Correction of Myopia Wtih or Without Astigmatism Using the VisuMax™ Femtosecond Laser
Primary Purpose
Myopia, Astigmatism
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Carl Zeiss Meditec VisuMax Femtosecond Laser
Sponsored by
About this trial
This is an interventional treatment trial for Myopia
Eligibility Criteria
Inclusion Criteria:
- Male and female subjects age 22 years of age and older;
- Myopia from ≥ -1.00 D to ≤ -10.00 D with ≤ -3.00 D cylinder and MRSE ≤ -11.50 D in the eye to be treated;
- A stable refraction for the past year, as demonstrated by a change in MRSE of ≤ 0.50 D in the eye to be treated;
- A difference between cycloplegic and manifest refractions of < 0.75 D spherical equivalent in the eye to be treated;
- UCVA worse than 20/40 in the eye to be treated;
- BSCVA at least 20/20 in the eye to be treated;
- Discontinue use of contact lenses for at least 2 weeks (for hard lenses) or 3 days (for soft lenses) prior to the preoperative examination, and through the day of surgery;
- All contact lens wearers must demonstrate a stable refraction (within ±0.5 D), as determined by MRSE, on two consecutive examinations at least 1 week apart, in the eye to be treated;
- Central corneal thickness of at least 500 microns in the eye to be treated;
- Willing and able to return for scheduled follow-up examinations;
- Able to provide written informed consent and follow study instructions in English
Exclusion Criteria:
- Mesopic pupil diameter >8.0 mm;
- Cylinder > -3.00 D;
- Treatment depth is less than 250 microns from the corneal endothelium;
- Eye to be treated is targeted for monovision;
- Fellow eye has BSCVA worse than 20/40;
- Keratometry readings via Sim-K values less than 40.00 D;
- Abnormal corneal topographic findings, e.g. keratoconus, pellucid marginal degeneration in either eye;
- History of or current anterior segment pathology, including cataracts in the eye to be treated;
- Clinically significant dry eye syndrome unresolved by treatment in either eye;
- Residual, recurrent, active ocular or uncontrolled eyelid disease, corneal scars or other corneal abnormality such as recurrent corneal erosion or severe basement membrane disease in the eye to be treated;
- Ophthalmoscopic signs of progressive or unstable myopia or keratoconus (or keratoconus suspect) in either eye;
- Irregular or unstable (distorted/not clear) corneal mires on central keratometry images in either eye;
- History of ocular herpes zoster or herpes simplex keratitis;
- Deep orbits, strong blink, anxiety, pterygium, or any other finding suggesting difficulty in achieving or maintaining suction;
- Difficulty following directions or unable to fixate;
- Previous intraocular or corneal surgery of any kind in the eye to be treated, including any type of surgery for either refractive or therapeutic purposes;
- History of steroid-responsive rise in intraocular pressure, glaucoma, or preoperative IOP > 21 mmHg in either eye;
- History of diabetes, diagnosed autoimmune disease, connective tissue disease or clinically significant atopic syndrome;
- Immunocompromised or requires chronic systemic corticosteroids or other immunosuppresive therapy that may affect wound healing;
- History of known sensitivity to planned study medications;
- Participating in any other ophthalmic drug or device clinical trial during the time of this clinical investigation;
- Pregnant, lactating, or of child-bearing potential and not practicing a medically approved method of birth control.
Sites / Locations
- Dishler Laser Institute
- Discover Vision Centers
- Vance Thompson Vision
- Slade and Baker Vision Center
- Davis Duehr Dean
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
VisuMax lenticule removal
Arm Description
VisuMax femtosecond laser sphere-only or spherocylindrical treatment
Outcomes
Primary Outcome Measures
Number of subjects with MRSE within ± 1.00 D and ± 0.50 D
Predictability: Decrease in manifest refraction spherical equivalent (MRSE) to within ± 1.00 D and ± 0.50 D of the intended refractive outcome at the point at which stability is first reached
Improvement in UCVA following treatment
The uncorrected visual acuity of 20/40 or better for eyes targeted for emmetropia at the postoperative interval at which stability has been established
Preservation of Best-Spectacle Corrected Visual Acuity (BSCVA)
Preservation of Best-Spectacle Corrected Visual Acuity (BSCVA):
In eyes with preoperative BSCVA 20/20 or better, the percentage of eyes with BSCVA worse than 20/40 at the postoperative interval at which stability has been established
The percentage of eyes with BCVA loss ≥ 2 lines
Number of subjects with induced MRCyl > 2.00 D
Induced manifest refractive astigmatism: The percentage of eyes treated for spherical myopia only with induced manifest refractive cylinder of > 2.00 D at the postoperative interval at which stability has been established
Incidence of Adverse Events
Incidence of Adverse Events: The rate of each type of adverse event will be summarized
Change in Contrast Sensitivity
Contrast Sensitivity: Mean of "within-eye" loss of contrast sensitivity from baseline to 12 months will be provided with the 1-sided 95% confidence interval for each spatial frequency. Percentage of eyes showing ≥ 0.3 log units loss at two or more spatial frequencies at the last available postoperative visit will be calculated.
