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Diabetic Macular Edema (DME)Phase 4QuellNCT07456826

Study Evaluating the Efficacy and Safety of Chloroprocaine HCl Ophthalmic Gel 3% vs Proparacaine Ophthalmic Solution 0.5% Plus Subconjunctival Lidocaine in Patients Undergoing Intravitreal Injections

A Phase 4 study testing Chloroprocaine Ophthalmic Gel 3% (IHEEZO), Proparacaine Hydrochloride Ophthalmic Solution 0.5% and Lidocaine Hydrochloride Injection 2% in people with Diabetic Macular Edema (DME) and Age-Related Macular Degeneration (AMD), run by Harrow Inc at 1 site in United States.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

This Phase 4, multicenter, randomized, double-masked clinical study evaluates the efficacy and safety of chloroprocaine hydrochloride ophthalmic gel 3% (IHEEZO) compared with routine anesthesia (topical proparacaine 0.5% combined with subconjunctival lidocaine 2%) for ocular surface anesthesia during intravitreal… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Chloroprocaine Ophthalmic Gel 3% (IHEEZO), Proparacaine Hydrochloride Ophthalmic Solution 0.5% and Lidocaine Hydrochloride Injection 2%
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
236 participants
Where
1 siteUnited States
Study dates
31 Mar 2026to Aug 2026
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Able to understand and voluntarily provide written informed consent prior to initiation of any study-specific procedures
  • Male or female, age ≥ 18 years
  • Scheduled to undergo unilateral, uncomplicated intravitreal injection of an FDA-approved, non-biosimilar anti-VEGF agent in the study eye
  • Diagnosis requiring anti-vascular endothelial growth factor (anti-VEGF) treatment, including macular edema (cystoid or diabetic), retinal vein occlusion, diabetic retinopathy, or neovascular age-related macular degeneration
  • At least three prior intravitreal anti-VEGF injections in the study eye
  • Fewer than 13 intravitreal anti-VEGF injections in the study eye within the last 365 days
  • Willing and able to comply with study procedures and follow-up assessments

Who cannot join

  • Scheduled to undergo simultaneous bilateral intravitreal injection
  • Pre-existing eye pain in the study eye
  • Fewer than three prior intravitreal anti-VEGF injections in the study eye within 365 days prior to enrollment
  • Mental disability or cognitive impairment that prevents reliable pain assessment
  • Prisoner
  • Pregnant or breastfeeding
Show all 20Show fewer
  • Woman of childbearing potential not using an acceptable method of contraception
  • Inability to comply with study procedures or follow-up assessments
  • Known sensitivity or allergy to any study medications or related drug classes
  • History of resistance to local anesthetics
  • History of Ehlers-Danlos syndrome
  • Participation in another investigational drug or device study within 30 days prior to screening (unless previously randomized to a control group receiving Eylea, Eylea HD, Lucentis, or Vabysmo)
  • Use of pain medication, opioids, analgesics, or NSAIDs (any route) within 24 hours prior to Visit 1
  • Clinically significant systemic disease or condition that, in the Investigator's judgment, may compromise safety or study integrity
  • Cataract extraction, intraocular surgery, or extraocular surgery within 60 days prior to enrollment that may affect ocular pain
  • History of autoimmune disease, graft-versus-host disease, fibromyalgia, uveitis, neurotrophic corneal disease, keratitis or corneal ulceration, uncontrolled glaucoma, or herpetic ocular disease
  • History of endophthalmitis or ocular trauma within 3 months prior to enrollment
  • Pre-existing subconjunctival hemorrhage or bulbar conjunctival hyperemia
  • Chronic ocular pain rated moderate to severe within 1 week prior to Visit 1
  • Active bacterial or viral infection in either eye

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site
  • Tyler Retina Research Institute

    Tyler, Texas, 75703

Other trials in United States

About this study

Official title: A Phase 4, Multisite, Randomized, Double-Masked, Well-Controlled Study Evaluating the Efficacy and Safety of Chloroprocaine HCl Ophthalmic Gel 3% vs Proparacaine Ophthalmic Solution 0.5% Plus Subconjunctival Lidocaine in Patients Undergoing Intravitreal Injections: The QUELL Study

This Phase 4, multicenter, randomized, double-masked clinical study evaluates the efficacy and safety of chloroprocaine hydrochloride ophthalmic gel 3% (IHEEZO) compared with routine anesthesia (topical proparacaine 0.5% combined with subconjunctival lidocaine 2%) for ocular surface anesthesia during intravitreal injection procedures. Adult participants scheduled to undergo unilateral intravitreal injection of an FDA-approved anti-vascular endothelial growth factor (anti-VEGF) agent for retinal conditions will be randomized in a 1:1 ratio to receive either IHEEZO with a sham subconjunctival procedure or routine anesthesia.

