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Safety and Effectiveness of the PXL-Platinum 330 System for Corneal Collagen Cross-Linking in Eyes With Corneal Thinning Conditions

Primary Purpose

Keratoconus, Unstable, Bacterial Keratitis, Ectasia of Cornea

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PXL-330 Platinum device for crosslinking with Peschke ribofflavin solution
Sponsored by
Pacific Clear Vision Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Keratoconus, Unstable

Eligibility Criteria

10 Years - 45 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Subjects who have one or both eyes that meet criteria 1 and 1 or more of the following criteria will be considered candidates for this study:

  1. 12 years of age or older
  2. Presence of central or inferior steepening.
  3. Axial topography consistent with keratoconus, post-surgical ectasia, or pellucid marginal degeneration
  4. Presence of one or more findings associated with keratoconus or pellucid marginal degeneration, such as:

    1. Fleischer ring
    2. Vogt's striae
    3. Decentered corneal apex
    4. Munson's sign
    5. Rizzutti's sign
    6. Apical Corneal scarring consistent with Bowman's breaks
    7. Scissoring of the retinoscopic reflex
    8. Crab-claw appearance on topography
  5. Steepest keratometry (Kmax) value ≥ 47.20 D
  6. I-S keratometry difference > 1.5 D on the Pentacam/Galilei/Orbscan/Cassini map or topography map
  7. Posterior corneal elevation >16 microns
  8. Thinnest corneal point <485 microns
  9. Predicted Post LASIK/PRK stromal ablation depth <350 microns or expected keratometry >47.2 D, or patients undergoing PRK/SMILE in keratoconus suspect eyes
  10. AvaGen (Avellino Labs) genetic testing keratoconus risk score of 67 or higher (high risk).
  11. Bacterial or fungal corneal keratitis persistent and not responding despite > 2 weeks of standard antimicrobial therapy or with rapid progression of corneal thinning, with loss of >25% corneal thickness
  12. Contact Lens Wearers Only:

    a. Removal of contact lenses for the required period of time prior to the screening refraction:

    Contact Lens Type Minimum Discontinuation Time Soft 1 Week Soft Extended Wear 2 Weeks Soft Toric 3 Weeks Rigid gas permeable Scleral Lenses 2 Weeks per decade of wear Investigator Discretion

    Discontinuation of scleral lenses not required unless there is clinical evidence of corneal hypoxia (e.g. corneal neovascularization) at time of screening.

  13. Signed written informed consent
  14. Willingness and ability to comply with schedule for follow-up visits

Exclusion Criteria (any of the following are reasons for exclusion):

1. All subjects meeting any of the following criteria will be excluded from this study:

  1. Eyes classified as either normal or atypical normal on the severity grading scheme.
  2. Corneal pachymetry at the screening exam that is <300 microns at the thinnest point in the eye(s) to be treated.
  3. Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye for future complications, for example:

    1. History of or active corneal disease (e.g., herpes simplex, herpes zoster keratitis, recurrent erosion syndrome, acanthomeoeba, etc.)
    2. Clinically significant corneal scarring in the CXL treatment zone that is not related to keratoconus or, in the investigator's opinion, will interfere with the cross-linking procedure.
  4. Pregnancy (including plan to become pregnant) or lactation during the course of the study
  5. A known sensitivity to study medications
  6. Patients with nystagmus or any other condition that would prevent a steady gaze during the CXL treatment or other diagnostic tests.
  7. Patients with a current condition that, in the physician's opinion, would interfere with or prolong epithelial healing.

Sites / Locations

  • Pacific Clear Vision InstituteRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Pulsed, accelerated

Conventional

Arm Description

18 mW, 5 sec, 5 sec off, 10 minutes of illumination

9 mW, continuous 10 minutes of illumination

Outcomes

Primary Outcome Measures

Mean keratometry in diopters
Average keratometry across the anterior topography of the cornea computed by a validated Scheimpflug topographer

Secondary Outcome Measures

Best corrected visual acuity
Measurement of best corrected visual acuity on the validated early-treatment diabetic retinopathy study scale

Full Information

First Posted
April 14, 2019
Last Updated
December 29, 2022
Sponsor
Pacific Clear Vision Institute
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1. Study Identification

Unique Protocol Identification Number
NCT03918408
Brief Title
Safety and Effectiveness of the PXL-Platinum 330 System for Corneal Collagen Cross-Linking in Eyes With Corneal Thinning Conditions
Official Title
Safety and Effectiveness of the PXL-Platinum 330 System for Corneal Collagen Cross-Linking in Eyes With Corneal Thinning Conditions
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2019 (Actual)
Primary Completion Date
June 2029 (Anticipated)
Study Completion Date
June 2030 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pacific Clear Vision Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
To determine whether the Peschke PXL-330 system is safe and effective in the treatment of corneal thinning conditions.
Detailed Description
Patients with progressive keratoconus, pellucid marginal degeneration, infectious keratitis, or at risk for post-refractive corneal ectasia will be recruited and undergo epithelial-on corneal crosslinking with the Peschke PXL-330 system using pulsed, accelerated energy delivery. Patients will undergo monitoring for 1 year, with serial measurements of corneal topography, visual acuity, intraocular pressure, and visual function questionnaire.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Keratoconus, Unstable, Bacterial Keratitis, Ectasia of Cornea

