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Protocol summary

Study aim
Investigation of anterior segment morphological changes using anterior segment optical coherence tomography in patients with coexisting primary angle closure glaucoma and cataract, undergoing either phacoemulsification or phacotrabeculectomy.
Design
Two-arm, parallel groups randomized clinical trial. The observer was masked to the study group; however, the participants were not blinded. Randomization was done with random-digit table.
Settings and conduct
Consecutive, eligible patients, consented to participate in the study in Glaucoma Clinic, Khatam Eye Hospital, Mashhad University of Medical Sciences, enters the study and randomly allocate to the study groups. Outcome measures are evaluated at postoperative 1 week, 1 month and 6 months intervals.
Participants/Inclusion and exclusion criteria
Patients with coexisting primary angle closure glaucoma and cataract, requiring surgical intervention, and without a history of previous intraocular surgery or other ocular diseases.
Intervention groups
Group A, Phacoemulsification. In this group, patient undergo standard phacoemulsification cataract surgery with foldable intraocular lens implantation. Group B, Phacotrabeculectomy. In this group, patients undergo phacoemulsification cataract surgery and foldable intraocular lens implantation with concurrent fornix based trabeculectomy with releasable sutures and intraoperative mitomycin-C application.
Main outcome variables
1. Intraocular pressure 2. Angel opening distance 3. Trabecular iris surface area 4. Trabecular iris angle

General information

Reason for update
There are typos in entering the trial recruitment's start and end dates. Recruitment was started after approval by the Ethical Committee.
Acronym
IRCT registration information
IRCT registration number: IRCT20080901001154N2
Registration date: 2020-10-07, 1399/07/16
Registration timing: retrospective

Last update: 2021-05-19, 1400/02/29
Update count: 1
Registration date
2020-10-07, 1399/07/16
Registrant information
Name
Ramin Danehvar
Name of organization / entity
Eye Research Center, Mashhad University of Medical Sciences
Country
Iran (Islamic Republic of)
Phone
+98 51 1728 1401
Email address
daneshvarr@mums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2015-06-20, 1394/03/30
Expected recruitment end date
2016-12-19, 1395/09/29
Actual recruitment start date
2015-08-21, 1394/05/30
Actual recruitment end date
2017-02-01, 1395/11/13
Trial completion date
2017-03-03, 1395/12/13
Scientific title
Comparison of anterior segment morphological changes using anterior segment optical coherence tomography (ASOCT) in patients with coexisting primary angle closure glaucoma and cataract, undergoing phacoemulsification and phacotrabeculectomy.
Public title
Anterior segment parameters following surgical management in angle closure glaucoma
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Primary angle closure glaucoma Cataract
Exclusion criteria:
Any previous intraocular surgery (except laser iridotomy) History of ocular trauma History of other ocular diseases (except cataract and glaucoma)
Age
From 40 years old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size: 60
Actual sample size reached: 52
Randomization (investigator's opinion)
Randomized
Randomization description
Envelops, containing random numbers were prepared and sealed. ،To pick the number, the first number was selected by a pen with closed eyes and then successive numbers were selected from the table (eg, if the first number was 7, we moved to the right and down of that digit and selected every 7th number to reach the required 60 envelops with random numbers). For each participants, a new envelope was opened and those with odd number allocate to phacoemulsification group and those with even number allocated to the phacotrabeculectomy group.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features
The main purpose of the study is to investigate the effect of either surgical method on the anterior chamber drainage angle.