The primary objective is to determine whether IHEEZO is non-inferior to routine anesthesia in achieving successful ocular surface anesthesia, defined as a participant-reported pain score of 0 or 1 (on a 0-5 ordinal pain scale) immediately before and immediately after intravitreal injection. Secondary outcomes include individual and cumulative pain scores, change from baseline in dry eye symptoms measured by the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and ocular safety assessments through Day 7 follow-up.

Read the detailed description

This is a prospective, multicenter, randomized, double-masked, controlled Phase 4 clinical trial evaluating the non-inferiority of chloroprocaine hydrochloride ophthalmic gel 3% (IHEEZO) compared with routine anesthesia (topical proparacaine 0.5% plus subconjunctival lidocaine 2%) for ocular surface anesthesia during intravitreal injection (IVT).

Adults scheduled to undergo unilateral intravitreal injection of an FDA-approved anti-vascular endothelial growth factor (anti-VEGF) agent for neovascular age-related macular degeneration, diabetic macular edema, retinal vein occlusion, or diabetic retinopathy will be randomized 1:1 to receive either IHEEZO with a sham subconjunctival procedure or routine anesthesia. Randomization will be stratified by clinical site and baseline ocular dryness severity (Standard Patient Evaluation of Eye Dryness [SPEED] score).

Participants in the experimental arm will receive three topical drops of chloroprocaine ophthalmic gel 3% followed by a sham subconjunctival procedure. Participants in the comparator arm will receive three topical drops of proparacaine 0.5% followed by subconjunctival lidocaine 2%. Standard antiseptic preparation with 5% povidone-iodine will be performed prior to IVT in both arms.

The primary endpoint is the proportion of participants achieving successful ocular surface anesthesia, defined as a pain score of 0 or 1 on a 0-5 ordinal pain scale both immediately before and immediately after IVT. Participants requiring rescue anesthesia prior to or during IVT will be considered treatment failures.

Secondary endpoints include individual and cumulative pain scores, change from baseline in SPEED questionnaire score, and ocular safety assessments including best-corrected visual acuity, intraocular pressure, corneal fluorescein staining (Oxford scale), and treatment-emergent adverse events through Day 7 (±2 days). Participants will be followed for approximately 7 days after injection.

Being tested
Chloroprocaine Ophthalmic Gel 3% (IHEEZO), Sham Subconjunctival Injection, Proparacaine Hydrochloride Ophthalmic Solution 0.5%, Lidocaine Hydrochloride Injection 2%
Medical subject headings
Macular Degeneration, Retinal Vein Occlusion, Diabetic Retinopathy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Chloroprocaine Ophthalmic Gel 3% (IHEEZO)Drug

    Preservative-free chloroprocaine hydrochloride ophthalmic gel 3% administered as 3 topical drops to the study eye prior to intravitreal injection.

  • Sham Subconjunctival InjectionProcedure or surgery

    Sham procedure performed using a syringe with a blunt-tipped cannula that does not contact the conjunctiva, performed to maintain masking prior to intravitreal injection.

  • Proparacaine Hydrochloride Ophthalmic Solution 0.5%Drug

    Topical proparacaine hydrochloride ophthalmic solution 0.5% administered as 3 drops to the study eye prior to intravitreal injection.

  • Lidocaine Hydrochloride Injection 2%Drug

    Subconjunctival injection of lidocaine hydrochloride 2% administered after topical proparacaine and prior to intravitreal injection.

Study groups in NCT07456826
Study groupRoleWhat they receive
IHEEZO (Chloroprocaine Ophthalmic Gel 3%) + Sham InjectionExperimentalParticipants receive chloroprocaine hydrochloride ophthalmic gel 3% (IHEEZO) administered as 3 topical drops to the study eye approximately 1 minute apart prior to intravitreal injection. Approximately 5 minutes after the third drop, a sham subconjunctival injection (using a blunt cannula without conjunctival contact) is performed to maintain masking. Intravitreal injection is then administered per standard of care.
Receives: Drug: Chloroprocaine Ophthalmic Gel 3% (IHEEZO); Procedure: Sham Subconjunctival Injection
Routine Anesthesia (Proparacaine + Subconjunctival Lidocaine)Active comparatorParticipants receive proparacaine hydrochloride ophthalmic solution 0.5% administered as 3 topical drops to the study eye approximately 1 minute apart prior to intravitreal injection. This is followed by a subconjunctival injection of lidocaine hydrochloride 2%. Intravitreal injection is then administered per standard of care.
Receives: Drug: Proparacaine Hydrochloride Ophthalmic Solution 0.5%; Drug: Lidocaine Hydrochloride Injection 2%

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Participants Achieving Successful Ocular Surface Anesthesia

    Successful ocular surface anesthesia is defined as a participant-reported pain score of 0 (no pain/discomfort) or 1 (pressure only, no pain) at BOTH of the following timepoints:

    1. Immediately before intravitreal injection (after subconjunctival or sham injection), and
    2. Immediately after intravitreal injection.

