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Safety and Efficacy of Corneal Crosslinking Using the PXL-Platinum 330 for Eyes With Corneal Ectatic Conditions

Primary Purpose

Keratoconus, Cornea Ectasia

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Epithelial-on Corneal Crosslinking with the PXL 330 Platinum system.
Sponsored by
Arbor Center for Eye Care
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Keratoconus

Eligibility Criteria

12 Years - 60 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Inclusion Criteria: Criterion 1,2,3 are required for all participants. Participants must also meet one or more of criteria 4-12 . Criterion 13 is relevant only for contact lens wearers

Subjects who have one or both eyes that meet criteria 1 and one 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 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 in keratoconus suspect eyes
  10. Contact Lens Wearers Only:

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

  11. Signed written informed consent
  12. Willingness and ability to comply with schedule for follow-up visits
  13. Contact Lens Wearers Only:

    1. 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 2 Weeks per decade of wear

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

  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, acanthamoeba, 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

  • Arbor Center for Eye Care

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Pulsed, accelerated

Conventional

Arm Description

18mW, 5 seconds on, 5 seconds off, 10 minutes of illumination.

9mW 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 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
January 22, 2020
Last Updated
March 29, 2023
Sponsor
Arbor Center for Eye Care
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1. Study Identification

Unique Protocol Identification Number
NCT04240457
Brief Title
Safety and Efficacy of Corneal Crosslinking Using the PXL-Platinum 330 for Eyes With Corneal Ectatic Conditions
Official Title
Safety and Effectiveness of the PXL-Platinum 330 System for Corneal Crosslinking in Eyes With Corneal Ectatic Conditions
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Terminated
Why Stopped
Study was terminated due to enrollment and other challenges attributable to the Covid-19 public health emergency.
Study Start Date
July 8, 2020 (Actual)
Primary Completion Date
February 18, 2023 (Actual)
Study Completion Date
February 18, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Arbor Center for Eye Care

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 evaluate the safety and effectiveness of the PXL Platinum 330 device for performing Corneal Crosslinking in patients with corneal thinning conditions.
Detailed Description
Patients with progressive keratoconus, pellucid marginal degeneration, 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 assessments.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Treatment of patients with disease
Masking
Outcomes Assessor
Masking Description
Randomized at outset
Allocation
Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pulsed, accelerated
Arm Type
Experimental
Arm Description
18mW, 5 seconds on, 5 seconds off, 10 minutes of illumination.
Arm Title
Conventional
Arm Type
Active Comparator
Arm Description
9mW continuous, 10 minutes of illumination.
Intervention Type
Combination Product
Intervention Name(s)
Epithelial-on Corneal Crosslinking with the PXL 330 Platinum system.
Intervention Description
PXL-330 Platinum device for crosslinking with Peschke riboflavin solution. 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 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
12 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Inclusion Criteria: Criterion 1,2,3 are required for all participants. Participants must also meet one or more of criteria 4-12 . Criterion 13 is relevant only for contact lens wearers Subjects who have one or both eyes that meet criteria 1 and one 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 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 in keratoconus suspect eyes Contact Lens Wearers Only: a. Removal of contact lenses for the required period of time prior to the screening refraction: Signed written informed consent Willingness and ability to comply with schedule for follow-up visits Contact Lens Wearers Only: 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 2 Weeks per decade of wear Exclusion Criteria (any of the following are reasons for exclusion): 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, acanthamoeba, 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 -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Lubeck, MD
Organizational Affiliation
Arbor Center for Eye Care
Official's Role
Principal Investigator
Facility Information:
Facility Name
Arbor Center for Eye Care
City
Orland Park
State/Province
Illinois
ZIP/Postal Code
60467
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety and Efficacy of Corneal Crosslinking Using the PXL-Platinum 330 for Eyes With Corneal Ectatic Conditions

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