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A Post-Market Evaluation of LipiFlow Treatment in Cataract Surgery Practice

Primary Purpose

Cataracts, Meibomian Gland Dysfunction (MGD)

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
LipiFlow Thermal Pulsation System
LipiFlow Thermal Pulsation System
Sponsored by
Johnson & Johnson Surgical Vision, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cataracts

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria (all criteria apply to each study eye):

  • Minimum 22 years of age.
  • Bilateral cataracts for which phacoemulsification extraction and implantation with Symfony IOLs have been planned.
  • Evidence of Meibomian Gland Dysfunction (MGD) in both eyes based on assessment of meibomian glands of the lower eyelid
  • None to moderate dry eye symptoms with questionnaire
  • Clear intraocular media other than cataract in each eye.
  • Availability, willingness, ability and sufficient cognitive awareness to comply with the study protocol including: randomization; examination procedures; completion of planned bilateral cataract surgeries; compliance with no use of other MGD or dry eye treatments.
  • Ability to understand, read and write English to consent to study participation and complete study questionnaires.
  • Willingness to sign informed consent and HIPAA authorization or equivalent documentation necessary to comply with applicable privacy laws pertaining to medical treatment in the governing country.

Exclusion Criteria (all criteria apply to each study eye):

  • Any medical finding that would predictably result in a postoperative best corrected distance visual acuity worse than 20/30 in either eye.
  • Use of systemic or ocular medications that, in the opinion of the investigator, may affect vision or impact pupil dilation or iris structure.
  • Irregular corneal astigmatism.
  • Any clinically-significant corneal pathology / abnormality other than regular corneal astigmatism.
  • Any clinically-significant pupil abnormalities.
  • Subjects with conditions associated with increased risk of zonular rupture.
  • Unwillingness or inability to stop wearing contact lens at least two weeks prior to the baseline visit.
  • Known ocular disease or pathology that, in the opinion of the investigator, may affect visual acuity or require surgical intervention during the study.
  • Systemic disease condition that causes dry eye.
  • Unwillingness or inability to abstain from the use of systemic medications known to cause dryness for the study duration. Subjects must have discontinued these medications for at least 1 month prior to Preoperative Visit.
  • Unwillingness or inability to abstain from the use of systemic antihistamines.
  • Unwillingness or inability to abstain from use of prescription medications for treatment of MGD or dry eye. Subject must have dicontinued using prescription medications for MGD or dry eye at least 1 month prior to baseline preoperative visit #1 measurements.
  • Any of the following ocular (eye or eyelid) conditions in either eye within 3 months prior to the LipiFlow treatment visit:

    • Prior intraocular, oculoplastic, corneal or refractive surgery procedure (LASIK, LASEK, RK, PRK, etc.).
    • Ocular trauma.
    • Ocular Herpes simplex or Herpes zoster (eye or eyelid) infection.
    • History of recurrent ocular inflammation.
    • Punctal plug insertion or punctal occlusion.
  • Any of the following active ocular (eye or eyelid) conditions in either eye at the baseline Preoperative Visit #1 measurements:

    • Ocular infection.
    • Ocular inflammation.
    • Moderate to severe (Grade 2-4) allergic, vernal or giant papillary conjunctivitis
    • Severe (Grade 3 or 4) inflammation of the eyelid.
    • Eyelid abnormalities that affect lid function.
    • Ocular surface abnormality that may compromise corneal integrity.
  • Concurrent participation or participation within 30 days prior to study visit in any other clinical trial.
  • Planned monovision correction.
  • Patient is pregnant, plans to become pregnant, is lactating or has another condition associated with the fluctuation of hormones that could lead to refractive changes.

Sites / Locations

  • Empire Eye & Laser Center, Inc.
  • Eye Doctors of Washington
  • Matossian Eye Associates
  • JW Eye Associates, P.A.
  • Texas Eye & Laser Center, P.A.

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Study Group: LipiFlow Treatment at PreOp

Control Group

Arm Description

Study subjects that meet all inclusion and exclusion criteria will be randomized to receive LipiFlow Thermal Pulsation System treatment at preoperative visit before bilateral implantation with commercially-available Symfony Intraocular Lens

Study subjects that meet all inclusion and exclusion criteria will be randomized to not receive the LipiFlow Thermal Pulsation System treatment at a preoperative visit before bilaterally implanted with the commercially available Symfony Intraocular Lens. Control Group will receive LipiFlow treatment as cross-over group at 3 months postoperative visit.

