Endothelial Cell Loss and Induced Astigmatism After Wound-directed and Wound-assisted IOL Injection

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01250964
Recruitment Status : Completed
First Posted : December 1, 2010
Last Update Posted : December 1, 2010
Information provided by:
University of North Carolina, Chapel Hill

November 29, 2010
December 1, 2010
December 1, 2010
April 2010
November 2010   (Final data collection date for primary outcome measure)
Surgically induced astigmatism [ Time Frame: 1 month ]
measured by topography at 1 month post operative visit
Same as current
No Changes Posted
  • Endothelial cell loss [ Time Frame: one month ]
    As measured by specular microscopy
  • Best corrected visual acuity [ Time Frame: one month ]
    By manifest refraction
  • Final incision size [ Time Frame: intraoperatively (day #0) ]
    measured with incision gauges before and after lens injection.
Same as current
Not Provided
Not Provided
Endothelial Cell Loss and Induced Astigmatism After Wound-directed and Wound-assisted IOL Injection
Endothelial Cell Loss and Surgically Induced Astigmatism After 2.2 mm Wound Assisted vs 2.4 mm Wound-Directed Clear Corneal Incisions for Intraocular Lens Insertion During Cataract Surgery
The purpose of this study is to determine if there is any difference in astigmatism (eye surface curvature) or corneal endothelial cell density (the inner cell lining of the eye surface) after two different methods for inserting a lens during cataract surgery.

Cataract surgery (removal of a cloudy lens) is currently performed through increasingly smaller incisions. Bimanual surgery, where two instruments are used to remove the lens, is performed through two 1.4 mm incisions. Typically, one of these incisions is enlarged to 2.2 or 2.4 mm in order that the IOL (artificial lens) can be inserted into the eye. Surgeons insert these lenses by placing a lens injector cartridge completely into the eye (wound-directed insertion) or by placing only the tip inside the incision (wound-assisted insertion). While wound-assisted insertion can be performed through slightly smaller incisions (2.2 mm versus 2.4 mm for wound-directed insertion), both methods of insertion cause some incision enlargement. There is some evidence that wound-assisted insertion can cause very short-term pressure within the eye to go up. Neither method is considered inferior or superior to the other, and the primary investigator (Dr. Kenneth Cohen) routinely uses both methods.

No studies have directly compared wound-healing characteristics between these two methods. We seek to compare differences in:

  1. Surgically-induced astigmatism (changes in the corneal curvature from cataract surgery incisions.
  2. Endothelial cell density loss. Endothelial cells line the inside surface of the cornea, and their overall density can be decreased by cataract surgery.
  3. Best-corrected vision after surgery
  4. Sizes of the incisions after lens injection
Not Provided
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
  • Cataracts
  • Cataract Surgery
Procedure: Lens insertion during cataract surgery
After cataract removal during cataract surgery, a lens needs to be injected into the eye. Both arms are routinely used but different methods for injecting the lens.
  • Active Comparator: Wound-assisted lens injection
    Wound-assisted lens injection is considered neither superior or inferior to wound-directed lens injection.
    Intervention: Procedure: Lens insertion during cataract surgery
  • Active Comparator: Wound-directed lens injection
    Wound-directed lens injection is neither considered superior nor inferior to wound-assisted lens injection.
    Intervention: Procedure: Lens insertion during cataract surgery

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
November 2010
November 2010   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Eligible patients include those who undergo uncomplicated cataract extraction surgery and IOL implantation by KLC.

Exclusion Criteria: Patients who:

  1. suffer from diabetes and have more than mild background diabetic retinopathy,
  2. have a history of intraocular surgery,
  3. have a history of ocular trauma,
  4. have known pathology of the cornea,
  5. have a history of intraocular inflammation,
  6. are unable to understand English,
  7. are decisionally impaired,
  8. are currently incarcerated, or
  9. are less than 18 years of age.

No exclusions will be made on the basis of gender, ethnicity, or race.

Sexes Eligible for Study: All
18 Years and older   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
United States
Not Provided
Not Provided
Dr. Kenneth Cohen, Dept. of Ophthalmology, UNC Chapel Hill
University of North Carolina, Chapel Hill
Not Provided
Principal Investigator: Kenneth Cohen, MD UNC dept. of ophthalmology
University of North Carolina, Chapel Hill
November 2010

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP