Trabeculectomy Versus 2-iStent and Prostaglandin Study (TIPS)
Primary Purpose
Glaucoma, Open-Angle
Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
iStent and travoprost or latanoprost
Trabeculectomy
Sponsored by
About this trial
This is an interventional treatment trial for Glaucoma, Open-Angle
Eligibility Criteria
Inclusion Criteria:
- Patients who have mental capacity to give consent
- Age >= 21 years
- Pseudophakic or phakic without visually significant cataract
- Open angle glaucoma
- IOP in the range of 18-30 mmHg with 2 or more topical medications
- Cup-disc ratio =< 0.9
- Best corrected visual acuity of 20/100 or better
Exclusion Criteria:
- Inability to give consent
- Inability to tolerate or presence of allergy to prostaglandin analogs
- Patient preference for non-surgical treatment or preference for either of the recommended surgical modalities in the study
- Age < 21 years
- Visually significant cataract that would benefit from cataract surgery, as determined by the treating surgeon in consultation with the patient
- Secondary glaucoma or angle closure glaucoma
- Aphakia
- Prior glaucoma incisional surgery (trabeculectomy, tube surgery, other Microinvasive Glaucoma Surgery (MIGS) surgeries, deep sclerectomy)
- Prior laser trabeculoplasty < 90 days prior to screening or absolute failure of prior laser trabeculoplasty.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
2 iStent with travoprost or latanoprost
trabeculectomy
Arm Description
2 iStents will be injected into the trabecular meshwork and patients will be administered topical latanoprost or travoprost following surgery
Standard trabeculectomy
Outcomes
Primary Outcome Measures
IOP <= 18 mmHg
IOP
IOP <= 15 mmHg
IOP
IOP >= 20% reduction from untreated baseline
IOP
Secondary Outcome Measures
Full Information
NCT ID
NCT03274323
First Posted
September 5, 2017
Last Updated
January 17, 2018
Sponsor
Johns Hopkins University
1. Study Identification
Unique Protocol Identification Number
NCT03274323
Brief Title
Trabeculectomy Versus 2-iStent and Prostaglandin Study
Acronym
TIPS
Official Title
Trabeculectomy Versus 2-iStent and Prostaglandin Study
Study Type
Interventional
2. Study Status
Record Verification Date
January 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Difficulty obtaining IDE by the FDA. Currently not worthwhile to pursue further.
Study Start Date
January 12, 2018 (Actual)
Primary Completion Date
January 12, 2018 (Actual)
Study Completion Date
January 12, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Johns Hopkins University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Investigators hypothesize that the synergistic action of iStent in increasing aqueous outflow through the trabecular meshwork and use of prostaglandin analog such as travoprost or latanoprost to increase uveoscleral outflow will achieve good Intra-ocular Pressure (IOP) control with minimal complications in Primary Open Angle Glaucoma (POAG) patients with suboptimal IOP on 2 or more medications compared to mitomycin C (MMC) augmented trabeculectomy.
Detailed Description
This will be a prospective randomized controlled study.
20 phakic or pseudophakic open angle glaucoma patients with an IOP in the range of 18-30 mmHg on 2 or more topical glaucoma medications will be randomly selected to undergo either (1) mitomycin-augmented trabeculectomy or (2) placement of 2 iStent devices and initiation of a daily prostaglandin analog. This study is looking at the combined effects of the 2 iStents and a prostaglandin analog as a method to achieve low IOP. At 3 months (+/- 2 weeks) postoperatively, the iStent patients will be left only on the prostaglandin analog with a washout performed for any other hypotensive medication used. Patients who had a trabeculectomy will be have a terminal washout of all IOP-lowering medications at 3 months (+/- 2 weeks) post-surgery. The IOP will then be measured for both groups at 4 months (+/- 3 weeks) postoperatively.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glaucoma, Open-Angle
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
2 iStent with travoprost or latanoprost
Arm Type
Experimental
Arm Description
2 iStents will be injected into the trabecular meshwork and patients will be administered topical latanoprost or travoprost following surgery
Arm Title
trabeculectomy
Arm Type
Active Comparator
Arm Description
Standard trabeculectomy
Intervention Type
Device
Intervention Name(s)
iStent and travoprost or latanoprost
Intervention Description
2 iStents will be inserted and patients will be started on travoprost or latanoprost following the procedure
Intervention Type
Procedure
Intervention Name(s)
Trabeculectomy
Intervention Description
Standard trabeculectomy
Primary Outcome Measure Information:
Title
IOP <= 18 mmHg
Description
IOP
Time Frame
Post surgery month 4
Title
IOP <= 15 mmHg
Description
IOP
Time Frame
Post surgery month 4
Title
IOP >= 20% reduction from untreated baseline
Description
IOP
Time Frame
Post surgery month 4
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Patients who have mental capacity to give consent
Age >= 21 years
Pseudophakic or phakic without visually significant cataract
Open angle glaucoma
IOP in the range of 18-30 mmHg with 2 or more topical medications
Cup-disc ratio =< 0.9
Best corrected visual acuity of 20/100 or better
Exclusion Criteria:
Inability to give consent
Inability to tolerate or presence of allergy to prostaglandin analogs
Patient preference for non-surgical treatment or preference for either of the recommended surgical modalities in the study
Age < 21 years
Visually significant cataract that would benefit from cataract surgery, as determined by the treating surgeon in consultation with the patient
Secondary glaucoma or angle closure glaucoma
Aphakia
Prior glaucoma incisional surgery (trabeculectomy, tube surgery, other Microinvasive Glaucoma Surgery (MIGS) surgeries, deep sclerectomy)
Prior laser trabeculoplasty < 90 days prior to screening or absolute failure of prior laser trabeculoplasty.
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Trabeculectomy Versus 2-iStent and Prostaglandin Study
We'll reach out to this number within 24 hrs