search
Back to results

Efficacy and Safety of CLEAR in Myopia and Astigmatism in Chinese Population

Primary Purpose

Myopic Astigmatism

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
CLEAR
Sponsored by
Ziemer Ophthalmic Systems AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myopic Astigmatism focused on measuring CLEAR, Ziemer, FEMTO LDV, Lenticule, Myopic astigmatism

Eligibility Criteria

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

Inclusion Criteria:

  1. Medically suitable for corneal refractive surgery
  2. Signed informed consent form
  3. Age ≥ 18 years
  4. Pre-operative BCVA ≥ 5.0 (corresponding to 20/20 as per Snellen chart lines)
  5. Myopia sphere from -0.5 D to -10.00 D
  6. Maximum cylinder diopter of -5.00 D
  7. Maximum resulting MRSE of -12.5 D
  8. Calculated residual stromal thickness ≥ 250 microns
  9. Non-contact IOP < 21mmHg
  10. Stable refraction for the past year, as demonstrated by a change in manifest refraction spherical equivalent (MRSE) of ≤ 0.50 D
  11. A difference between cycloplegic refraction spherical equivalent and MRSE < 0.75 D.
  12. For contact lens wearers (where applicable) after pre-operative stop of contact lens wear: Stable refraction (within ±0.5 D), as determined by MRSE, on two consecutive examinations at least 1 week apart.
  13. Patient willing and able to return to the study site for the follow-up visits, in the judgement of the investigator.

Exclusion Criteria:

  1. Wearing of contact lenses pre-operatively i) soft contact lenses: <2 weeks before Visit 1 OR from Visit 1 till the day of surgery ii) hard contact lenses: <1 month before Visit 1 OR from Visit 1 till the day of surgery iii) therapeutic contact lenses (such as Ortho-K): <3 months before Visit 1 OR from Visit 1 till the day of surgery
  2. Corneal disease or pathology, such as corneal scaring or opacity, that precludes transmission of laser wavelength or that distorts laser light
  3. Residual, recurrent, or active ocular disease or corneal abnormality (including, but not limited to ocular herpes zoster or simplex, active infections and inflammation)
  4. History of ocular herpes simplex or herpes zoster keratitis
  5. 3 months before the inclusion have taken systemic medication likely to negatively affect wound healing, such as glucocorticosteroide or antimetabolites
  6. Severe dry eye
  7. Glaucoma
  8. Nystagmus or hemofacial spasm preventing placement of the patient interface
  9. Previous corneal surgery of any kind, including any type of surgery for either refractive or therapeutic purposes
  10. Unstable central keratometry readings
  11. Mesopic pupil diameter > 8.0 mm
  12. Keratometry readings via Sim-K values less than 40.00 D
  13. Allergy to medications required in surgery, pre- and post-operative treatment
  14. Keratoconus or keratectasia, including patients with suspicion of keratoconus on corneal topography
  15. At the time of inclusion, participation in other medical device clinical trials within one month or in drug clinical trials within 3 months
  16. Diagnosis of autoimmune disease, connective tissue disease, clinically significant atopic disease, diabetes or AIDS and other acute or chronic illnesses that increases the risk to the subject or confounds the outcomes of this study in the opinion of the study principal investigator
  17. Known psychotic disorders associated with delusions (e.g. schizophrenia)
  18. Woman who is pregnant or nursing

Sites / Locations

  • Beijing Tongren Hospital
  • Guangzhou Aier Eye Hospital
  • Ineye Hospital of Chengdu University of TCM
  • Eye Hospital, WMURecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Refractive correction using CLEAR

Arm Description

Subjects 18+ years old with myopic (-0.50 to -10.00 D) astigmatism (up to -5.00 D) treated bilaterally with FEMTO LDV Z8 using CLEAR application.

Outcomes

Primary Outcome Measures

UCDVA (with cycloplegia)
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA (without cycloplegia)
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
UCDVA
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.

