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Endoscopic Goniotomy for Infantile Glaucoma
This study has been completed.
Sponsored by: Vanderbilt University
Information provided by: Vanderbilt University
ClinicalTrials.gov Identifier: NCT00338533
  Purpose

Glaucoma surgery is performed on children less than 3 years old for infantile glaucoma which untreated can cause blindness. Glaucoma is an uncontrolled high eye pressure in these children often due to incomplete development of the part of the eye which normally allows fluid to drain out of the eye. Two procedures are possible and equal in their success of lowering the eye pressure. However, one (the goniotomy procedure) is preferred since it takes 10 minutes rather than 1 hour (for the trabeculotomy procedure) to perform under general anesthesia. This is important in young children to reduce anesthesia exposure especially if both eyes need surgery. If the glaucoma has caused the cornea or front of the eye to become too cloudy, then the view is too poor to place a lens on the cornea and use a needle to perform the shorter procedure. However, a small endoscope which has been FDA approved for use in the eye will allow direct viewing of the area which needs treatment. A needle attached to this endoscope allows the shorter goniotomy to be performed rather than proceeding to the longer trabeculotomy procedure. The outcome measure of this study is anesthesia time and reduction in intraocular pressure .


Condition Intervention
Glaucoma
Device: endoscopic goniotomy

Genetics Home Reference related topics: early-onset glaucoma
MedlinePlus related topics: Anesthesia Endoscopy Glaucoma
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study
Official Title: Endoscopic Goniotomy for Infantile Glaucoma

Further study details as provided by Vanderbilt University:

Primary Outcome Measures:
  • Intraocular pressure reduction [ Time Frame: Postoperatively ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Clearing of corneal edema [ Time Frame: Postoperatively ] [ Designated as safety issue: Yes ]

Enrollment: 7
Study Start Date: April 1997
Study Completion Date: July 2007
Primary Completion Date: July 2007 (Final data collection date for primary outcome measure)
Intervention Details:
    Device: endoscopic goniotomy
    The goninotomy is performed through an endoscope; allowing the physician a better view of the structure within the eye
Detailed Description:

b. The standard examination under anesthesia initially will be performed including measuring the child's intraocular pressure, measuring dimensions of the eye, examining the front of the eye under the operating microscope, examining the portion of the eye where the fluid drains, evaluating the back of the eye with an ultrasound, and possible documentation with photographs.

When the diagnosis is confirmed by this examination, the eye or eyes will be carefully evaluated for their clarity. If a standard goniotomy procedure can not be done, then the endoscopic goniotomy will be performed. The procedure is identical with: cleaning the eyelid skin, using a speculum to open the eyelids, making a small cut into the cornea, and placing a viscoelastic substance into the eye to maintain its shape. The procedure then differs since the inserted needle is attached to the viewing endoscope. I will then view the inside of the eye on a TV monitor in addition to looking through the operating microscope. This will allow me to directly see the structures which I will need to cut. Normally, I depend upon looking through a lens placed on the cornea which must be fairly clear so that I can see to cut the structures in the standard procedure. The procedure should not take much longer than the standard goniotomy and the same amount of tissue will be cut as in a standard goniotomy. The needle is then removed. The remainder of the procedure is identical which includes placing a stitch in the corneal incision, adjusting the amount of fluid in the eye so the pressure is not too low or high, giving a dilating drop, giving a steroid and antibiotic injection around the eye, giving steroid ointment and an eye patch.

  Eligibility

Ages Eligible for Study:   up to 3 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • childhood glaucoma with corneal edema unable to perform goniotomy

Exclusion Criteria:

  • older than 3 years
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00338533

Locations
United States, Tennessee
Vanderbilt University
Nashville, Tennessee, United States, 37232
Sponsors and Collaborators
Vanderbilt University
Investigators
Principal Investigator: karen Joos, MD, PhD Vanderbilt University
  More Information

Publications of Results:
Responsible Party: Vanderbilt University Medical Center ( Karen Joos, MD, PI )
Study ID Numbers: Vanderbilt IRB # 8542
Study First Received: June 15, 2006
Last Updated: February 1, 2008
ClinicalTrials.gov Identifier: NCT00338533  
Health Authority: United States: Food and Drug Administration

Keywords provided by Vanderbilt University:
childhood glaucoma

Study placed in the following topic categories:
Hydrophthalmos
Glaucoma
Glaucoma, Open-Angle
Eye Diseases
Infant, Newborn, Diseases
Glaucoma, congenital
Congenital Abnormalities
Eye Abnormalities
Hypertension
Ocular Hypertension

ClinicalTrials.gov processed this record on January 14, 2009