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
Treatment of patients with disease
Masking
ParticipantOutcomes Assessor
Masking Description
Randomized at outset
Allocation
Randomized
Enrollment
300 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pulsed, accelerated
Arm Type
Experimental
Arm Description
18 mW, 5 sec, 5 sec off, 10 minutes of illumination
Arm Title
Conventional
Arm Type
Active Comparator
Arm Description
9 mW, continuous 10 minutes of illumination
Intervention Type
Combination Product
Intervention Name(s)
PXL-330 Platinum device for crosslinking with Peschke ribofflavin solution
Other Intervention Name(s)
Corneal crosslinking
Intervention Description
Riboflavin will be used to load the cornea, followed by UV-A crosslinking of the cornea
Primary Outcome Measure Information:
Title
Mean keratometry in diopters
Description
Average keratometry across the anterior topography of the cornea computed by a validated Scheimpflug topographer
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Best corrected visual acuity
Description
Measurement of best corrected visual acuity on the validated early-treatment diabetic retinopathy study scale
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
10 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who have one or both eyes that meet criteria 1 and 1 or more of the following criteria will be considered candidates for this study: 12 years of age or older Presence of central or inferior steepening. Axial topography consistent with keratoconus, post-surgical ectasia, or pellucid marginal degeneration Presence of one or more findings associated with keratoconus or pellucid marginal degeneration, such as: Fleischer ring Vogt's striae Decentered corneal apex Munson's sign Rizzutti's sign Apical Corneal scarring consistent with Bowman's breaks Scissoring of the retinoscopic reflex Crab-claw appearance on topography Steepest keratometry (Kmax) value ≥ 47.20 D I-S keratometry difference > 1.5 D on the Pentacam/Galilei/Orbscan/Cassini map or topography map Posterior corneal elevation >16 microns Thinnest corneal point <485 microns Predicted Post LASIK/PRK stromal ablation depth <350 microns or expected keratometry >47.2 D, or patients undergoing PRK/SMILE in keratoconus suspect eyes AvaGen (Avellino Labs) genetic testing keratoconus risk score of 67 or higher (high risk). Bacterial or fungal corneal keratitis persistent and not responding despite > 2 weeks of standard antimicrobial therapy or with rapid progression of corneal thinning, with loss of >25% corneal thickness Contact Lens Wearers Only: a. Removal of contact lenses for the required period of time prior to the screening refraction: Contact Lens Type Minimum Discontinuation Time Soft 1 Week Soft Extended Wear 2 Weeks Soft Toric 3 Weeks Rigid gas permeable Scleral Lenses 2 Weeks per decade of wear Investigator Discretion Discontinuation of scleral lenses not required unless there is clinical evidence of corneal hypoxia (e.g. corneal neovascularization) at time of screening. Signed written informed consent Willingness and ability to comply with schedule for follow-up visits Exclusion Criteria (any of the following are reasons for exclusion): 1. All subjects meeting any of the following criteria will be excluded from this study: Eyes classified as either normal or atypical normal on the severity grading scheme. Corneal pachymetry at the screening exam that is <300 microns at the thinnest point in the eye(s) to be treated. Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye for future complications, for example: History of or active corneal disease (e.g., herpes simplex, herpes zoster keratitis, recurrent erosion syndrome, acanthomeoeba, etc.) Clinically significant corneal scarring in the CXL treatment zone that is not related to keratoconus or, in the investigator's opinion, will interfere with the cross-linking procedure. Pregnancy (including plan to become pregnant) or lactation during the course of the study A known sensitivity to study medications Patients with nystagmus or any other condition that would prevent a steady gaze during the CXL treatment or other diagnostic tests. Patients with a current condition that, in the physician's opinion, would interfere with or prolong epithelial healing.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
BALAMURALI AMBATI, MD, PhD
Phone
541-343-5000
Email
bambati@pcvi.com
First Name & Middle Initial & Last Name or Official Title & Degree
Scott Cherne, MD
Phone
541-343-5000
Email
scherne@pcvi.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
BALAMURALI AMBATI, MD, PhD
Organizational Affiliation
PCVI
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pacific Clear Vision Institute
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
BALAMURALI AMBATI, MD
Phone
706-231-3958
Email
bambati@pcvi.com
First Name & Middle Initial & Last Name & Degree
Scott K Cherne, MD
Phone
5413435000
Email
scherne@pcvi.com

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Individual participant data will be help in a secure location. While summary outcomes data will be provided on request to other researchers and periodically at scientific conferences, protected health information will not.

Learn more about this trial

Safety and Effectiveness of the PXL-Platinum 330 System for Corneal Collagen Cross-Linking in Eyes With Corneal Thinning Conditions

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