Evaluation of Amphotericin B in Optisol-GS for Prevention of Post-Keratoplasty Fungal Infections.

NCT ID: NCT04018417

Last Updated: 2019-07-12

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

WITHDRAWN

Clinical Phase

PHASE2/PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-03

Study Completion Date

2019-07-03

Brief Summary

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With the increasing popularity of endothelial keratoplasty, a coincident increase in the rate of fungal infections post-keratoplasty has been seen in the United States. In this study, the eye bank will harvest pairs of donor corneas and randomize one cornea from each pair to be stored in Optisol-GS per Eye Bank Association of America guidelines. The eye bank will add amphotericin B 0.255 μg/mL (antifungal) to the storage solution for the mate cornea. The study donor corneas will be assigned to participants who are scheduled to undergo Descemet membrane endothelial keratoplasty. The surgeons, participants, and evaluators will remain masked regarding the donor cornea storage solution assignment. The participants will be followed for 6 months.

Detailed Description

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Conditions

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Fuchs' Endothelial Dystrophy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Amphotericin B

The eye bank will add amphotericin B 0.255 μg/mL to the Optisol-GS donor cornea storage solution.

Group Type EXPERIMENTAL

Amphotericin B

Intervention Type DRUG

Drug concentration: 0.255 μg/mL

Control

The donor cornea will be stored in Optisol-GS per the eye bank's standard procedure.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Amphotericin B

Drug concentration: 0.255 μg/mL

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Male or female at least 18 years of age and any race or ethnicity
* Scheduled to have Descemet membrane endothelial keratoplasty

Exclusion Criteria

* History of glaucoma surgery in operative eye
* Known allergy or intolerance to amphotericin B
* Presence of anterior chamber intraocular lens
* Corneal stromal or epithelial dysfunction
* Presence of glaucoma defined as optic nerve damage as confirmed on Humphrey visual field testing or retinal nerve fiber layer analysis
* Presence of peripheral anterior synechiae
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cornea Research Foundation of America

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Francis W Price, Jr, MD

Role: PRINCIPAL_INVESTIGATOR

Price Vision Group

Locations

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Price Vision Group

Indianapolis, Indiana, United States

Site Status

Countries

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United States

References

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Aldave AJ, DeMatteo J, Glasser DB, Tu EY, Iliakis B, Nordlund ML, Misko J, Verdier DD, Yu F. Report of the Eye Bank Association of America medical advisory board subcommittee on fungal infection after corneal transplantation. Cornea. 2013 Feb;32(2):149-54. doi: 10.1097/ICO.0b013e31825e83bf.

Reference Type BACKGROUND
PMID: 23051906 (View on PubMed)

Armitage WJ. Preservation of Human Cornea. Transfus Med Hemother. 2011;38(2):143-147. doi: 10.1159/000326632. Epub 2011 Mar 16.

Reference Type BACKGROUND
PMID: 21566714 (View on PubMed)

Hassan SS, Wilhelmus KR; Medical Review Subcommittee of the Eye Bank Association of America. Eye-banking risk factors for fungal endophthalmitis compared with bacterial endophthalmitis after corneal transplantation. Am J Ophthalmol. 2005 Apr;139(4):685-90. doi: 10.1016/j.ajo.2004.12.016.

Reference Type BACKGROUND
PMID: 15808165 (View on PubMed)

Hassan SS, Wilhelmus KR, Dahl P, Davis GC, Roberts RT, Ross KW, Varnum BH; Medical Review Subcommittee of the Eye Bank Association of America. Infectious disease risk factors of corneal graft donors. Arch Ophthalmol. 2008 Feb;126(2):235-9. doi: 10.1001/archophthalmol.2007.45.

Reference Type BACKGROUND
PMID: 18268215 (View on PubMed)

Keyhani K, Seedor JA, Shah MK, Terraciano AJ, Ritterband DC. The incidence of fungal keratitis and endophthalmitis following penetrating keratoplasty. Cornea. 2005 Apr;24(3):288-91. doi: 10.1097/01.ico..0000138832.3486.70.

Reference Type BACKGROUND
PMID: 15778600 (View on PubMed)

Merchant A, Zacks CM, Wilhelmus K, Durand M, Dohlman CH. Candidal endophthalmitis after keratoplasty. Cornea. 2001 Mar;20(2):226-9. doi: 10.1097/00003226-200103000-00026.

Reference Type BACKGROUND
PMID: 11248837 (View on PubMed)

Doshi H, Pabon S, Price MO, Feng MT, Price FW Jr. Overview of Systemic Candida Infections in Hospital Settings and Report of Candida After DMEK Successfully Treated With Antifungals and Partial Graft Excision. Cornea. 2018 Aug;37(8):1071-1074. doi: 10.1097/ICO.0000000000001608.

Reference Type BACKGROUND
PMID: 29634675 (View on PubMed)

Duncan K, Parker J, Hoover C, Jeng BH. The Effect of Light Exposure on the Efficacy and Safety of Amphotericin B in Corneal Storage Media. JAMA Ophthalmol. 2016 Apr;134(4):432-6. doi: 10.1001/jamaophthalmol.2016.0008.

Reference Type BACKGROUND
PMID: 26914028 (View on PubMed)

Lopez RM, Ayestaran A, Pou L, Montoro JB, Hernandez M, Caragol I. Stability of amphotericin B in an extemporaneously prepared i.v. fat emulsion. Am J Health Syst Pharm. 1996 Nov 15;53(22):2724-7. doi: 10.1093/ajhp/53.22.2724.

Reference Type BACKGROUND
PMID: 8931814 (View on PubMed)

Other Identifiers

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2019-005

Identifier Type: -

Identifier Source: org_study_id

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