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SINGLE PATIENT EXPANDED ACCESS OF A PROSPECTIVE, MULTICENTER CLINICAL TRIAL DESIGNED TO EVALUATE THE SAFETY AND PROBABLE BENEFIT OF THE KERAKLEAR NON-PENETRATING KERATOPROSTHESIS IN SUBJECTS WITH CORNEAL OPACITY WITH POOR PROGNOSIS FOR CORNEAL TRANSPLANT

Primary Purpose

CORNEAL OPACITY WITH POOR PROGNOSIS FOR CORNEAL TRANSPLANT

Status
Withdrawn
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Experimental
Sponsored by
University of California, Irvine
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for CORNEAL OPACITY WITH POOR PROGNOSIS FOR CORNEAL TRANSPLANT

Eligibility Criteria

88 Years - 88 Years (Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Corneal blindness where cornea transplantation is necessary but is expected to be unsuccessful due to severe limbal stem cell deficiency (LSCD) associated with aniridia or due to multiple (two or more) failed cornea transplantation surgeries and spontaneous visual improvement without surgical intervention is not expected or probable.
  • Best Corrected Distance Visual Acuity (Snellen) which is equal or worse than 20/200 in the study eye (but at least light perception with projection)
  • Estimated visual potential of the study eye is greater than or equal to at least two lines visual improvement of BCDVA of current vision in the study eye.

Exclusion Criteria:

  • Visual Acuity of No Light Perception (NLP) in the study eye
  • The patient is monocular or the non-study eye has Best Corrected Distance Visual Acuity (Snellen) of worse than 20/160 due to an ocular condition other than severe aniridic limbal stem cell deficiency or due to multiple (two or more) failed cornea transplantation surgeries.
  • Suitable for standard PK with donor tissue in the study eye.
  • History of severe dry eye syndrome or a Schirmer test with results of less than 3mm after 5 minutes of testing with the use of topical anesthetic in either eye.
  • Active or history of an auto-immune disease (e.g. Rheumatoid Arthritis, Ocular Cicatricial Pemphigoid, Lupus, Steven's Johnson Syndrome, atopic keratoconjunctivitis, etc.).
  • On medications that may affect wound healing, such as antimetabolites or other chemotherapeutic agents.
  • History of posterior segment eye disease in either eye (including macular degeneration, optic neuropathy, posterior uveitis) which is expected to limit the visual improvement to less than two lines of vision.
  • History of retinal surgery in the fellow eye (including retinal detachment repair, intravitreal injection etc.).
  • History of retinal surgery in the study eye (including retinal detachment repair, intravitreal injection, etc.) unless the vision is at least light perception with projection in four field quadrants and the macula is attached (if there is no view of the retina, an ultrasound must show the macula is attached).
  • History of uncontrolled glaucoma in either eye (IOP has been measured above 25 mmHg at any time in the last 6 months).
  • Current use of beta blocker eye drops (e.g. timolol, levobunolol, etc.).
  • Vertical cup-to-disc (C:D) ratio greater than or equal to 0.8 in either eye (if able to visible through corneal opacity). If not visible, patient is not to be excluded.
  • Limited visual potential (patient does not have the ability to improve a minimum of two lines of vision of BCDVA by history).
  • History of amblyopia in the study eye limiting visual potential.
  • If the patient has had a corneal transplant, corneal transplantation surgery was performed less than 2 years ago.
  • Anticipated need for surgery on the study eye during the course of the study (including cataract surgery).
  • Aphakia in the study eye.
  • Active ocular infection in either eye.
  • Hypotony in the study eye (IOP < 6mmHg).
  • History of herpetic ocular infection in the study eye.
  • Corneal thickness less than 400 microns in any region of the pachymetry map.
  • Inability to protect the operated eye from trauma.
  • Females who are pregnant, lactating, or unwilling to use adequate birth control for t the duration of the study.
  • Patient is currently taking Sumatriptan (Imitrex) and unable to discontinue during the study.