Secondary Outcome Measures
Patient Symptoms
Patient Symptoms: Will be considered as a secondary safety variable and will be evaluated via a subject questionnaire.
Full Information
NCT ID
NCT02430428
First Posted
April 23, 2015
Last Updated
January 25, 2021
Sponsor
Carl Zeiss Meditec, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT02430428
Brief Title
Correction of Myopia Wtih or Without Astigmatism Using the VisuMax™ Femtosecond Laser
Official Title
Use of the VisuMax™ Femtosecond Laser Lenticule Removal Procedure for the Correction of Myopia Wtih or Without Astigmatism
Study Type
Interventional
2. Study Status
Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
March 2015 (undefined)
Primary Completion Date
October 2017 (Actual)
Study Completion Date
October 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Carl Zeiss Meditec, Inc.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The objective of this clinical trial is to evaluate the safety and effectiveness of the Carl Zeiss Meditec VisuMax™ Femtosecond Laser lenticule removal procedure for the reduction or elimination of myopia from ≥ -1.00 D to ≤ -10.00 D with ≤ -3.00 D cylinder (myopia with or without astigmatism) and MRSE ≤ -11.50 D.
Detailed Description
This is a prospective multi-center clinical trial in which a maximum of 360 eyes of 360 consecutive subjects will be enrolled and treated with the VisuMax™ Femtosecond Laser. The study will be conducted at up to 8 clinical sites.
Subjects will be screened for eligibility, and informed consent will be obtained from those who meet screening criteria and are interested in participating in the study. Eligible subjects will be examined preoperatively to obtain a medical history and to establish a baseline ocular condition. Baseline and postoperative measurements will include manifest refraction, cycloplegic refraction, distance visual acuity (best corrected and uncorrected), slit-lamp examination, fundus examination, corneal topography, central corneal pachymetry, mesopic pupil measurement, wavefront analysis, mesopic contrast sensitivity, and intraocular pressure (IOP).
Only eyes with astigmatism ≥ -0.75 D to ≤ -3.00 D targeted for the full distance manifest spherocylindrical refraction, or eye(s) with astigmatism < -0.75 D targeted for the full distance manifest sphere-only refraction, will be enrolled into the study.
Subjects must have astigmatism ≤ -3.00 D in the eye to be treated. Eyes with astigmatism ≥ -0.75 D to ≤ -3.00 D will receive a spherocylindrical treatment. Eyes with astigmatism < -0.75 D will receive a sphere-only treatment.
Operative eyes with astigmatism ≥ -0.75 D to ≤ -3.00 D must be targeted for the full distance manifest spherocylindrical refraction. Operative eye(s) with astigmatism < -0.75 D must be targeted for the full distance manifest sphere-only refraction.
Monovision treatments and retreatments of the study eye will not be allowed during the course of the study. Bilateral investigational treatments will not be allowed during the study.
Safety and effectiveness criteria from the American National Standard for Ophthalmics (ANSI Z80.11-2012) - Laser Systems for Corneal Reshaping will be utilized in the evaluation of the VisuMax Femtosecond Laser.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myopia, Astigmatism
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
357 (Actual)
8. Arms, Groups, and Interventions
Arm Title
VisuMax lenticule removal
Arm Type
Experimental
Arm Description
VisuMax femtosecond laser sphere-only or spherocylindrical treatment
Intervention Type
Device
Intervention Name(s)
Carl Zeiss Meditec VisuMax Femtosecond Laser
Intervention Description
VisuMax femtosecond laser sphere-only or spherocylindrical treatment
Primary Outcome Measure Information:
Title
Number of subjects with MRSE within ± 1.00 D and ± 0.50 D
Description
Predictability: Decrease in manifest refraction spherical equivalent (MRSE) to within ± 1.00 D and ± 0.50 D of the intended refractive outcome at the point at which stability is first reached
Time Frame
1 Year
Title
Improvement in UCVA following treatment
Description
The uncorrected visual acuity of 20/40 or better for eyes targeted for emmetropia at the postoperative interval at which stability has been established
Time Frame
1 Year
Title
Preservation of Best-Spectacle Corrected Visual Acuity (BSCVA)
Description
Preservation of Best-Spectacle Corrected Visual Acuity (BSCVA):
In eyes with preoperative BSCVA 20/20 or better, the percentage of eyes with BSCVA worse than 20/40 at the postoperative interval at which stability has been established
The percentage of eyes with BCVA loss ≥ 2 lines
Time Frame
1 Year
Title
Number of subjects with induced MRCyl > 2.00 D
Description
Induced manifest refractive astigmatism: The percentage of eyes treated for spherical myopia only with induced manifest refractive cylinder of > 2.00 D at the postoperative interval at which stability has been established
Time Frame
1 Year
Title
Incidence of Adverse Events
Description
Incidence of Adverse Events: The rate of each type of adverse event will be summarized
Time Frame
1 Year
Title
Change in Contrast Sensitivity
Description
Contrast Sensitivity: Mean of "within-eye" loss of contrast sensitivity from baseline to 12 months will be provided with the 1-sided 95% confidence interval for each spatial frequency. Percentage of eyes showing ≥ 0.3 log units loss at two or more spatial frequencies at the last available postoperative visit will be calculated.
