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Trial registered on ANZCTR
Registration number
ACTRN12616000620426
Ethics application status
Approved
Date submitted
8/03/2016
Date registered
12/05/2016
Date last updated
21/04/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Comparing success rates of two surgical techniques for involutional entropion of the lower eyelid: the everting sutures and the lateral tarsal strip.
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Scientific title
Prospective randomised controlled trial to compare success rates of two surgical techniques for involutional entropion of the lower eyelid:the everting sutures and the lateral tarsal strip.
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Secondary ID [1]
288615
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none
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Universal Trial Number (UTN)
U1111-1180-0298
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Involutional entropion of the lower eyelid.
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Condition category
Condition code
Eye
297953
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0
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Diseases / disorders of the eye
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Surgery
298512
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients suffering from primary involutional entropion will participate in the study. Patients will be randomised to everting sutures technique (commonly used) and to lateral tarsal strip technique (commonly not used as standard practice).
The lateral tarsal strip technique:
Cantholysis of the lateral palpebral ligament.
Preparation of an outer tarsus flap (sling) by removing the dermis, the orbicularis muscle and the conjuctiva.
Flap fixation by using sutures 5.0 to the temporal orbit periosteum .
Wound restorarion by using 6.0 sutures.
These procedures will be performed by the qualified ophthalmologist Elias Nakos expert in oculoplastics.
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Intervention code [1]
294017
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Treatment: Surgery
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Comparator / control treatment
Control group: The everting sutures technique.
It consists in the insertion of three (3) absorbable sutures 6.0 with double needle obliquely from the lower limit of the palpebral conjuctiva through rhe skin of the eyelid below the eyelashes.
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Control group
Active
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Outcomes
Primary outcome [1]
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Success rate.
The success is assessed by clinical examination. At the follow-up visit, eyelid is asessed in the primary and downgaze position.
The patients will also asked to squeeze their eyelids closed to detect any latent recurrence.
The surgical success is defined as complete resolution of the inward eyelid margin rotation and symptoms.
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Assessment method [1]
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Timepoint [1]
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6 (six) months and 1 (one) year follow up..
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Primary outcome [2]
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Quality of life by using the VQF-25 Questionnaire preoperatively and at six months follow-up.
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Assessment method [2]
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Timepoint [2]
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Preoperatively and at 6(six) months..
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Secondary outcome [1]
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Complications rate by using clinical examination and asking the patient for possible problems postoperatively.
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Assessment method [1]
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Timepoint [1]
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6 (six) months and 1 (one) year follow up.
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Eligibility
Key inclusion criteria
Lower eyelid involutional entropion.
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Minimum age
25
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Scarry entropion.
Another surgery for the same reason.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
simple randomisation using a randomisation table from a statistic book
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
About 40 to 60 patients is a satisfacory number of patients if we take under consideration the prevalence of the lower eyelid entropion in the general population.
Methods:
A.t-test : 1. independent samples t- test and
2. paired samples t-test.
In these two t tests, the null hypothesis being tested is that quantitative variable average values in both populations from which the planned "samples" are derived are equal. Thus, the p-value, the difference between the means of two "samples" and the 95% confidence interval for the difference, are calculated.
When the p-value is less than a value, which is usually defined at the level of 0.05, then the null hypothesis is rejected and the difference between the means of the two populations are statistically significant.
B. Non-parametric methods which take into account the provisions of observations rather than actual values of observations, making possible their application in the case of 'samples' with a small number of observations. In non-parametric methods, the null hypothesis is not the comparison of average populations prices from which they derive the "samples", but comparing medians.
Where the "samples" are two and independently the statistical test of Wilcoxon (wilcoxon rank-sum test devices) is used..
In the case where the "samples" are two, but in pairs, so for each observation in the first group there is a corresponding remark in the second group, the Wilcoxon signed-ranked test or sign test will be used.
