Banerjee Philip J, Bunce Catey, Charteris David G
Moorfields Eye Hospital NHS Foundation Trust, City Road, EC1V 2PD London, UK.
Trials. 2013 Oct 28;14:358. doi: 10.1186/1745-6215-14-358.
Proliferative vitreoretinopathy (PVR) is the commonest cause of late anatomical failure in rhegmatogenous retinal detachment. Visual and anatomical outcomes remain poor despite advances in vitreoretinal surgical techniques with reported primary failure rates of up to nearly 50%. Numerous adjunctive medications have been evaluated in clinical trials with no agent gaining widespread acceptance and use.This study was designed to investigate the benefits of using a slow-release dexamethasone implant delivered intra-operatively in patients undergoing vitrectomy surgery for retinal detachment with established PVR.
METHODS/DESIGN: For the study, 140 patients requiring vitrectomy surgery with silicone oil for retinal detachment with established PVR will be randomised to receive either standard treatment or study treatment in a 1:1 treatment allocation ratio. Both groups will receive the standard surgical treatment appropriate for their eye condition and routine peri-operative treatment and care, differing only in the addition of the supplementary adjunctive agent in the treatment group. The investigated primary outcome measure is stable retinal reattachment with removal of silicone oil without additional vitreoretinal surgical intervention at 6 months.
This is the first randomised controlled clinical trial to investigate the use of an adjunctive slow-release dexamethasone implant in patients undergoing vitrectomy surgery for retinal detachments with proliferative vitreoretinopathy.
EudraCT No: 2011-004498-96.
增殖性玻璃体视网膜病变(PVR)是孔源性视网膜脱离后期解剖结构失败的最常见原因。尽管玻璃体视网膜手术技术有所进步,但视觉和解剖学结果仍然不佳,报道的原发性失败率高达近50%。许多辅助药物已在临床试验中进行评估,但没有一种药物得到广泛认可和使用。本研究旨在调查在接受玻璃体切除术治疗已确诊PVR的视网膜脱离患者术中植入缓释地塞米松的益处。
方法/设计:在本研究中,140例因已确诊PVR的视网膜脱离而需要进行硅油玻璃体切除术的患者将按1:1的治疗分配比例随机接受标准治疗或研究治疗。两组患者均将接受适合其眼部状况的标准手术治疗以及常规围手术期治疗和护理,仅治疗组会额外添加辅助药物。研究的主要结局指标是在6个月时视网膜复位稳定,可取出硅油且无需额外的玻璃体视网膜手术干预。
这是第一项随机对照临床试验,旨在研究在接受玻璃体切除术治疗增殖性玻璃体视网膜病变性视网膜脱离的患者中使用辅助性缓释地塞米松植入物的情况。
欧洲临床试验数据库编号:2011-004498-96。