Transepithelial (Epi-on) Corneal Collagen Crosslinking to Treat Keratoconus and Corneal Ectasia

NCT ID: NCT04905108

Last Updated: 2023-01-04

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-02

Study Completion Date

2025-12-31

Brief Summary

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Corneal collagen crosslinking (CXL) has been demonstrated as an effective method of reducing progression of both keratoconus and corneal ectasia after surgery, as well as possibly decreasing the steepness of the cornea in these pathologies. Transepithelial crosslinking in which the epithelium is not removed has been proposed to offer a number of advantages over traditional crosslinking including an increased safety profile by reducing the risk for infection and scarring, faster visual recovery and improved patient comfort in the early postoperative healing period.

Detailed Description

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The objective of this randomized study is to investigate the difference between two regimens of transepithelial crosslinking. The study will compare two riboflavin dosing regimens during the crosslinking procedure. The primary objective of this study is to evaluate the safety and efficacy of transepithelial corneal collagen crosslinking performed with two different riboflavin administration protocols during the UVA portion of the procedure. Safety and efficacy outcomes will then be compared between the treatment groups. In particular, the two groups will be compared with regard to their efficacy in reducing corneal curvature. Secondary outcomes will include visual acuity. Safety assessments will include a tabulation of adverse events, patient symptoms, loss of visual acuity, changes in endothelial cell density, and slit lamp examination.

Conditions

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Keratoconus Corneal Ectasia

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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Riboflavin drop every 2 minutes

Administration of one drop of Riboflavin every 2 minutes during UV exposure

Group Type ACTIVE_COMPARATOR

Riboflavin

Intervention Type DRUG

Administration of riboflavin one drop every 10 minutes during UVA exposure

Riboflavin drop every 10 minutes

Administration of one drop of Riboflavin every 10 minutes during UV exposure

Group Type ACTIVE_COMPARATOR

Riboflavin

Intervention Type DRUG

Administration of riboflavin one drop every 2 minutes during UVA exposure

Interventions

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Riboflavin

Administration of riboflavin one drop every 2 minutes during UVA exposure

Intervention Type DRUG

Riboflavin

Administration of riboflavin one drop every 10 minutes during UVA exposure

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* 12 years of age or older
* Having a diagnosis of keratoconus or corneal ectasia after corneal refractive surgery (e.g., LASIK, photorefractive keratectomy \[PRK\])
* Presence of central or inferior steepening on the Pentacam map
* Axial topography consistent with keratoconus or post-surgical corneal ectasia
* Contact lens wearers only: Removal of contact lenses for the required period of 1 week prior to the screening refraction
* Signed written informed consent
* Willingness and ability to comply with schedule for follow-up visits

Exclusion Criteria

* Eyes classified as either normal, atypical normal, or keratoconus suspect on the severity grading scheme
* Corneal pachymetry measuring 300 microns or less at the thinnest point measured by Pentacam in the eye(s) to be treated
* Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye for future complications, for example:

1. History of corneal disease (e.g., herpes simplex, herpes zoster keratitis, recurrent erosion syndrome, corneal melt, corneal dystrophy, etc.)
2. Clinically significant corneal scaring in the CXL treatment zone
* A history of chemical injury or delayed epithelial healing in the eye(s) to be treated
* Pregnancy (including plan to become pregnant) or lactation during the course of the study
* A known sensitivity to study medications
* Patients with nystagmus or any other condition that would prevent a steady gaze during the CXL treatment or other diagnostic tests
* Patients with a current condition that,in the investigator's opinion, would interfere with or prolong epithelial healing
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Cornea and Laser Eye Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter S Hersh, MD

Role: STUDY_DIRECTOR

Cornea and Laser Eye Institute - Hersh Vision Group

Steven A Greenstein, MD

Role: PRINCIPAL_INVESTIGATOR

Cornea and Laser Eye Institute - Hersh Vision Group

Locations

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Cornea and Laser Eye Institute, Hersh Vision Group

Teaneck, New Jersey, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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BethAnn Furlong-HIbbert

Role: CONTACT

(201) 692-9434

Stacey Lazar

Role: CONTACT

(201) 692-9434

Facility Contacts

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BethAnn Hibbert

Role: primary

201-692-9434

Stacey Lazar

Role: backup

201 692-434

Other Identifiers

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TE-CXL-002

Identifier Type: -

Identifier Source: org_study_id

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