The purpose of the study is to study the safety of the combination of ranibizumab and MMC vs monotherapy MMC vs intravitreal ranibizumab injection in patients with glaucoma.
A common problem after undergoing trabeculectomy surgery to create a bleb (blister or bubble) to reduce intraocular pressure, is scarring of the opening. This scarring prevents fluid drainage and interferes with the proper functioning of the bleb. MMC (Mitomycin C) is usually administered intraoperatively, to reduce scarring and increase filtration. However, the failure rate of trabeculectomy remains high. Anti-VEGF (Vascular endothelial growth factor) agents have been used successfully in cases requiring bleb needling. The purpose of the study is to determine the safety of the combination of ranibizumab and MMC vs monotherapy MMC in patients with glaucoma. This is an open-label, Phase I/II safety study of 30 patients randomized to either treatment with ranibizumab 0.5 mg intravitreally injected (n=10), combination ranibizumab 0.5mg intravitreally injected and MMC (0.4 mg/ml for 2 min) in eyes after trabeculectomy (n=10) or MMC therapy alone (n=10). For the ranibizumab groups, a repeat injection of ranibizumab 0.5mg may be given PRN (as needed) at 1 month if hypervascularity or neovascularization of the conjunctiva exists.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
0.5mg of ranibizumab intravitreally injected after surgery and at 1 month if needed
Combination ranibizumab 0.5mg intravitreally injected and MMC (0.4 mg/ml for 2 min) in eyes after trabeculectomy
MMC (0.4 mg/ml for 2 min) in eyes after trabeculectomy.
Rocky Mountain Lions Eye Institute
Aurora, Colorado, United States
Assessment of Ocular Adverse Events
To assess ocular adverse events of combination ranibizumab and MMC therapy at 6 months
Time frame: 6 months
Percent of Subjects With a Qualified Success and Viable Bleb at 6 Months.
To determine percent of subjects with a qualified success and viable bleb at 6 months (IOP between 6mm Hg and 22 mm Hg with pressure controlled with and without adjunctive medications)
Time frame: 6 months
Mean Change in in Intraocular Pressure.
Mean change in in intraocular pressure at 3 months and at 6 months
Time frame: 6 months
Mean Change in Visual Acuity
Mean change in visual acuity in logMAR.
Time frame: 6 months
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