CClinicalTrials.gg
CompletedNCT03184428Updated Apr 29, 2020Results posted

Posterior Capsule Opacification Following Cataract Surgery With Implantation of the MICS IOL L313

An observational study in Posterior Capsule Opacification, sponsored by Dietrich-Bonhoeffer-Klinikum. Completed at 1 site in Germany. Per ClinicalTrials.gov, last updated 2020-04-29.

Sponsored by Dietrich-Bonhoeffer-Klinikum · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
3,785
Sex
All
01

Study summary

This study collects intra- and postoperative data from the patients´charts retrospectively and evaluates retro- and prospectively the rate of posterior capsule opacification (PCO) following implantation of the intraocular lens L 313.

Read the detailed description

This study is a postmarket study without interventions. Within the Standard Care Cataract surgery the participants have been implanted with the intraocular lens L313 in the period between September 2009 and December 2013. As criterium for the PCO was considered the Nd:YAG capsulotomy.

In the first step of the study, data was collected from the patients´charts.

In the second phase, a questionaire was sent to the patients with no recent examination, asking them to answer whether or not participants received a laser procedure due to PCO. In doubt the participants could answer: "I am not certain". For this step the investigator ensured the positive Votum of the Ethic Committee of the University of Greifswald, Germany.

On the third step of the study, the patients that were not certain of having such a laser procedure or did not answer per post, will be contacted on telephone. By uncertainty or no answer on the telephone the family eye doctor will be contacted to receive the necessary information. If the eye doctor has lost contact to the patient, then this patient will be documented as lost-to-follow-up.

Excluded were the patients that live >50km from the Department of Ophthalmology in Neubrandenburg, as well as patients with intraoperative capsule tear.

For the statistical analysis was used the program STATISTICA (StatSoft, Hamburg, Germany) and the survival analysis using the Kaplan-Meier formula, the statistical significance using the Chi-squared test and Spearman-Rank corelation and the Bonferroni adjustment if the test was repeated.

The investigators compared these results with the results of other publication. In order to do that the investigators calculated the capsulotomy quote from this study according to the time of the PCO recorded on the other studies. Included were only comparing studies that also used YAG-capsulotomy as criterium for the PCO.

Furthermore secondary data was collected: age, gender, cutting length, core hardness, duration of whole operation, time of phaco-emulsification, phaco-energy, phaco-machine, combination with other operation, surgeon, power of IOL. This data will be taken in concern for the validity of this study.

02

Conditions studied

  • Posterior Capsule Opacification

Keywords

  • YAG-Laser Capsulotomy
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

3785 (5549 eyes)

Inclusion criteria

  • retrospective: Patients who have undergone a Cataract surgery with Implantation of IOL L313
  • prospective: signed informed consent

Exclusion criteria

Exclusion Criteria:

  • capsule rupture
  • patients with too much travel distance between study center and home
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
3,785 participants (actual)
Patient registry
No

Groups and cohorts

  • Implantation of IOL L313

    Patients who have undergone a cataract surgery with implantation of the monofocal MICS IOL L313 more than 3 Years ago will be asked about the Treatment for Postoperative observation and survey.

    Other: Postoperative observation and survey

Interventions

  • OtherPostoperative observation and survey

    For postoperative Observation with a survey we ask the patients (or in case of no information the ophthalmologist) whether they had undergone a YAG-Laser-Capsulotomy after Cataract-Surgery or not.

05

What researchers measure

Primary outcomes

  1. Percentage of Eyes With Posterior Capsule Opacification Following Implantation of IOL 313 up to 8 Years

    In order to find out whether patients with cataract surgery are affected by lens opacification, we assessed whether a Nd:YAG laser capsulotomy was performed for treatment. For this purpose, the patient files were spotted first. Those who had no recent findings were asked in writing if and when a laser treatment was performed. In the absence of feedback and in case of uncertain or unusable written answer, a telephone consultation with the patient was made. If sufficient information was not available afterwards, the ophthalmologist was asked for information (by phone, by written request or by collecting the data on site in the practices).