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics Committee, Mashhad University of Medical Sciences
Street address
Ghoreishi building, Daneshgah street
City
Mashhad
Province
Razavi Khorasan
Postal code
91375345
Approval date
2015-05-21, 1394/02/31
Ethics committee reference number
IR.MUMS.REC.1394.262

Health conditions studied

1

Description of health condition studied
Glaucoma
ICD-10 code
H40
ICD-10 code description
Glaucoma

2

Description of health condition studied
cataract
ICD-10 code
H25
ICD-10 code description
Age-related cataract

Primary outcomes

1

Description
Intraocular pressure (IOP)
Timepoint
Postoperative 1st week, 1st month, 6th and month
Method of measurement
IOP measurement with Goldmann applanation tonometer

2

Description
Angle opening distance at 500 micron (AOD500)
Timepoint
Before surgery, 1 week, 1 month and 6 months after surgery
Method of measurement
Measuring AOD using Casia AS-OCT device (Tomey)

3

Description
Trabecular iris angle at 500 micron (TIA500)
Timepoint
Before surgery; 1 week, 1 month and 6 months after surgery
Method of measurement
Measuring TIA using Casia ASOCT (Tomey)

4

Description
Trabecular-iris surface area (TISA)
Timepoint
Before surgery; 1 week, 1 month and 6 months after surgery
Method of measurement
Measuring TIA using Casia ASOCT (Tomey)

Secondary outcomes

empty

Intervention groups

1

Description
In intervention group, the patients undergo phacoemulsification cataract surgery with a temporal incision and posterior chamber intraocular lens (PCIOL) implantation in the capsular bag. At the conclusion of cataract surgery and in the same session, a superior fornix-based trabeculectomy with intraoperative mitomycin-c is done for the patients.
Category
Treatment - Surgery

2

Description
In the control group, the patients undergo temporal phacoemulsification and in the bag PCIOL implantation. No separate, additional glaucoma surgery is done in this group.
Category
Treatment - Surgery

Recruitment centers

1

Recruitment center
Name of recruitment center
Khatam Eye Hospital
Full name of responsible person
Ramin Daneshvar, MD, MSc
Street address
Gharani Blvd.
City
Mashhad
Province
Razavi Khorasan
Postal code
9195961151
Phone
+98 51 3728 9911
Fax
+98 51 3728 9911
Email
daneshvarr@mums.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Mohsen Tafaghodi, MD
Street address
Daneshgah St
City
Mashhad
Province
Razavi Khorasan
Postal code
9138813944
Phone
+98 51 3841 1538
Email
tafaghodim@mums.ac.ir
Web page address
https://v-research.mums.ac.ir/
Grant name
Grant code / Reference number
930126
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Mashhad University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Ramin Daneshvar, MD, MSc
Position
Associate Professor
Latest degree
Subspecialist
Other areas of specialty/work
Ophthalmology
Street address
Gharani Blvd
City
Mashhad
Province
Razavi Khorasan
Postal code
9195961151
Phone
0098513289911
Email
daneshvarr@mums.ac.ir

Person responsible for scientific inquiries

Contact
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Ramin Daneshvar, MD, MS
Position
Associate Professor
Latest degree
Subspecialist
Other areas of specialty/work
Ophthalmology
Street address
Gharani Blvd
City
Mashhad
Province
Razavi Khorasan
Postal code
9195961151
Phone
+98 51 3728 9911
Email
daneshvarr@mums.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Ramin Daneshvar, MD, MSc
Position
Associate Professor
Latest degree
Subspecialist
Other areas of specialty/work
Ophthalmology
Street address
Khatam Anbia Eye Hospital, Gharani Blvd.,
City
Mashhad
Province
Razavi Khorasan
Postal code
9195961151
Phone
+98 51 1728 9911
Fax
Email
daneshvarr@mums.ac.ir
Web page address

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Not applicable
Title and more details about the data/document
Deidentified, anonymous participants data are available in a MS Excel file.
When the data will become available and for how long
One year after publication of the article.
To whom data/document is available
Other researcher, upon written request
Under which criteria data/document could be used
Accreditation and meta-analysis
From where data/document is obtainable
Written request, directed to corresponding person or PI
What processes are involved for a request to access data/document
Upon approval of the request by Vice chancellor of Research at MUMS and the legal authorities, the information would be send to the requester.
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