State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
BMJ Open. 2020 Feb 25;10(2):e032957. doi: 10.1136/bmjopen-2019-032957.
Trabeculotomy and combined trabeculotomy-trabeculectomy (CTT) are major surgical options for primary congenital glaucoma (PCG). However, it is unclear which of these two surgical procedures should be recommended as the optimum first-line treatment for PCG. This trial aims to determine whether the outcomes of trabeculotomy are non-inferior to those of CTT in moderate PCG with a horizontal corneal diameter (HCD) of 12-14 mm.
This is a 3-year, non-inferiority, prospective, randomised controlled trial. We plan to recruite 248 participants (aged ≤3 years) with PCG with an HCD of 12-14 mm from the Department of Glaucoma, Zhongshan Ophthalmic Center, Guangzhou, China. One eye per participant will be randomly (1:1) assigned to receive trabeculotomy or CTT. The primary outcome is the 3-year postoperative success rate in lowering intraocular pressure (IOP), and the secondary clinical outcomes will include IOP reduction, visual acuity, HCD, central corneal thickness, axial length, cup-disc ratio, refractive error and postoperative complications. Data will be analysed by the intention-to-treat principle.
The study protocol has been approved by the ethics committee of Zhongshan Ophthalmic Center (2014MEKY023) and the '5010 Plan' evaluation committee at Sun Yat-Sen University, Guangzhou, China. The results will be disseminated in international academic meetings and published in peer-reviewed journals.
Chinese Clinical Trial Registry, ChiCTR-IOR-14005588; Date registered: 20 November 2014.
小梁切开术和小梁切开联合小梁切除术(CTT)是原发性先天性青光眼(PCG)的主要手术选择。然而,目前尚不清楚这两种手术中哪一种应作为 PCG 的首选一线治疗。本试验旨在确定对于水平角膜直径(HCD)为 12-14mm 的中度 PCG,小梁切开术的结果是否不劣于 CTT。
这是一项为期 3 年的非劣效性、前瞻性、随机对照试验。我们计划从中国广州中山大学中山眼科中心青光眼科招募 248 名(年龄≤3 岁)HCD 为 12-14mm 的 PCG 患者。每位患者的每只眼将被随机(1:1)分配接受小梁切开术或 CTT。主要结局是术后 3 年降低眼内压(IOP)的成功率,次要临床结局将包括 IOP 降低、视力、HCD、中央角膜厚度、眼轴长度、杯盘比、屈光不正和术后并发症。数据将按照意向治疗原则进行分析。
该研究方案已获得中山大学中山眼科中心伦理委员会(2014MEKY023)和中国广州中山大学“5010 计划”评估委员会的批准。研究结果将在国际学术会议上发表,并发表在同行评议的期刊上。
中国临床试验注册中心,ChiCTR-IOR-14005588;注册日期:2014 年 11 月 20 日。