    Time frame: up to 8 years

Secondary outcomes

  1. Correlation Coefficient Between Capsulotomy Rate and Parameters

    Correlation coefficients between capsulotomy rate and patient parameters: 1. age 2. gender, and surgical parameters: 3. cutting length, 4. core hardness, 5. duration of whole operation, 6. time of phaco-emulsification, 7. phaco-energy, 8. phaco-machine, 9. combination with other operation, 10. surgeon, 11. power of IOL.

    Time frame: up to 8 years

06

Results

Posted Apr 29, 2020

Participant flow

Eyes of patients who underwent a cataract surgery in the Department of Ophthalmology in Neubrandenburg between September 2009 and December 2013 and had an L313 MICS lens implanted.

Participant flow — Overall Study
MilestoneL313-Implantation
Started3785
Completed2963
Not completed822

Outcome measures

PrimaryPercentage of Eyes With Posterior Capsule Opacification Following Implantation of IOL 313 up to 8 Years

In order to find out whether patients with cataract surgery are affected by lens opacification, we assessed whether a Nd:YAG laser capsulotomy was performed for treatment. For this purpose, the patient files were spotted first. Those who had no recent findings were asked in writing if and when a laser treatment was performed. In the absence of feedback and in case of uncertain or unusable written answer, a telephone consultation with the patient was made. If sufficient information was not available afterwards, the ophthalmologist was asked for information (by phone, by written request or by collecting the data on site in the practices).

Time frame:
up to 8 years
Reported as:
Number · percentage of eyes
Percentage of Eyes With Posterior Capsule Opacification Following Implantation of IOL 313 up to 8 Years
percentage of eyesImplantation of IOL L313 Age<55Implantation of IOL L313 Age≥55
1 year7.94.7
2 years17.18.2
after 4 years25.017.2
after 6 years25.622.4
SecondaryCorrelation Coefficient Between Capsulotomy Rate and Parameters

Correlation coefficients between capsulotomy rate and patient parameters: 1. age 2. gender, and surgical parameters: 3. cutting length, 4. core hardness, 5. duration of whole operation, 6. time of phaco-emulsification, 7. phaco-energy, 8. phaco-machine, 9. combination with other operation, 10. surgeon, 11. power of IOL.

Time frame:
up to 8 years
Reported as:
Number · Correlation coefficient
Correlation Coefficient Between Capsulotomy Rate and Parameters
Correlation coefficientCapsulotomy Rate/AgeCapsulotomy Rate/GenderCapsulotomy Rate/Cutting LenthCapsulotomy Rate/Core HardnessCapsulotomy Rate/Duration of Whole OperationCapsulotomy Rate/Time of Phaco-emulsificationCapsulotomy Rate/Phaco-energyCapsulotomy Rate/Phaco-machineCapsulotomy Rate/Combination With Other opCapsulotomy Rate/SurgeonCorrelation Rate/Power of IOL
Correlation Coefficient Between Capsulotomy Rate and Parameters0.00010.2760.5780.0410.4670.7390.7820.7460.0020.7270.578
Statistical analysis
  • Capsulotomy Rate/Age vs Capsulotomy Rate/Gender vs Capsulotomy Rate/Cutting Lenth vs Capsulotomy Rate/Core Hardness vs Capsulotomy Rate/Duration of Whole Operation vs Capsulotomy Rate/Time of Phaco-emulsification vs Capsulotomy Rate/Phaco-energy vs Capsulotomy Rate/Phaco-machine vs Capsulotomy Rate/Combination With Other op vs Capsulotomy Rate/Surgeon vs Correlation Rate/Power of IOL · Spearman's rank-order correlation · p = <0.05Bonferroni adjustment in addition