Time Frame
1 Year
Secondary Outcome Measure Information:
Title
Patient Symptoms
Description
Patient Symptoms: Will be considered as a secondary safety variable and will be evaluated via a subject questionnaire.
Time Frame
1 Year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Male and female subjects age 22 years of age and older;
Myopia from ≥ -1.00 D to ≤ -10.00 D with ≤ -3.00 D cylinder and MRSE ≤ -11.50 D in the eye to be treated;
A stable refraction for the past year, as demonstrated by a change in MRSE of ≤ 0.50 D in the eye to be treated;
A difference between cycloplegic and manifest refractions of < 0.75 D spherical equivalent in the eye to be treated;
UCVA worse than 20/40 in the eye to be treated;
BSCVA at least 20/20 in the eye to be treated;
Discontinue use of contact lenses for at least 2 weeks (for hard lenses) or 3 days (for soft lenses) prior to the preoperative examination, and through the day of surgery;
All contact lens wearers must demonstrate a stable refraction (within ±0.5 D), as determined by MRSE, on two consecutive examinations at least 1 week apart, in the eye to be treated;
Central corneal thickness of at least 500 microns in the eye to be treated;
Willing and able to return for scheduled follow-up examinations;
Able to provide written informed consent and follow study instructions in English
Exclusion Criteria:
Mesopic pupil diameter >8.0 mm;
Cylinder > -3.00 D;
Treatment depth is less than 250 microns from the corneal endothelium;
Eye to be treated is targeted for monovision;
Fellow eye has BSCVA worse than 20/40;
Keratometry readings via Sim-K values less than 40.00 D;
Abnormal corneal topographic findings, e.g. keratoconus, pellucid marginal degeneration in either eye;
History of or current anterior segment pathology, including cataracts in the eye to be treated;
Clinically significant dry eye syndrome unresolved by treatment in either eye;
Residual, recurrent, active ocular or uncontrolled eyelid disease, corneal scars or other corneal abnormality such as recurrent corneal erosion or severe basement membrane disease in the eye to be treated;
Ophthalmoscopic signs of progressive or unstable myopia or keratoconus (or keratoconus suspect) in either eye;
Irregular or unstable (distorted/not clear) corneal mires on central keratometry images in either eye;
History of ocular herpes zoster or herpes simplex keratitis;
Deep orbits, strong blink, anxiety, pterygium, or any other finding suggesting difficulty in achieving or maintaining suction;
Difficulty following directions or unable to fixate;
Previous intraocular or corneal surgery of any kind in the eye to be treated, including any type of surgery for either refractive or therapeutic purposes;
History of steroid-responsive rise in intraocular pressure, glaucoma, or preoperative IOP > 21 mmHg in either eye;
History of diabetes, diagnosed autoimmune disease, connective tissue disease or clinically significant atopic syndrome;
Immunocompromised or requires chronic systemic corticosteroids or other immunosuppresive therapy that may affect wound healing;
History of known sensitivity to planned study medications;
Participating in any other ophthalmic drug or device clinical trial during the time of this clinical investigation;
Pregnant, lactating, or of child-bearing potential and not practicing a medically approved method of birth control.
Facility Information:
Facility Name
Dishler Laser Institute
City
Greenwood Village
State/Province
Colorado
ZIP/Postal Code
80111
Country
United States
Facility Name
Discover Vision Centers
City
Leawood
State/Province
Kansas
ZIP/Postal Code
66211
Country
United States
Facility Name
Vance Thompson Vision
City
Sioux Falls
State/Province
South Dakota
ZIP/Postal Code
57108
Country
United States
Facility Name
Slade and Baker Vision Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77027
Country
United States
Facility Name
Davis Duehr Dean
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53715
Country
United States
12. IPD Sharing Statement
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Correction of Myopia Wtih or Without Astigmatism Using the VisuMax™ Femtosecond Laser
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