Standard Versus Transepithelial Corneal Crosslinking

NCT ID: NCT02349165

Last Updated: 2015-01-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

61 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-05-31

Study Completion Date

2014-09-30

Brief Summary

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The gold standard corneal crosslinking (CXL) technique involves the initial step of epithelial removal, in order to achieve a sufficient treatment effect (meaning: stabilisation of progressive keratoconus (KC). Our aim is to evaluate the effects of transepithelial CXL (TE-CXL), whereby the epithelium is left intact and the cornea is instead treated by a solution composed of 0.1% riboflavin, combined with enhancers, after which standard CXL is performed. This solution seems to facilitate riboflavin penetration into the corneal stroma through the intact epithelium. The investigators expect to achieve a similar effect of TE-CXL with the advantage of a faster healing time and less risk of infections.

Detailed Description

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Conditions

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Keratoconus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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epithelium off CXL

epithelium removal + 30 minute isotonic riboflavin eye drops (3 minute interval) + 30 minutes ultraviolet-A irradiation (riboflavin every 5 minutes)

Group Type ACTIVE_COMPARATOR

Transepithelial versus epithelium-off CXL

Intervention Type PROCEDURE

A comparison of the CXL procedure with and without epithelium removal

Isotonic riboflavin

Intervention Type DRUG

After epithelium removal, isotonic riboflavin was instilled during 30 minutes before ultraviolet-A irradiation

Ricrolin TE CXL

Ricrolin-TE eye drops for 15 minutes (2 minute interval) and 15 minute Ricrolin TE pooled on the cornea using a silicone ring + 30 minutes ultraviolet-A irradiation (Ricrolin TE every 5 minutes).

Group Type EXPERIMENTAL

Transepithelial versus epithelium-off CXL

Intervention Type PROCEDURE

A comparison of the CXL procedure with and without epithelium removal

Ricrolin TE

Intervention Type DRUG

Ricrolin TE was instilled during 30 minutes before ultraviolet-A irradiation

Interventions

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Transepithelial versus epithelium-off CXL

A comparison of the CXL procedure with and without epithelium removal

Intervention Type PROCEDURE

Ricrolin TE

Ricrolin TE was instilled during 30 minutes before ultraviolet-A irradiation

Intervention Type DRUG

Isotonic riboflavin

After epithelium removal, isotonic riboflavin was instilled during 30 minutes before ultraviolet-A irradiation

Intervention Type DRUG

Other Intervention Names

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epithelium-on versus epithelium-ff corneal crosslinking

Eligibility Criteria

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Inclusion Criteria

* Documented progressive KC (by Pentacam and/or corneal topography imaging).
* A clear central cornea.
* A minimal corneal thickness of ≥ 400 µm at the thinnest corneal location (Pentacam imaging).
* Minimal Snellen corrected distance visual acuity of ≥ 0.4.
* Patient age of ≥ 18 years.


* Documented progression of KC, as demonstrated by anterior segment imaging and/or corneal topography:

o Defined an increase in maximal keratometry, steepest keratometry, mean keratometry or topographic cylinder value by ≥ 0.5 D over the previous 6 months and/or a decrease in thinnest pachymetry
* Documented progression of KC defined by increase in refractive cylinder of ≥ 0.5 D over the previous 6 months

Exclusion Criteria

* Presence of corneal scars.
* History of epithelial healing problems.
* Presence of previous ocular infection (such as herpes keratitis).
* Patients who are pregnant and/or breastfeeding.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dr. F.P. Fischer Stichting

UNKNOWN

Sponsor Role collaborator

Stichting Nederlands Oogheelkundig Onderzoek

UNKNOWN

Sponsor Role collaborator

Nienke Soeters

OTHER

Sponsor Role lead

Responsible Party

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Nienke Soeters

BOptom

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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University Medical Center Utrecht

Utrecht, Utrecht, Netherlands

Site Status

Countries

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Netherlands

References

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Davis SA, Bovelle R, Han G, Kwagyan J. Corneal collagen cross-linking for bacterial infectious keratitis. Cochrane Database Syst Rev. 2020 Jun 17;6(6):CD013001. doi: 10.1002/14651858.CD013001.pub2.

Reference Type DERIVED
PMID: 32557558 (View on PubMed)

Other Identifiers

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10-374

Identifier Type: REGISTRY

Identifier Source: secondary_id

NL29961

Identifier Type: -

Identifier Source: org_study_id

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