Adverse events

Collected over n/a All-Cause Mortality, Serious, and Other (Not Including Serious) Adverse Events were not monitored/assessed because no interventions were performed in the Department of Ophthalmology (only a questionnaire for information sampling was required).. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Implantation of IOL L313———

Baseline characteristics

Age, Categorical
Age, Categorical(eyes)Implantation of IOL L313
<=18 years2
Between 18 and 65 years886
>=65 years4661
Age, Continuous
Age, Continuous(years)Implantation of IOL L313
Mean73.75 ± 9.06
Sex: Female, Male
Sex: Female, Male(eyes)Implantation of IOL L313
Female3285
Male2264
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Implantation of IOL L313
07

Study locations

1 site
  • Dietrich-Bonhoeffer-Klinikum
    Neubrandenburg, Mecklenburg/Vorpommern 17036, Germany
08

References and documents

Publications

  • Apple DJ, Peng Q, Visessook N, Werner L, Pandey SK, Escobar-Gomez M, Ram J, Auffarth GU. Eradication of posterior capsule opacification: documentation of a marked decrease in Nd:YAG laser posterior capsulotomy rates noted in an analysis of 5416 pseudophakic human eyes obtained postmortem. Ophthalmology. 2001 Mar;108(3):505-18. doi: 10.1016/s0161-6420(00)00589-3. PubMed 11237905 ↗
  • Apple DJ, Peng Q, Visessook N, Werner L, Pandey SK, Escobar-Gomez M, Ram J, Whiteside SB, Schoderbeck R, Ready EL, Guindi A. Surgical prevention of posterior capsule opacification. Part 1: Progress in eliminating this complication of cataract surgery. J Cataract Refract Surg. 2000 Feb;26(2):180-7. doi: 10.1016/s0886-3350(99)00353-3. PubMed 10683785 ↗
  • Auffarth GU, Brezin A, Caporossi A, Lafuma A, Mendicute J, Berdeaux G, Smith AF; European PCO Study Group. Comparison of Nd : YAG capsulotomy rates following phacoemulsification with implantation of PMMA, silicone, or acrylic intra-ocular lenses in four European countries. Ophthalmic Epidemiol. 2004 Oct;11(4):319-29. doi: 10.1080/09286580490515116. PubMed 15512993 ↗
  • Chitkara DK, Smerdon DL. Risk factors, complications, and results in extracapsular cataract extraction. J Cataract Refract Surg. 1997 May;23(4):570-4. doi: 10.1016/s0886-3350(97)80216-7. PubMed 9209994 ↗
  • Meacock WR, Spalton DJ, Boyce JF, Jose RM. Effect of optic size on posterior capsule opacification: 5.5 mm versus 6.0 mm AcrySof intraocular lenses. J Cataract Refract Surg. 2001 Aug;27(8):1194-8. doi: 10.1016/s0886-3350(01)00855-0. PubMed 11524189 ↗
  • Menapace R. [After-cataract following intraocular lens implantation. Part II: prevention with alternative implants and techniques]. Ophthalmologe. 2007 Apr;104(4):345-53; quiz 354-5. doi: 10.1007/s00347-007-1505-1. German. PubMed 17372739 ↗
  • Menapace R. [After-cataract following intraocular lens implantation. Part I. Genesis and prevention by optimizing conventional lens implants and surgical techniques]. Ophthalmologe. 2007 Mar;104(3):253-62; quiz 263-4. doi: 10.1007/s00347-007-1492-2. German. PubMed 17323043 ↗
  • Mester U, Fabian E, Gerl R, Hunold W, Hutz W, Strobel J, Hoyer H, Kohnen T. Posterior capsule opacification after implantation of CeeOn Edge 911A, PhacoFlex SI-40NB, and AcrySof MA60BM lenses: one-year results of an intraindividual comparison multicenter study. J Cataract Refract Surg. 2004 May;30(5):978-85. doi: 10.1016/j.jcrs.2003.09.052. PubMed 15130632 ↗
