Glaucoma Drainage Device and Endothelial Cell Loss Compare Trial (DECLARE) is a multi-center, outcome-masked, randomized clinical trial. The purpose of this study is to compare glaucoma drainage device implantation in the anterior chamber (front part of the eye) and sulcus (small space between iris and front chamber of the eye) in efforts to minimize cell loss in the eye.
The DECLARE Trial is a prospective 1:1 randomized, parallel design, double-masked clinical trial to compare endothelial cell density (ECD), intraocular pressure (IOP) and metagenomic RNA deep sequencing (MDS) between sulcus and anterior chamber (AC) tube placement after glaucoma drainage device (GDD) implantation. The trial has fixed sample size with 12 months follow-up for primary outcome assessment and trial participants will continue to be followed to the end of grant cycle with a total of 24 months follow-up. Patients will be randomized to 2 tube locations for GDD implantation: * Tube placed in the AC * Tube placed in ciliary sulcus * Stratification: by clinical center and type of surgery (GDD alone vs GDD combined with phacoemulsification). Stratified randomization by clinical center is to ensure that a similar number of subjects will be randomized to either sulcus tube or AC tube placement for a specific clinical center. Because eyes undergoing a combined phacoemulsification with GDD implantation may be associate with larger ECL from phacoemulsification, stratified by surgery type is to ensure two tube location groups similar number of study eyes that will undergo a combined phacoemulsification with GDD implantation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
226
GDD implantation surgery with tube placement in the ciliary sulcus
GDD implantation surgery with tube placement in the anterior chamber
University of California San Francisco
San Francisco, California, United States
RECRUITINGDiablo Eye Associates
Walnut Creek, California, United States
RECRUITINGBascom Palmer Eye Institute
Central endothelial cell loss (ECL) from baseline
Change in central endothelial cell density based on assessment of Specular Microscopy images.
Time frame: Baseline to 12 months
Intraocular Pressure (IOP) at 12 months
Goldman applanation tonometry (preferred method)
Time frame: 12 months after GDD implantation
ECD at 12 months after GDD implantation
ECD measures will be based on the assessment of Specular Microscopy images
Time frame: 12 months after GDD implantation
Best-corrected visual acuity (BCVA) at 12 months after GDD implantation
Distance BCVA using an ETDRS eye chart and recorded as number of letters read correctly.
Time frame: 12 months after GDD implantation
Number of anti-glaucoma medications at 12 months after GDD implantation
Topical and oral anti-glaucoma medication information is collected at all visits.
Time frame: 12 months after GDD implantation
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Miami, Florida, United States
Wilmer Eye Institute, Johns Hopkins University
Baltimore, Maryland, United States
RECRUITINGMassachusetts Eye and Ear
Boston, Massachusetts, United States
RECRUITINGUniversity of Buffalo/State University of New York
Buffalo, New York, United States
RECRUITINGUniversity of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
RECRUITINGPrism Eye Institute, University of Toronto
Toronto, Canada
RECRUITING