C. If i need to make some correlation, the type and size of the linear relationship between two quantitative variables that follow the normal distribution is estimated by the correlation coefficient of Pearson (Pearson's coefficient of correlation), while when one of the two quantitative variables does not follow the normal distribution, then the correlation coefficient of Spearman provisions is used (Spearman's rank correlation coefficient).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
13/05/2013
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Date of last participant enrolment
Anticipated
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Actual
1/02/2016
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Date of last data collection
Anticipated
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Actual
1/02/2017
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Sample size
Target
54
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Accrual to date
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Final
54
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Recruitment outside Australia
Country [1]
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Greece
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State/province [1]
7615
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Aristotle university medical school
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Address [1]
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University city of Thessaloniki, Thessaloniki, Agiou Dimitriou st, 54124.
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Country [1]
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Greece
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Funding source category [2]
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Hospital
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Name [2]
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AHEPA University General Hospital of Thessaloniki
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Address [2]
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Kiriakidi 1, Thessaloniki, 54621.
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Country [2]
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Greece
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Funding source category [3]
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Hospital
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Name [3]
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424 General Military Hospital of Thessaloniki
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Address [3]
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Egnatia ring road of Thessaloniki, Thessaloniki, 56429.
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Country [3]
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Greece
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Primary sponsor type
University
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Name
Aristotle university medical school, lab of experimental ophthalmology
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Address
University city of Thessaloniki, Thessaloniki, Agiou Dimitriou st, 54124.
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Country
Greece
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Secondary sponsor category [1]
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None
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Name [1]
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NONE
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Address [1]
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NONE
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Country [1]
291751
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Bioethics commitee of Aristotle university medical school
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Ethics committee address [1]
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University city of Thessaloniki, Thessaloniki, Agiou Dimitriou st, 54124.
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Ethics committee country [1]
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Greece
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Date submitted for ethics approval [1]
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20/07/2013
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Approval date [1]
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08/10/2013
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Ethics approval number [1]
294490
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Summary
Brief summary
The surgical treatment of the involutional entropion of the lower eyelid by using two techniques: 1. the everting sutures and 2. the lateral tarsal strip technique. Prospective randomized comparative study of these two techniques. I want to find which is the best procedure, the outcome of anatomical and functional recovery over time and their contribution to improving patients’ quality of life. SURGICAL TECHNIQUES: 1. the everting sutures technique: It consists in the insertion of three (3) absorbable sutures 6.0 with double needle obliquely from the lower limit of the palpebral conjunctiva through the skin of the eyelid below the eyelashes. 2. the lateral tarsal strip technique: Cantholysis of the lateral palpebral ligament. Preparation of an outer tarsus flap (sling) by removing the dermis, the orbicularis muscle and the conjuctiva. Flap fixation by using sutures 5.0 to the temporal orbit periosteum . Wound restorarion by using 6.0 sutures. Based on the existing literature, there are some questions to be answered: Which is the most appropriate surgical rehabilitation technique for the lower involutional eyelid entropion with the best success rates, fewer complications and the lower recurrence rates? Importance: The result of the investigation may lead to the predominance of one technique over the other and to establish criteria for their selection.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Nakos Elias
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Address
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Eye Clinic, 424 General Military Hospital of Thessaloniki, Thessaloniki, ring road Egnatia, 56429
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Country
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Greece
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Phone
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+306949194259
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Fax
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+302310638193
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Email
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[email protected]
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Contact person for public queries
Name
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Nakos Elias
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Address
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Eye Clinic, 424 General Military Hospital of Thessaloniki, Thessalonki, ring road Egnatia, 56429
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Country
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Greece
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Phone
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+306949194259
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Fax
63847
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+302310638193
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Email
63847
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[email protected]
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Contact person for scientific queries
Name
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Nakos Elias
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Address
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Eye Clinic, 424 General Military Hospital of Thessaloniki, Thessaloniki, ring road Egnatia, 56429
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Country
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Greece
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Phone
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+306949194259
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Fax
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+302310638193
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Randomized Controlled Trial Comparing Everting Sutures with a Lateral Tarsal Strip for Involutional Lower Eyelid Entropion.
2019
https://dx.doi.org/10.1007/s40123-019-0189-3
N.B. These documents automatically identified may not have been verified by the study sponsor.
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