Combined Phacoemulsification and Diode Laser Therapy in Chronic Angle Closure Glaucoma

Overview

comparing different types of cuclophotocoagulation with cataract extraction to cataract extraction and goniocynechiolysis in cases of chronic angle closure glaucoma

Full Title of Study: “Combined Phacoemulsification and Different Modes of Diode Laser Therapy in Management of Chronic Angle Closure Glaucoma. A Comparative Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: October 1, 2023

Detailed Description

Evaluation of the safety of MP-TSCPC , CW-TSCPC and endoscopic cyclophotocoagulation when combined with phacoemulsification in cases with CACG Comparing the efficacy of the combined procedures in control of the IOP and the success rate versus lens extraction combined with synechiolysis

Interventions

  • Procedure: phaco+MP-TSCPC
    • The procedure starts with performing the cyclophotocoagulation using the Micropulse P3 device (IQ 810 Laser Systems; Iridex, Mountain View, CA, USA) at 2500 mW with a duration of 90 seconds in each hemisphere at a 31.3% duty cycle under local anesthesia and then performing phacoemulsification and IOL implantation.
  • Procedure: phaco+TSCPC
    • The procedure starts with performing the cyclophotocoagulation using the IRIDEX’s G probe device (IRIDEX Corp. Mountain View, CA, USA) at 1500 to2000 mW with a duration of 1500 ms applying about 15 shots in one hemisphere only under local anesthesia and then performing phacoemulsification and IOL implantation.
  • Procedure: phaco+endocyclophotocoagulation
    • phacoemulsification will be done and endocyclophotocoagulation will be done after cataract extraction
  • Procedure: phaco GSL
    • phacoemulsification will be done and then the angle is visualized by direct goniolens then the synechia are dissected by cohesive viscoelastic.

Arms, Groups and Cohorts

  • Experimental: A:phaco+MP-TSCPC
    • 22 patients with primary angle closure glaucoma will undergo phacoemulsification and micropulse cyclophotocoagulation
  • Experimental: B:phaco+TSCPC
    • 22 patients with primary angle closure glaucoma will undergo phaco and transscleral cyclophotocoagulation
  • Experimental: C:phaco+endocyclophotocoagulation
    • 22 patients with primary angle closure glaucoma will undergo phaco and endocyclophotocoagulation after cataract removal
  • Experimental: D:phaco GSL
    • 22 patients with primary angle closure glaucoma will undergo phaco and goniosynechiolysis

Clinical Trial Outcome Measures

Primary Measures

  • the percentage of intraocular pressure change
    • Time Frame: 6 Months
    • measuring the intraocular pressure after 1M, 3M and 6M

Secondary Measures

  • percent change of antiglaucoma medications
    • Time Frame: 6 Months
    • the number of medication before and after the procedure

Participating in This Clinical Trial

Inclusion Criteria

  • Patients between 20 to 70 years chronic angle closure glaucoma Exclusion Criteria:

  • Patients in acute attack of angle closure. – Patients with previous filtering surgery or cycloablative procedure

Gender Eligibility: All

Minimum Age: 20 Years

Maximum Age: 70 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Cairo University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Fayrouz Aboalazayem, lecturer – Cairo University
  • Overall Official(s)
    • Ahmed Abdelrahman, PhD, Study Chair, kasr alainy

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