For this "Single Patient Expanded Access" the research procedures will be based on the Master Protocol Version #1.2 dated 18Dec2017, with one foreseen deviation. Section 7.1 Page 27 under Inclusion Criteria #1 Male or female from 22 years to 80 years of age at screening study visit. This patient is 88 years old.

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Sites / Locations

  • University of California Irvine

Outcomes

Primary Outcome Measures

1.Improvement in BCDVA compared to baseline [ Time Frame: Baseline, Month 1, Month 2, Month 3, Month 4, Month 6, Month 9 and Month 12 ]
Best Corrected Distance Visual Acuity (BCDVA) will be measured in the study eye. An ETDRS visual acuity chart will be used to measure BCDVA at baseline, Month 1, Month 2, Month 3, Month 4, Month 6, Month 9, and Month 12.

Secondary Outcome Measures

Full Information

First Posted
January 18, 2019
Last Updated
May 22, 2020
Sponsor
University of California, Irvine
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1. Study Identification

Unique Protocol Identification Number
NCT03812341
Brief Title
SINGLE PATIENT EXPANDED ACCESS OF A PROSPECTIVE, MULTICENTER CLINICAL TRIAL DESIGNED TO EVALUATE THE SAFETY AND PROBABLE BENEFIT OF THE KERAKLEAR NON-PENETRATING KERATOPROSTHESIS IN SUBJECTS WITH CORNEAL OPACITY WITH POOR PROGNOSIS FOR CORNEAL TRANSPLANT
Official Title
SINGLE PATIENT EXPANDED ACCESS OF A PROSPECTIVE, MULTICENTER CLINICAL TRIAL DESIGNED TO EVALUATE THE SAFETY AND PROBABLE BENEFIT OF THE KERAKLEAR NON-PENETRATING KERATOPROSTHESIS IN SUBJECTS WITH CORNEAL OPACITY WITH POOR PROGNOSIS FOR CORNEAL TRANSPLANT
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Withdrawn
Why Stopped
No enrollment
Study Start Date
August 10, 2018 (Actual)
Primary Completion Date
August 9, 2019 (Actual)
Study Completion Date
August 9, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of California, Irvine

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is for a "Single Patient Expanded Access" of an on-going study (IRB#2017-3526). In the on-going study, the maximum number of subject will be 35 subjects (35 eyes) will be implanted with the KeraKlear device and will be followed for one year. However, this expanded access is for single patient use below is a description of patient condition and circumstances necessitating treatment: 88 year old female with 2 previous failed corneal transplants, had significant scarring and mild edema, surface well epithelialized, has potential for 10 letters of improvement in visual acuity. Patient is high risk for recurrent corneal rejection and failure and therefore would not be a candidate for standard corneal transplant. She would potentially do well with a partial thickness artificial cornea such as the KeraKlear.
Detailed Description
For this "Single Patient Expanded Access" the research procedures will be based on the Master Protocol Version #1.2 dated 18Dec2017, with one foreseen deviation. Section 7.1 Page 27 under Inclusion Criteria #1 Male or female from 22 years to 80 years of age at screening study visit. This patient is 88 years old as of the submission of this Protocol Narrative to the IRB. Postoperatively, subject will be examined at (with window size in parentheses): 1 Day (+2 days) 1 Week (7±2 days) 1 Month (30±5 days) 2 Months (60±7 days) 3 Months (90±7 days) 4 Months (120±10 days) 6 Months (180±10 days) 9 Months (270±20 days) 12 Months (360±20 days)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
CORNEAL OPACITY WITH POOR PROGNOSIS FOR CORNEAL TRANSPLANT

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Other
Intervention Name(s)
Experimental
Intervention Description
KeraKlear Non-Penetrating Keratoprosthesis The KeraKlear is a flexible non-penetrating artificial cornea designed to be implanted through small corneal incisions in subjects with corneal opacity
Primary Outcome Measure Information:
Title
1.Improvement in BCDVA compared to baseline [ Time Frame: Baseline, Month 1, Month 2, Month 3, Month 4, Month 6, Month 9 and Month 12 ]
Description
Best Corrected Distance Visual Acuity (BCDVA) will be measured in the study eye. An ETDRS visual acuity chart will be used to measure BCDVA at baseline, Month 1, Month 2, Month 3, Month 4, Month 6, Month 9, and Month 12.
Time Frame
1 year