    Pain is assessed using a 0-5 descriptor-based ordinal scale:

    0 = No pain/discomfort

    1. = Pressure only, no pain
    2. = Mild, brief sting/burn; tolerable
    3. = Moderate discomfort; tolerable without rescue
    4. = Marked pain; difficult to tolerate
    5. = Severe/intolerable; procedure cannot continue without rescue

    Participants requiring rescue anesthesia at any time before or during intravitreal injection are considered treatment failures.

    Measured: Immediately before and immediately after intravitreal injection (Day 1)

Secondary outcomes (10)
  1. Pain Score Immediately Before Intravitreal Injection

    Pain is assessed using a 0-5 descriptor-based ordinal pain scale (minimum = 0, maximum = 5), where 0 indicates no pain and 5 indicates severe/intolerable pain. Higher scores indicate greater pain intensity.

    Measured: Immediately before intravitreal injection (Day 1)

  2. Pain Score Immediately After Intravitreal Injection

    Pain is assessed using a 0-5 descriptor-based ordinal pain scale (minimum = 0, maximum = 5), where 0 indicates no pain and 5 indicates severe/intolerable pain. Higher scores indicate greater pain intensity.

    Measured: Immediately after intravitreal injection (Day 1)

  3. Pain Score at Evening Follow-Up

    Participant-reported pain score assessed 3-12 hours after intravitreal injection. Pain is assessed using a 0-5 descriptor-based ordinal pain scale (minimum = 0, maximum = 5), where 0 indicates no pain and 5 indicates severe/intolerable pain. Higher scores indicate greater pain intensity.

    Measured: Evening of Day 1 (3-12 hours post-injection)

  4. Pain Score at 24 Hours Post-Injection

    Participant-reported pain score assessed 20-28 hours after intravitreal injection. Pain is assessed using a 0-5 descriptor-based ordinal pain scale (minimum = 0, maximum = 5), where 0 indicates no pain and 5 indicates severe/intolerable pain. Higher scores indicate greater pain intensity.

    Measured: Day 2 (20-28 hours post-injection)

  5. Cumulative 24-Hour Pain Score

    Sum of four pain assessments: pre-injection, post-injection, evening follow-up, and 24-hour follow-up. Each individual pain score ranges from 0 to 5; therefore, the cumulative 24-hour pain score ranges from 0 to 20. Higher scores indicate greater cumulative pain.

    Measured: Day 1 through 24 hours post-injection

  6. Change From Baseline in SPEED Questionnaire Score

    Change from baseline in Standard Patient Evaluation of Eye Dryness (SPEED) total score. The SPEED questionnaire total score ranges from 0 to 28, with higher scores indicating greater dry eye symptom severity.

    Measured: Baseline, Evening Day 1, and Day 2 (20-28 hours)

  7. Change in Best-Corrected Visual Acuity

    Best-corrected visual acuity measured using LogMAR visual acuity scale (minimum and maximum values dependent on chart range). Lower LogMAR values indicate better visual acuity.

    Measured: Time Frame: Baseline and Day 7 ± 2 days

  8. Change in Intraocular Pressure

    Intraocular pressure measured in millimeters of mercury (mmHg). Higher values indicate higher intraocular pressure.

    Measured: Time Frame: Baseline and Day 7 ± 2 days

  9. Corneal Fluorescein Staining Score

    Corneal staining graded using the Oxford Grading Scale (ordinal scale, minimum = 0, maximum = 5). Higher grades indicate greater corneal staining severity.

    Measured: Time Frame: Baseline, post-injection Day 1, and Day 7 ± 2 days

  10. Incidence of Treatment-Emergent Adverse Events

    Incidence of Treatment-Emergent Adverse Events

    Measured: Time Frame: Day 1 through Day 7 ± 2 days Unit: Number of participants with ≥1 TEA

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Mar 2026
  2. Study start31 Mar 2026
  3. Primary completionAug 2026 (estimated)
  4. Study completionAug 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
236 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07456826
Sponsor's protocol ID
IZ-4-002
Acronym
Quell
Status last verified
Apr 2026
First submitted
25 Feb 2026
Last updated
7 Apr 2026
Results posted
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Individual participant data (IPD) will not be shared. Harrow does not plan to make de-identified IPD available for secondary research purposes. IPD will not be available for access

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Chloroprocaine Ophthalmic Gel 3% (IHEEZO), Proparacaine Hydrochloride Ophthalmic Solution 0.5% and Lidocaine Hydrochloride Injection 2% in people with Diabetic Macular Edema (DME) and Age-Related Macular Degeneration (AMD), run by Harrow Inc at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 7 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Participants Achieving Successful Ocular Surface Anesthesia (time frame: Immediately before and immediately after intravitreal injection (Day 1)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Apr 2026.

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