Outcomes

Primary Outcome Measures

Mean Monocular UCDVA (Uncorrected Distance Visual Acuity)
Uncorrected Distance Visual Acuity was measured for the Study and Control groups at the 3-month visit using the Clinical Trial Suite (M&S Technologies) at 4.0 meters under photopic conditions (~85 cd/m2).
Precision (Standard Deviation) of Preoperative Keratometric Measurements
Biometry testing was done pre-operatively
Precision of Axial Length (AL) and Anterior Chamber Depth (ACD)
Biometry testing was done pre-operatively
Rate of Refractive Predictability
Percentage of eyes with achieved manifest refractive spherical equivalence (MRSE) within +/- 0.50 D and +/- 1.00 D. Achieved MRSE for each eye is defined as postoperative MRSE minus targeted MRSE.
Rate of Bothersome Ocular Symptoms
Patient-Reported Visual Symptom Questionnaire (PRVSQ) Rating Results at 3 months postoperative
Mean Change in Total Meibomian Gland Score From Baseline to 1 Month Postoperative
Total Meibomian Gland Score: Fifteen Meibomian Glands (five temporally, centrally and nasally) in the lower eye are assessed on a scale of 0 - 3 (0 - No secretion, 1 - Inspissated (toothpaste consistency), 2 - Colored/cloudy liquid secretion or 3 - Clear liquid oil secretion). The sum of all 15 glands constitute the total meibomian gland secretion score (range 0-45).

Secondary Outcome Measures

Full Information

First Posted
October 8, 2018
Last Updated
April 1, 2021
Sponsor
Johnson & Johnson Surgical Vision, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03708367
Brief Title
A Post-Market Evaluation of LipiFlow Treatment in Cataract Surgery Practice
Official Title
A Post-Market Evaluation of LipiFlow Treatment in Cataract Surgery Practice
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Completed
Study Start Date
October 16, 2018 (Actual)
Primary Completion Date
January 13, 2020 (Actual)
Study Completion Date
January 13, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Johnson & Johnson Surgical Vision, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a post-market, prospective, randomized, multi-center, bilateral, open-label, cross-over, comparative clinical study. Study group will undergo preoperative LipiFlow treatment and Control group will not receive preoperative LipiFlow treatment. Three months postoperatively, both groups will be evaluated for clinical outcomes and the Control group will receive LipiFlow treatment as the cross-over group. The Control group will be evaluated at 4 months postoperative for clinical outcomes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cataracts, Meibomian Gland Dysfunction (MGD)

