Evidence map›Paper›PMID 30267699›Full record

Trial reportAmerican journal of ophthalmology2019

Fluorometholone 0.1% as Ancillary Therapy for Trachomatous Trichiasis Surgery: Randomized Clinical Trial.

John H Kempen, Redda Tekle-Haimanot, Lelisa Hunduma, Menilik Alemayehu, Maxwell Pistilli, Aida Abashawl, Scott D Lawrence, Wondu Alemayehu

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in American journal of ophthalmology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 3 countries.

John H KempenDepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; MCM Eye Unit, MyungSung Christian Medical Center, General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia. Electronic address: john_kempen@meei.harvard.edu.
Redda Tekle-HaimanotGeneral Hospital and MyungSung Medical School, Addis Ababa, Ethiopia; Grarbet Tehadiso Mahber, Addis Ababa, Ethiopia.
Lelisa HundumaGrarbet Tehadiso Mahber, Addis Ababa, Ethiopia; Grarbet Hospital, Butajira, Ethiopia.
Menilik AlemayehuEye Department, Shashemene Referral Hospital, Shashemene, Ethiopia.
Maxwell PistilliBerhan Public Health and Eye Care Consultancy, Addis Ababa, Ethiopia; Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Epidemiology, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA.
Aida AbashawlEye Department, Shashemene Referral Hospital, Shashemene, Ethiopia.
Scott D LawrenceMCM Eye Unit, MyungSung Christian Medical Center, General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia; Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan Medicine School, Ann Arbor, Michigan, USA; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA.
Wondu AlemayehuEye Department, Shashemene Referral Hospital, Shashemene, Ethiopia; The Fred Hollows Foundation, Addis Ababa, Ethiopia.
Drexel University · USFred Hollows Foundation · AUHarvard University · USMichigan Medicine · USSt. Paul's Hospital Millennium Medical College · ET

Funding

Scientific TransparencyP30EY001583 · NEI · UNIVERSITY OF PENNSYLVANIA · PI CLAIRE H MITCHELL · 1985 to 2026
$19.5M
NEI NIH HHS P30 EY001583
6 · The paper itself

Abstract

purposeTo assess the hypothesis that fluorometholone 0.1% eye drops are safe and effective as adjunctive therapy for trachomatous trichiasis (TT) surgery; determining the most promising dose.

designRandomized, placebo-controlled, double-masked parallel dose-ranging clinical trial.

methodsPatients undergoing upper lid TT surgery at a rural Ethiopian hospital were randomized to fluorometholone 0.1% twice daily for 4 weeks, 4 times daily for 4 weeks, 4 times daily for 8 weeks, or matching frequency placebo in a 3:1:3:1:3:1 ratio for 1 eye. Randomization was stratified by TT severity (1-4 vs ≥5 lashes touching the globe). Safety outcomes (intraocular pressure [IOP] elevation, cataract, and other dose-limiting toxicities) and postoperative TT incidence were assessed over 1 year.

resultsSubjects randomized were 39:13:39:13:38:13 in the respective groups, and 1 subject in the 8-weeks fluorometholone group was withdrawn. Of 154 subjects, 148 (96.1%) completed 1 year's follow-up. Among 76 eyes receiving fluorometholone 4 times daily, 1 developed IOP elevation ≥ 30 mm Hg (to 37 mm Hg) and 1 had an allergic reaction attributed to the study drug; each resolved upon drug cessation without sequelae. No cataract or other dose-limiting toxicity events occurred. Postoperative TT within 1 year occurred in 29.3% of placebo eyes vs 17.7%, 19.6%, and 23.2% among the respective fluorometholone groups (P = .29 comparing placebo vs all active treatments combined).

conclusionsThe results suggest fluorometholone 0.1% is likely to be safe and efficacious to reduce postoperative TT following TT surgery, and 1 drop twice daily for 4 weeks is the most promising dose. Confirmation in a full-scale clinical trial is needed before programmatic implementation.

Indexed as

AdultAnti-Inflammatory AgentsChemotherapy, AdjuvantDose-Response Relationship, DrugDouble-Blind MethodFemaleFluorometholoneHumansIntraocular PressureMaleMiddle AgedTrachomaTrichiasisAnti-Inflammatory AgentsFluorometholone

Identifiers

PMID30267699
PMCPMC7453666
OpenAlexW2894101204

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.