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Study of the MEL 80 Excimer Laser Using LASIK in the Treatment of Mixed Astigmatism

Primary Purpose

Mixed Astigmatism

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
MEL 80 Mixed Astigmatism Treatment
Sponsored by
Carl Zeiss Meditec, Inc.
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mixed Astigmatism focused on measuring Mixed Astigmatism, Laser In Situ Keratomileusis, Laser Therapy, Laser Corneal Surgery, Refractive Surgical Procedures, Ophthalmologic Surgical Procedure, Operative Surgical Procedures, Therapeutics

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Naturally occurring mixed astigmatism when the magnitude of cylinder (up to 6.0 D) is greater than the magnitude of sphere, and the cylinder and sphere have opposite signs, at the spectacle plane;
  • Have a stable refraction for at least the past twelve months, as demonstrated by a change of less than or equal to 0.50 D preoperative spherical equivalent shift over twelve months prior to surgery;
  • Discontinue use of contact lenses at least 2 weeks for hard contacts and 3 days for soft lenses prior to the preoperative examination;
  • Hard contact lens wearers must have two central keratometry readings and two manifest refractions taken at least one week apart that do not differ by more than 0.50 D
  • Have visual acuity correctable to at least 20/40 in both eyes
  • Have no more than 0.75 D of latent hyperopia as determined by the difference between the preoperative manifest refractive spherical equivalent (MRSE) and cycloplegic refractive spherical equivalent (CRSE);
  • Be at least 18 years of age
  • Corneal topography should be normal;
  • The operative eye must be targeted for emmetropia;
  • Be willing and able to return for scheduled follow-up examinations for twelve months after surgery;
  • and provide written informed consent.

Exclusion Criteria:

  • History of anterior segment pathology, including cataracts (in the operative eye);
  • Clinically significant dry eye syndrome unresolved by treatment;
  • Residual, recurrent, active ocular or uncontrolled eyelid disease, corneal scars within the ablation zone or other corneal abnormality such as recurrent corneal erosion or severe basement membrane disease;
  • Ophthalmoscopic signs of keratoconus (or keratoconus suspect);
  • Required ablation is deeper than 250 microns from the corneal endothelium;
  • Irregular or unstable (distorted/not clear) corneal mires on central keratometry readings;
  • Blind in the fellow eye;
  • Previous intraocular or corneal surgery of any kind in the operative eye(s), including any type of surgery for either refractive or therapeutic purposes;
  • History of ocular Herpes zoster or Herpes simplex keratitis;
  • History of steroid-responsive rise in intraocular pressure, glaucoma, or preoperative IOP >21 mm Hg;
  • Diabetes, diagnosed autoimmune disease, connective tissue disease or clinically significant atopic syndrome;
  • Immunocompromised patients, or use of chronic systemic corticosteroid or other immunosuppressive therapy;
  • Pregnant, lactating, or child-bearing potential and not practicing a medically approved method of birth control;
  • Sensitivity to planned study medications;
  • Simultaneous participation in other ophthalmic drug or device clinical trial.
  • For Fellow (Second) Eyes in Simultaneous Bilateral Treatment Procedures
  • 1. Flap complications during the first eye's surgery such as a free cap, partial flap, thin flap, or irregular flap.
  • 2. Epithelial defect exceeding 2 mm x 2 mm in dimension, or clinically significant debris in the interface between the flap and underlying stroma for the first eye.
  • 3. Severe blepharospasm in the first eye that may have prevented or impeded the completion of the keratectomy and/or the laser ablation procedure.
  • 4. Poor subject cooperation with instructions for the first eye's surgery and/or poor subject fixation on the laser fixation target.
  • 5. Aborted LASIK procedure in the first eye or PRK was performed in the first eye because LASIK was not possible.