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
117 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Study Group: LipiFlow Treatment at PreOp
Arm Type
Experimental
Arm Description
Study subjects that meet all inclusion and exclusion criteria will be randomized to receive LipiFlow Thermal Pulsation System treatment at preoperative visit before bilateral implantation with commercially-available Symfony Intraocular Lens
Arm Title
Control Group
Arm Type
Other
Arm Description
Study subjects that meet all inclusion and exclusion criteria will be randomized to not receive the LipiFlow Thermal Pulsation System treatment at a preoperative visit before bilaterally implanted with the commercially available Symfony Intraocular Lens. Control Group will receive LipiFlow treatment as cross-over group at 3 months postoperative visit.
Intervention Type
Device
Intervention Name(s)
LipiFlow Thermal Pulsation System
Intervention Description
Treatment at preoperative visit for study group
Intervention Type
Device
Intervention Name(s)
LipiFlow Thermal Pulsation System
Intervention Description
Treatment at 3 month visit as the cross-over group
Primary Outcome Measure Information:
Title
Mean Monocular UCDVA (Uncorrected Distance Visual Acuity)
Description
Uncorrected Distance Visual Acuity was measured for the Study and Control groups at the 3-month visit using the Clinical Trial Suite (M&S Technologies) at 4.0 meters under photopic conditions (~85 cd/m2).
Time Frame
3 months Postoperative
Title
Precision (Standard Deviation) of Preoperative Keratometric Measurements
Description
Biometry testing was done pre-operatively
Time Frame
2-4 weeks after first Pre-operative visit
Title
Precision of Axial Length (AL) and Anterior Chamber Depth (ACD)
Description
Biometry testing was done pre-operatively
Time Frame
2-4 weeks after first Pre-operative visit
Title
Rate of Refractive Predictability
Description
Percentage of eyes with achieved manifest refractive spherical equivalence (MRSE) within +/- 0.50 D and +/- 1.00 D. Achieved MRSE for each eye is defined as postoperative MRSE minus targeted MRSE.
Time Frame
Difference between Baseline visit and Postoperative visit at 10-14 weeks after cataract surgery on the second eye.
Title
Rate of Bothersome Ocular Symptoms
Description
Patient-Reported Visual Symptom Questionnaire (PRVSQ) Rating Results at 3 months postoperative
Time Frame
3 months postoperative
Title
Mean Change in Total Meibomian Gland Score From Baseline to 1 Month Postoperative
Description
Total Meibomian Gland Score: Fifteen Meibomian Glands (five temporally, centrally and nasally) in the lower eye are assessed on a scale of 0 - 3 (0 - No secretion, 1 - Inspissated (toothpaste consistency), 2 - Colored/cloudy liquid secretion or 3 - Clear liquid oil secretion). The sum of all 15 glands constitute the total meibomian gland secretion score (range 0-45).
Time Frame
Preoperative Visit (Baseline) and Postoperative Visit between 30-60 days after cataract surgery on the second eye.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria (all criteria apply to each study eye): Minimum 22 years of age. Bilateral cataracts for which phacoemulsification extraction and implantation with Symfony IOLs have been planned. Evidence of Meibomian Gland Dysfunction (MGD) in both eyes based on assessment of meibomian glands of the lower eyelid None to moderate dry eye symptoms with questionnaire Clear intraocular media other than cataract in each eye. Availability, willingness, ability and sufficient cognitive awareness to comply with the study protocol including: randomization; examination procedures; completion of planned bilateral cataract surgeries; compliance with no use of other MGD or dry eye treatments. Ability to understand, read and write English to consent to study participation and complete study questionnaires. Willingness to sign informed consent and HIPAA authorization or equivalent documentation necessary to comply with applicable privacy laws pertaining to medical treatment in the governing country. Exclusion Criteria (all criteria apply to each study eye): Any medical finding that would predictably result in a postoperative best corrected distance visual acuity worse than 20/30 in either eye. Use of systemic or ocular medications that, in the opinion of the investigator, may affect vision or impact pupil dilation or iris structure. Irregular corneal astigmatism. Any clinically-significant corneal pathology / abnormality other than regular corneal astigmatism. Any clinically-significant pupil abnormalities. Subjects with conditions associated with increased risk of zonular rupture. Unwillingness or inability to stop wearing contact lens at least two weeks prior to the baseline visit. Known ocular disease or pathology that, in the opinion of the investigator, may affect visual acuity or require surgical intervention during the study. Systemic disease condition that causes dry eye. Unwillingness or inability to abstain from the use of systemic medications known to cause dryness for the study duration. Subjects must have discontinued these medications for at least 1 month prior to Preoperative Visit. Unwillingness or inability to abstain from the use of systemic antihistamines. Unwillingness or inability to abstain from use of prescription medications for treatment of MGD or dry eye. Subject must have dicontinued using prescription medications for MGD or dry eye at least 1 month prior to baseline preoperative visit #1 measurements. Any of the following ocular (eye or eyelid) conditions in either eye within 3 months prior to the LipiFlow treatment visit: Prior intraocular, oculoplastic, corneal or refractive surgery procedure (LASIK, LASEK, RK, PRK, etc.). Ocular trauma. Ocular Herpes simplex or Herpes zoster (eye or eyelid) infection. History of recurrent ocular inflammation. Punctal plug insertion or punctal occlusion. Any of the following active ocular (eye or eyelid) conditions in either eye at the baseline Preoperative Visit #1 measurements: Ocular infection. Ocular inflammation. Moderate to severe (Grade 2-4) allergic, vernal or giant papillary conjunctivitis Severe (Grade 3 or 4) inflammation of the eyelid. Eyelid abnormalities that affect lid function. Ocular surface abnormality that may compromise corneal integrity. Concurrent participation or participation within 30 days prior to study visit in any other clinical trial. Planned monovision correction. Patient is pregnant, plans to become pregnant, is lactating or has another condition associated with the fluctuation of hormones that could lead to refractive changes.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Priya Janakiraman, OD
Organizational Affiliation
Johnson & Johnson Surgical Vision, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Empire Eye & Laser Center, Inc.
City
Bakersfield
State/Province
California
ZIP/Postal Code
93309
Country
United States
Facility Name
Eye Doctors of Washington
City
Chevy Chase
State/Province
Maryland
ZIP/Postal Code
20815
Country
United States
Facility Name
Matossian Eye Associates
City
Pennington
State/Province
New Jersey
ZIP/Postal Code
08534
Country
United States
Facility Name
JW Eye Associates, P.A.
City
Dallas
State/Province
Texas
ZIP/Postal Code
75243
Country
United States
Facility Name
Texas Eye & Laser Center, P.A.
City
Hurst
State/Province
Texas
ZIP/Postal Code
76054
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Post-Market Evaluation of LipiFlow Treatment in Cataract Surgery Practice

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