  • Nishi Y, Ikeda T, Nishi K, Mimura O. Epidemiological evaluation of YAG capsulotomy incidence for posterior capsule opacification in various intraocular lenses in Japanese eyes. Clin Ophthalmol. 2015 Sep 1;9:1613-7. doi: 10.2147/OPTH.S89966. eCollection 2015. PubMed 26366054 ↗
  • Pandey SK, Apple DJ, Werner L, Maloof AJ, Milverton EJ. Posterior capsule opacification: a review of the aetiopathogenesis, experimental and clinical studies and factors for prevention. Indian J Ophthalmol. 2004 Jun;52(2):99-112. PubMed 15283214 ↗
  • Prosdocimo G, Tassinari G, Sala M, Di Biase A, Toschi PG, Gismondi M, Corbanese U. Posterior capsule opacification after phacoemulsification: silicone CeeOn Edge versus acrylate AcrySof intraocular lens. J Cataract Refract Surg. 2003 Aug;29(8):1551-5. doi: 10.1016/s0886-3350(02)02051-5. PubMed 12954304 ↗
  • Schaumberg DA, Dana MR, Christen WG, Glynn RJ. A systematic overview of the incidence of posterior capsule opacification. Ophthalmology. 1998 Jul;105(7):1213-21. doi: 10.1016/S0161-6420(98)97023-3. PubMed 9663224 ↗
  • Schmidbauer JM, Vargas LG, Apple DJ, Auffarth GU, Peng Q, Arthur SN, Escobar-Gomez M. [Millenniums update on posterior capsule opacification (PCO) scores, centration, biocompatibility and fixation of foldable intraocular lenses (IOL) - an analysis of 1,221 pseudophakic post mortem globes]. Klin Monbl Augenheilkd. 2001 Oct;218(10):649-57. doi: 10.1055/s-2001-18386. German. PubMed 11706380 ↗
  • Schriefl SM, Leydolt C, Stifter E, Menapace R. Posterior capsular opacification and Nd:YAG capsulotomy rates with the iMics Y-60H and Micro AY intra-ocular lenses: 3-year results of a randomized clinical trial. Acta Ophthalmol. 2015 Jun;93(4):342-7. doi: 10.1111/aos.12543. Epub 2014 Nov 13. PubMed 25393894 ↗
  • Spyridaki M, Hoh H. [Comparison of four MICS intraocular lenses regarding their rates of neodymium:YAG laser capsulotomy]. Klin Monbl Augenheilkd. 2010 Mar;227(3):208-14. doi: 10.1055/s-0028-1109853. Epub 2010 Mar 16. German. PubMed 20234985 ↗
  • Tetz MR, Nimsgern C. Posterior capsule opacification. Part 2: Clinical findings. J Cataract Refract Surg. 1999 Dec;25(12):1662-74. doi: 10.1016/s0886-3350(99)00259-x. PubMed 10609214 ↗
  • Wehner W. [Microincision intraocular lens with plate haptic design. Evaluation of rotational stability and centering of a microincision intraocular lens with plate haptic design in 12-19 months of follow-up]. Ophthalmologe. 2007 May;104(5):393-4, 396-8. doi: 10.1007/s00347-007-1500-6. German. PubMed 17384950 ↗

Study documents

  • Protocol and statistical analysis plan · Sep 15, 2015

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — results will be published in ophthalmological journals

09

Registry details

Key details

Study ID
NCT03184428
Lead sponsor
Dietrich-Bonhoeffer-Klinikum
Responsible party
Sponsor
First posted
Jun 12, 2017
Start date
Oct 1, 2015
Primary completion
Mar 1, 2018
Completion
Dec 10, 2018
Results posted
Apr 29, 2020
Last update
Apr 29, 2020

Study contacts

Helmut Hoeh, Prof. Dr.
principal investigator · Department of Ophthalmology, Neubrandenburg, Germany
Christoforos Stylianides
study chair · Department of Ophthalmology, Neubrandenburg, Germany

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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