Descemet Endothelial Thickness Comparison Trial I

NCT ID: NCT05289661

Last Updated: 2025-12-17

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-15

Study Completion Date

2027-11-30

Brief Summary

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Descemet Endothelial Thickness Comparison Trial (DETECT) I is a multi-center, outcome assessor-masked, placebo-controlled clinical trial randomizing 160 patients in a 2x2 factorial design. The purpose of this study is to determine differences in visual outcomes between two types of corneal transplant surgeries, ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK), and to determine the effect of rho-kinase inhibitors on endothelial cell loss.

Detailed Description

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Conditions

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Fuchs

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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UT-DSAEK plus topical ripasudil

This arm will receive UT-DSAEK plus topical ripasudil 0.4%

Group Type EXPERIMENTAL

Topical Ripasudil

Intervention Type DRUG

To determine the effect of rho-kinase inhibitors on endothelial cell loss

UT-DSAEK plus topical placebo

This arm will receive UT-DSAEK plus topical placebo

Group Type PLACEBO_COMPARATOR

Topical Placebo

Intervention Type DRUG

topical Placebo

DMEK plus topical ripasudil

This arm will receive DMEK plus topical ripasudil 0.4%

Group Type EXPERIMENTAL

Topical Ripasudil

Intervention Type DRUG

To determine the effect of rho-kinase inhibitors on endothelial cell loss

DMEK plus topical placebo

This arm will receive DMEK plus topical placebo

Group Type PLACEBO_COMPARATOR

Topical Placebo

Intervention Type DRUG

topical Placebo

Interventions

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Topical Ripasudil

To determine the effect of rho-kinase inhibitors on endothelial cell loss

Intervention Type DRUG

Topical Placebo

topical Placebo

Intervention Type DRUG

Other Intervention Names

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Ripasudil Placebo

Eligibility Criteria

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Inclusion Criteria

* Dysfunctional endothelium from Fuchs Endothelial Corneal Dystrophy (FECD) with guttata extending beyond 4.5 mm of the central cornea or severe edema without visualization of guttata
* Dysfunctional endothelium from Pseudophakic Corneal Edema (PCE) or Iridocorneal Endothelial Syndrome (ICE) or other primary endothelial dysfunction such as Posterior Polymorphous Corneal Dystrophy (PPMD)
* Dysfunctional endothelium from prior graft failure after PKP or EK
* Controlled uveitis (defined as quiet for \> 3 months off of topical steroids with or without systemic immunosuppression) or no uveitis
* Controlled glaucoma with topical medications and/or prior trabeculectomy or tube shunt without ongoing hypotony (IOP \< 5 mmHg) or no glaucoma
* Good candidate for corneal transplantation for either DMEK or UT-DSAEK
* Willingness to participate
* Age greater than 18 years

Exclusion Criteria

* Aphakia, or anterior chamber IOL or scleral fixated IOL in study eye prior to or anticipated during EK
* Pre-operative central sub-epithelial or stromal scarring that the investigator believes is visually significant and could impact post-operative stromal clarity assessment
* Peripheral anterior synechiae (iris to angle) in the angle greater than a total of three clock hours
* Visually significant optic nerve (ok to have small visual field defects) or macular severe pathology
* Pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Oregon Health and Science University

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

University of California, Davis

OTHER

Sponsor Role collaborator

Case Western Reserve University

OTHER

Sponsor Role collaborator

Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role collaborator

University of Miami

OTHER

Sponsor Role collaborator

Wills Eye Hospital

UNKNOWN

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Jennifer Rose-Nussbaumer

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jennifer Rose-Nussbaumer, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Stanford University

Palo Alto, California, United States

Site Status

University of California Davis

Sacramento, California, United States

Site Status

University of Miami

Palm Beach Gardens, Florida, United States

Site Status

Dartmouth-Hitchcock Medical Center

Lebanon, New Hampshire, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Wills Eye Hospital

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

Other Identifiers

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20220590-I

Identifier Type: -

Identifier Source: org_study_id