Total energy used to create patency on the iris

Secondary Outcome Measures

Bleeding
iris bleeding immediate after laser reported as Yes or No
Corneal endothelial cell count
Corneal endothelial cell count directly over the area of laser
Central corneal thickness
Central corneal thickness
Patency of iridotomy
Iridotomy patency is confirmed objectively reported as yes or no
Intraocular pressure spike
Intraocular pressure spike if present mean that IOP evelation of at least 8mmHg from baseline intraocular pressure

Full Information

First Posted
June 11, 2015
Last Updated
August 24, 2018
Sponsor
Prince of Songkla University
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1. Study Identification

Unique Protocol Identification Number
NCT02474238
Brief Title
Comparing Nd:YAG Laser and Sequential Double Frequency YAG-Nd:YAG Laser Iridotomy
Official Title
Randomized Clinical Trial Comparing Neodynium:Ytrium-aluminium-garnet (Nd:YAG) Laser and Sequential Double Frequency YAG-Nd:YAG Laser Iridotomy in Patients With Dark Iris
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
May 2015 (undefined)
Primary Completion Date
August 2018 (Actual)
Study Completion Date
August 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Prince of Songkla University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
No single type of laser or set of laser parameters is appropriate for all type of irides. Pure Nd:YAG laser iridotomy is very effective in the light color irides. It was considered as the gold standard for iridotomy. It, however, is less effective and causes some complication such as iris hemorrhage especially in patients with dark iris.
Detailed Description
By using the double frequency YAG to make the initial bore and the Nd:YAG laser to complete the perforation, the technique should be able to effectively combine most of the advantages of both lasers whilst avoiding their disadvantages. It is possibly the ideal iridotomy technique to use in the Asian irides. The investigators aim to study the energy use for laser iridotomy comparing between the two techniques as well as objectively measure the variables associated with complications.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Angle Closure Glaucoma
Keywords
Iridotomy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
82 (Actual)

8. Arms, Groups, and Interventions

Arm Title
The sequential technique
Arm Type
Experimental
Arm Description
By using the double frequency YAG laser to make the initial bore and the Nd:YAG laser to complete the perforation on iris.
Arm Title
The pure Nd:YAG laser technique
Arm Type
Active Comparator
Arm Description
By using the pure Nd:YAG to make a complete perforation on iris.
Intervention Type
Device
Intervention Name(s)
The sequential technique
Intervention Description
By using 'the double frequency YAG laser' to make the initial bore and 'the Nd:YAG laser' to complete the perforation on iris.
Intervention Type
Device
Intervention Name(s)
The pure Nd:YAG laser technique
Intervention Description
By using 'the pure Nd:YAG laser' to make a complete perforation on iris.
Primary Outcome Measure Information:
Title
Laser energy
Description
Total energy used to create patency on the iris
Time Frame
1-hour
Secondary Outcome Measure Information:
Title
Bleeding
Description
iris bleeding immediate after laser reported as Yes or No
Time Frame
1-hour
Title
Corneal endothelial cell count
Description
Corneal endothelial cell count directly over the area of laser
Time Frame
12-month
Title
Central corneal thickness
Description
Central corneal thickness
Time Frame
12-month
Title
Patency of iridotomy
Description
Iridotomy patency is confirmed objectively reported as yes or no
Time Frame
12-month
Title
Intraocular pressure spike
Description
Intraocular pressure spike if present mean that IOP evelation of at least 8mmHg from baseline intraocular pressure
Time Frame
1-hour

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient in need to have a laser iridotomy primary angle closure glaucoma or primary angle closure or primary angle closure suspect (needed repeated pupil dilation) or fellow eyes of acute angle closure crisis, and Age of at least 18 years, and Dark iris patients (only black and dark brown color) Exclusion Criteria: Eye with acute angle closure crisis Active conjunctiva or corneal infection or inflammation Active anterior uveitis History of any prior laser treatment History intraocular surgery Eye with corneal scar Corneal haziness obscure iridotomy site Endothelial cell count less than 1000 cells/mm2 (pre-laser) Iris color other than black or dark brown Inability to sit at the slit lamp to have laser done
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Asst.Prof.Weerawat Kiddee, MD
Organizational Affiliation
Prince of Songkla University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Weerawat Kiddee
City
Hat Yai
State/Province
Songkhla
ZIP/Postal Code
90110
Country
Thailand

12. IPD Sharing Statement

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Comparing Nd:YAG Laser and Sequential Double Frequency YAG-Nd:YAG Laser Iridotomy

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