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The purpose of this clinical study is to evaluate the safety and efficacy of cooling anesthesia application to the eye as anesthesia for intravitreal injection using a novel cooling anesthesia device and determine the effects of temperature and duration of application on subjective pain after intravitreal injection.
Intravitreal injections have become the standard of care for administering medications for retinal diseases such as age related macular degeneration and diabetic macular edema. There is considerable apprehension among patients receiving these injections, primarily revolving around adequate anesthesia during the injection. Current methods of anesthesia involve topical anesthetic drops, lidocaine gels, or subconjunctival injections of lidocaine, which suffer from either poor anesthetic effect, corneal irritation, or subconjunctival hemorrhage, as well as significant time for the onset of anesthesia.
Recens Medical has developed a novel medical device which can precisely and rapidly cool the surface of the eye This device cools to a temperature around -5 to -10 degrees Celsius, about the temperature of a cold ice cube, and thus has an excellent safety profile compared to conventional ophthalmic cryotherapy units. The value of such a device is both improved patient comfort, as well as increased efficiency and workflow for retina specialists administering intravitreal injections.
This device has been extensively tested in animal safety studies as well as pilot human studies and has not demonstrated any serious adverse effects and has shown anesthetic effects comparable to current standard of care.
This dose escalation study will test various temperatures and duration of temperatures to evaluate for safety as well as determine the optimal temperature for anesthesia during intravitreal injection.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| -5 degrees Celsius for 10 seconds | Experimental |
| |
| -5 degrees Celsius for 20 seconds | Experimental |
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| -10 degrees Celsius for 10 seconds | Experimental |
| |
| -10 degrees Celsius for 20 seconds | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cooling Anesthesia | Device | Application of cooling anesthesia device prior to intravitreal injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Subjective Pain | Pain as measured by the visual analogue scale (VAS). This was used in the previously presented SOLAR study (Clinical trials.gov, NCT01926977). Total range is 0-10, with 0 being no pain, and 10 being unbearable pain. | 24-48 hours after injection |
| Number of patients with treatment adverse events as measured by slit lamp examination | Full slit lamp examination of anterior and posterior segment after intravitreal injection | 30 minutes after injection |
| Measure | Description | Time Frame |
|---|---|---|
| Subject response to needle penetration | subject response to needle penetration as evaluated by physician | Intraoperative (During injection) |
| Time to perform intravitreal injection | Time to perform injection, measured from beginning of anesthesia to intravitreal injection |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Arshad Khanani, MD | Sierra Eye Associates | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sierra Eye Associates | Reno | Nevada | 89502 | United States | ||
| Retina Consultants of Houston |
Results of this study will be presented at a national meeting
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| ID | Term |
|---|---|
| D008268 | Macular Degeneration |
| ID | Term |
|---|---|
| D012162 | Retinal Degeneration |
| D012164 | Retinal Diseases |
| D005128 | Eye Diseases |
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A dose escalation strategy of differing temperatures and duration to test safety and efficacy of cooling anesthesia for intravitreal injection
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| Intraoperative (injection procedure) |
| Houston |
| Texas |
| 77030 |
| United States |