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
88 year old female.
Minimum Age & Unit of Time
88 Years
Maximum Age & Unit of Time
88 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Corneal blindness where cornea transplantation is necessary but is expected to be unsuccessful due to severe limbal stem cell deficiency (LSCD) associated with aniridia or due to multiple (two or more) failed cornea transplantation surgeries and spontaneous visual improvement without surgical intervention is not expected or probable. Best Corrected Distance Visual Acuity (Snellen) which is equal or worse than 20/200 in the study eye (but at least light perception with projection) Estimated visual potential of the study eye is greater than or equal to at least two lines visual improvement of BCDVA of current vision in the study eye. Exclusion Criteria: Visual Acuity of No Light Perception (NLP) in the study eye The patient is monocular or the non-study eye has Best Corrected Distance Visual Acuity (Snellen) of worse than 20/160 due to an ocular condition other than severe aniridic limbal stem cell deficiency or due to multiple (two or more) failed cornea transplantation surgeries. Suitable for standard PK with donor tissue in the study eye. History of severe dry eye syndrome or a Schirmer test with results of less than 3mm after 5 minutes of testing with the use of topical anesthetic in either eye. Active or history of an auto-immune disease (e.g. Rheumatoid Arthritis, Ocular Cicatricial Pemphigoid, Lupus, Steven's Johnson Syndrome, atopic keratoconjunctivitis, etc.). On medications that may affect wound healing, such as antimetabolites or other chemotherapeutic agents. History of posterior segment eye disease in either eye (including macular degeneration, optic neuropathy, posterior uveitis) which is expected to limit the visual improvement to less than two lines of vision. History of retinal surgery in the fellow eye (including retinal detachment repair, intravitreal injection etc.). History of retinal surgery in the study eye (including retinal detachment repair, intravitreal injection, etc.) unless the vision is at least light perception with projection in four field quadrants and the macula is attached (if there is no view of the retina, an ultrasound must show the macula is attached). History of uncontrolled glaucoma in either eye (IOP has been measured above 25 mmHg at any time in the last 6 months). Current use of beta blocker eye drops (e.g. timolol, levobunolol, etc.). Vertical cup-to-disc (C:D) ratio greater than or equal to 0.8 in either eye (if able to visible through corneal opacity). If not visible, patient is not to be excluded. Limited visual potential (patient does not have the ability to improve a minimum of two lines of vision of BCDVA by history). History of amblyopia in the study eye limiting visual potential. If the patient has had a corneal transplant, corneal transplantation surgery was performed less than 2 years ago. Anticipated need for surgery on the study eye during the course of the study (including cataract surgery). Aphakia in the study eye. Active ocular infection in either eye. Hypotony in the study eye (IOP < 6mmHg). History of herpetic ocular infection in the study eye. Corneal thickness less than 400 microns in any region of the pachymetry map. Inability to protect the operated eye from trauma. Females who are pregnant, lactating, or unwilling to use adequate birth control for t the duration of the study. Patient is currently taking Sumatriptan (Imitrex) and unable to discontinue during the study. For this "Single Patient Expanded Access" the research procedures will be based on the Master Protocol Version #1.2 dated 18Dec2017, with one foreseen deviation. Section 7.1 Page 27 under Inclusion Criteria #1 Male or female from 22 years to 80 years of age at screening study visit. This patient is 88 years old. -
Facility Information:
Facility Name
University of California Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

SINGLE PATIENT EXPANDED ACCESS OF A PROSPECTIVE, MULTICENTER CLINICAL TRIAL DESIGNED TO EVALUATE THE SAFETY AND PROBABLE BENEFIT OF THE KERAKLEAR NON-PENETRATING KERATOPROSTHESIS IN SUBJECTS WITH CORNEAL OPACITY WITH POOR PROGNOSIS FOR CORNEAL TRANSPLANT

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