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Status unknownNCT03274024TVTUpdated Sep 6, 2017

The Asia Primary Tube Versus Trab (TVT) Study

An interventional study of Ahmed Glaucoma Implant and Trabeculectomy with Mitomycin C in Glaucoma, sponsored by Singapore Eye Research Institute. Status unknown at 1 site in Singapore. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2017-09-06.

Sponsored by Singapore Eye Research Institute · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Sep 2017), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
300
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Study summary

Comparison of Ahmed Glaucoma Implant (AGI) against trabeculectomy with mitomycin C in patients with uncontrolled open angle glaucoma

Read the detailed description

The objective of the Asia Primary Tube versus Trab (TVT) study is to compare the efficacy and safety of placement of an Ahmed Glaucoma Implant (AGI) (New World Medical Inc., Rancho Cucamonga, CA, USA) against trabeculectomy with mitomycin C in patients with uncontrolled glaucoma, who may or may not have had previous clear corneal cataract surgery with intraocular lens implantation, over 5 years. Outcome discrimination between the two treatment groups will be made using following parameters:

  1. Intraocular pressure
  2. Need for supplemental medical therapy
  3. Incidence of short and long term surgical complications and need for re-operation.
  4. Visual function (Visual acuity and Visual field)

Hypothesis: Glaucoma drainage implants have better surgical outcomes in terms of IOP lowering efficacy compared to trabeculectomy with mitomycin-C over 5 years in Asian patients with medically uncontrolled glaucoma.

02

Conditions studied

  • Glaucoma

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03

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Open angle glaucoma including primary open angle glaucoma, pseudoexfoliative or pigmentary glaucoma.
  2. IOP > 18 mm Hg on 2 or more medications on at least 2 visits
  3. Informed consent given and consent form signed.

Exclusion criteria

Exclusion Criteria:

  1. Unwilling or unable to give consent, unwilling to accept randomisation, or unable to return for scheduled protocol visits.
  2. Pregnant or nursing women
  3. No light perception vision
  4. Previous incisional intraocular surgery, other than uncomplicated clear corneal cataract surgery
  5. Previous ocular laser in study eye (keratorefractive surgery and cyclodestructive procedure), except for laser trabeculoplasty procedures (Argon Laser and Selective Laser Trabeculoplasty)
  6. Iris neovascularisation or proliferative retinopathy
  7. Primary angle closure or primary angle closure glaucoma
  8. Iridocorneal endothelial syndrome or anterior segment dysgenesis
  9. Epithelial or fibrous downgrowth
  10. Aphakia
  11. Chronic or recurrent uveitis
  12. Severe posterior blepharitis
  13. Unwilling to discontinue contact lens use after surgery
  14. Glaucoma secondary to penetrating keratoplasty, trauma, steroids, retinal disease/surgery or neovascular disease
  15. Conjunctival scarring from prior ocular surgery, trauma or cicatrizing disease precluding a superior trabeculectomy
  16. Need for glaucoma surgery combined with other ocular procedures (i.e. cataract surgery, penetrating keratoplasty, or retinal surgery) or anticipated need for urgent additional ocular surgery
  17. Advanced glaucoma with MD \<-20dB
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
300 participants (estimated)

Study arms

  • Experimental
    Tube implant

    Ahmed Glaucoma Implant (AGI) surgery

    Device: Ahmed Glaucoma Implant

  • Active comparator
    Trabeculectomy

    Trabeculectomy with mitomycin C surgery

    Procedure: Trabeculectomy with Mitomycin C

Interventions

  • DeviceAhmed Glaucoma Implant

    Conjunctival Flap Scleral Exposure Insertion of Episcleral Plate Priming of the tube prior to AC entrance Insertion of Tube into the Anterior Chamber Suturing tube Coverage of tube

  • ProcedureTrabeculectomy with Mitomycin C

    Conjunctival Flap Mitomycin C Application Scleral Flap Paracentesis Excision of Limbal Tissue Peripheral Iridectomy Scleral Flap Closure Conjunctival Flap Closure

05

What researchers measure

Primary outcomes

  1. Failure

    Failure defined by ANY of the following criteria: * IOP ≥ 18 mm Hg on two consecutive follow-up visits after 6 months * IOP not reduced to 20% below baseline on two consecutive visits after 6 months * IOP ≤ 5 mm Hg with visually significant hypotony maculopathy on two consecutive visits after 3 months * Additional glaucoma surgery, excluding laser suture lysis, removal of releasable trabeculectomy or conjunctival sutures, needling of the bleb or tube plate with or without 5FU, subconjunctival 5FU injections and anterior chamber reformation. * Loss of light perception vision

    Time frame: 6 months

Secondary outcomes

  1. IOP

    Intraocular pressure (mmHg)

    Time frame: 60 months

  2. Best Corrected Visual Acuity (BCVA)

    ETDRS visual acuity chart (logMAR or equivalent)

    Time frame: 60 months

  3. Supplemental medication

    Number of supplemental glaucoma medications used at Month 60

    Time frame: 60 months

  4. Adverse Events

    Number of Adverse Events during the trial

    Time frame: 60 months

06

Study locations

1 of 1 sites recruiting
  • Singapore Eye Research Institute
    Singapore, 168751, Singapore
    Recruiting
07

Registry details

Key details

Study ID
NCT03274024
Lead sponsor
Singapore Eye Research Institute
Collaborators
National Medical Research Council (NMRC), Singapore
Responsible party
Dr Ho Ching Lin (Research Director, Singapore Eye Research Institute) — Principal investigator
First posted
Sep 6, 2017
Start date
Sep 28, 2016
Primary completion
Oct 30, 2020 (estimated)
Completion
Oct 30, 2020 (estimated)
Last update
Sep 6, 2017

Study contacts

Natalia Porporato, Fellow
Contact
natalia.porporato@gmail.com
+6591378217
Ya Ying Ooi
Contact
ooi.ya.ying@seri.com.sg
+658186 7051
Ching Lin Ho
principal investigator · Singapore National Eye Centre

Oversight

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

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This study is status unknown, as verified in Sep 2017. You cannot join it, but the record below documents what was studied.

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