Sites / Locations

  • US Navy Refractive Surgery Center
  • Dishler Laser Institute
  • Discover Vision Centers
  • Fine, Hoffman, and Packer
  • Davis Duehr Dean Eye Clinic

Outcomes

Primary Outcome Measures

At the point of stability, a minimum of 75% of eyes should have an achieved refraction within ± 1.00 D of the intended outcome, and at least 50% of eyes should be within ± 0.50 D of the intended outcome.
A minimum of 85% of eyes should have an uncorrected visual acuity of 20/40 or better at the postoperative interval at which stability has been established.
A minimum of 95% of eyes should have a change of < 1.00 D in manifest refraction spherical equivalent (MRSE) between 2 refractions performed at least 3 months apart, and the mean rate of MRSE change per month should be < 0.04 D.
Distance BSCVA of worse than 20/40 at the postoperative interval at which stability has been established should occur in less than 1.0 % of eyes that had a BSCVA of 20/20 or better before surgery.
Loss of more than 2 lines of BSCVA should occur in less than 5.0 % of eyes.
Incidence of adverse events to occur in less than 1% of eyes

Secondary Outcome Measures

Subject Satisfaction: As measured by a subjective questionnaire, and will be considered as a secondary efficacy variable.
Incidence of complications
Patient Symptoms: As measured by a subjective questionnaire, will be considered as a secondary safety variable.

Full Information

First Posted
September 26, 2008
Last Updated
July 17, 2018
Sponsor
Carl Zeiss Meditec, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00761826
Brief Title
Study of the MEL 80 Excimer Laser Using LASIK in the Treatment of Mixed Astigmatism
Official Title
A Prospective Multicenter Trial To Evaluate The Safety And Effectiveness Of The MEL 80 Excimer Laser Using LASIK (Laser In Situ Keratomileusis) For The Correction Of Naturally Occuring Mixed Astigmatism Up To 6.0 D
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Completed
Study Start Date
January 2007 (undefined)
Primary Completion Date
December 2008 (Actual)
Study Completion Date
December 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Carl Zeiss Meditec, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether the MEL 80 Excimer Laser is effective in the treatment of mixed astigmatism up to 6.0 D, when used as part of the Laser In Situ Keratomileusis (LASIK) procedure.
Detailed Description
LASIK has become one of the most common refractive eye procedures performed in the country. In the mixed astigmatism procedure, a combination of both a steepening (hyperopic treatment) and a flattening (myopic treatment) occur on the corneal surface. The surgeon will produce a standard keratomileusis flap using a microkeratome, exposing the corneal stroma. Recontouring under the flap is then accomplished by the removal of tissue from the stroma with the laser. This recontouring results in an altering of effective lens power of the central cornea, measured in diopters (D). The MEL 80 Excimer Laser System will be evaluated for its ability to create accurate and stable mixed astigmatic refractive correction results.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mixed Astigmatism
Keywords
Mixed Astigmatism, Laser In Situ Keratomileusis, Laser Therapy, Laser Corneal Surgery, Refractive Surgical Procedures, Ophthalmologic Surgical Procedure, Operative Surgical Procedures, Therapeutics

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
126 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Device
Intervention Name(s)
MEL 80 Mixed Astigmatism Treatment
Intervention Description
Treatment of Naturally Occuring Mixed Astigmatic corrections up to 6.0 D.
Primary Outcome Measure Information:
Title
At the point of stability, a minimum of 75% of eyes should have an achieved refraction within ± 1.00 D of the intended outcome, and at least 50% of eyes should be within ± 0.50 D of the intended outcome.
Time Frame
Point of stability
Title
A minimum of 85% of eyes should have an uncorrected visual acuity of 20/40 or better at the postoperative interval at which stability has been established.
Time Frame
Point of stability
Title
A minimum of 95% of eyes should have a change of < 1.00 D in manifest refraction spherical equivalent (MRSE) between 2 refractions performed at least 3 months apart, and the mean rate of MRSE change per month should be < 0.04 D.
Time Frame
Point of stability
Title
Distance BSCVA of worse than 20/40 at the postoperative interval at which stability has been established should occur in less than 1.0 % of eyes that had a BSCVA of 20/20 or better before surgery.
Time Frame
Point of stability
Title
Loss of more than 2 lines of BSCVA should occur in less than 5.0 % of eyes.
Time Frame
Postoperative visits
Title
Incidence of adverse events to occur in less than 1% of eyes
Time Frame
Postoperative visits
Secondary Outcome Measure Information:
Title
Subject Satisfaction: As measured by a subjective questionnaire, and will be considered as a secondary efficacy variable.
Time Frame
Postoperative visits 3, 6, 9 and 12 months
Title
Incidence of complications
Time Frame
Postoperative visits
Title
Patient Symptoms: As measured by a subjective questionnaire, will be considered as a secondary safety variable.
Time Frame
Preoperative and Postoperative visits 3, 6, 9 and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Naturally occurring mixed astigmatism when the magnitude of cylinder (up to 6.0 D) is greater than the magnitude of sphere, and the cylinder and sphere have opposite signs, at the spectacle plane; Have a stable refraction for at least the past twelve months, as demonstrated by a change of less than or equal to 0.50 D preoperative spherical equivalent shift over twelve months prior to surgery; Discontinue use of contact lenses at least 2 weeks for hard contacts and 3 days for soft lenses prior to the preoperative examination; Hard contact lens wearers must have two central keratometry readings and two manifest refractions taken at least one week apart that do not differ by more than 0.50 D Have visual acuity correctable to at least 20/40 in both eyes Have no more than 0.75 D of latent hyperopia as determined by the difference between the preoperative manifest refractive spherical equivalent (MRSE) and cycloplegic refractive spherical equivalent (CRSE); Be at least 18 years of age Corneal topography should be normal; The operative eye must be targeted for emmetropia; Be willing and able to return for scheduled follow-up examinations for twelve months after surgery; and provide written informed consent. Exclusion Criteria: History of anterior segment pathology, including cataracts (in the operative eye); Clinically significant dry eye syndrome unresolved by treatment; Residual, recurrent, active ocular or uncontrolled eyelid disease, corneal scars within the ablation zone or other corneal abnormality such as recurrent corneal erosion or severe basement membrane disease; Ophthalmoscopic signs of keratoconus (or keratoconus suspect); Required ablation is deeper than 250 microns from the corneal endothelium; Irregular or unstable (distorted/not clear) corneal mires on central keratometry readings; Blind in the fellow eye; Previous intraocular or corneal surgery of any kind in the operative eye(s), including any type of surgery for either refractive or therapeutic purposes; History of ocular Herpes zoster or Herpes simplex keratitis; History of steroid-responsive rise in intraocular pressure, glaucoma, or preoperative IOP >21 mm Hg; Diabetes, diagnosed autoimmune disease, connective tissue disease or clinically significant atopic syndrome; Immunocompromised patients, or use of chronic systemic corticosteroid or other immunosuppressive therapy; Pregnant, lactating, or child-bearing potential and not practicing a medically approved method of birth control; Sensitivity to planned study medications; Simultaneous participation in other ophthalmic drug or device clinical trial. For Fellow (Second) Eyes in Simultaneous Bilateral Treatment Procedures 1. Flap complications during the first eye's surgery such as a free cap, partial flap, thin flap, or irregular flap. 2. Epithelial defect exceeding 2 mm x 2 mm in dimension, or clinically significant debris in the interface between the flap and underlying stroma for the first eye. 3. Severe blepharospasm in the first eye that may have prevented or impeded the completion of the keratectomy and/or the laser ablation procedure. 4. Poor subject cooperation with instructions for the first eye's surgery and/or poor subject fixation on the laser fixation target. 5. Aborted LASIK procedure in the first eye or PRK was performed in the first eye because LASIK was not possible.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Doane, MD
Organizational Affiliation
Discover Vision Centers
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Richard Hoffman, MD
Organizational Affiliation
Fine, Hoffman, and Packer LLC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Howard Fine, MD
Organizational Affiliation
Fine, Hoffman, and Packer LLC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mark Packer, MD
Organizational Affiliation
FIne, Hoffman, and Packer LLC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
David Tanzer, MD
Organizational Affiliation
US Navy Refractive Surgery Center, San Diego, CA
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
John Vukich, MD
Organizational Affiliation
Davis Duehr Dean Eye Clinic
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jon Dishler, MD
Organizational Affiliation
Dishler Laser Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
US Navy Refractive Surgery Center
City
San Diego
State/Province
California
ZIP/Postal Code
92106
Country
United States
Facility Name
Dishler Laser Institute
City
Greenwood Village
State/Province
Colorado
ZIP/Postal Code
80111
Country
United States
Facility Name
Discover Vision Centers
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64055
Country
United States
Facility Name
Fine, Hoffman, and Packer
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Facility Name
Davis Duehr Dean Eye Clinic
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53717
Country
United States

12. IPD Sharing Statement

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Study of the MEL 80 Excimer Laser Using LASIK in the Treatment of Mixed Astigmatism

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