Secondary Outcome Measures

Stability of MRSE
The percentage of eyes with: a change of less than or equal to 1.00 D of MRSE between two refractions a change of less than or equal to 0.50 D of MRSE between two refractions will be reported for the corresponding time period.
Predictability of MRSE
Percentage of eyes achieving MRSE within ± 1.00 D and within ± 0.50 D of the intended outcome at the point at which MRSE stability is achieved.
Efficacy Index
Efficacy Index is defined as UCDVA at the time point, when stability of MRSE is reached, divided by CDVA at baseline: (UCDVA VX /CDVA V1). Note: "X" corresponds to the visit, when stability of MRSE will have been reached. The Efficacy Index being above the efficacy cut-off level 0.8 indicates loss of less than two lines of UCDVA
Stability of MRCYL
The stability of the manifest refractive cylinder (MRCYL) will be evaluated for the whole set of eyes treated for astigmatic myopia. The following statistics for the change in the MRCYL between two consecutive post-operative follow-up visits will be recorded: • percentage of eyes with a change in MRCYL within ±1.0 D and ±0.5 D Stability analyses will be performed on the eyes that had every follow-up exam from 1- month up to the stability time point (the Consistent Cohort), as well as on the eyes that had 2 consecutive post-op exams, but not necessarily every follow-up exam
Predictability of MRCYL
Percentage of eyes achieving MRCYL within ± 1.00 D of the intended outcome, and within ± 0.50 D of the intended outcome at the point at which stability of MRSE is achieved.
Vector analysis (IRC)
Intended Refractive Correction Vector (IRC) IRC = Preoperative cylinder - Target (attempted) cylinder
Vector analysis (SIRC)
Assessment of change in the Surgically Induced Refractive Correction Vector (SIRC) during follow up; assessed until the MRSE stability is reached. SIRC = Preoperative cylinder - Postoperative cylinder
Vector analysis (EV)
Assessment of change in the Error Vector during follow up; assessed until the MRSE stability is reached. Error Vector (EV) EV = IRC - SIRC
Vector analysis (CR)
Assessment of change in the Correction Rate during follow up; assessed until the MRSE stability is reached. Correction Ratio (CR) CR = magnitude of SIRC / magnitude of IRC
Vector analysis (ER)
Assessment of change in the Error Ratio during follow up; assessed until the MRSE stability is reached. Error Ratio (ER) ER = magnitude of EV/ magnitude of IRC
Safety Index
Safety Index defined as CDVA at the time point, when the stability of MRSE is reached, divided by CDVA at baseline (CDVA VX / CDVA V1).
Number of Adverse Events observed in the study
Complications, including all related (Serious) Adverse Events, during surgery day and follow-up.
Number of Device defects observed in the study
Number of device defects observed during the clinical trial.

Full Information

First Posted
December 22, 2021
Last Updated
January 26, 2022
Sponsor
Ziemer Ophthalmic Systems AG
Collaborators
Tigermed Consulting Co., Ltd
search

1. Study Identification

Unique Protocol Identification Number
NCT05229133
Brief Title
Efficacy and Safety of CLEAR in Myopia and Astigmatism in Chinese Population
Official Title
A Multicentre, Prospective, Single-arm Clinical Trial to Evaluate Efficacy and Safety of Femtosecond Laser Corneal Lenticule Extraction for Advanced Refractive Correction (CLEAR) in Myopia and Astigmatism in Chinese Population
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Recruiting
Study Start Date
November 29, 2021 (Actual)
Primary Completion Date
March 1, 2023 (Anticipated)
Study Completion Date
March 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ziemer Ophthalmic Systems AG
Collaborators
Tigermed Consulting Co., Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
In this multicenter, prospective, interventional, single-arm clinical trial, the aim is to determine safety and efficacy of CLEAR using the FEMTO LDV Z8 in Chinese patients in China. The primary objective is to evaluate the visual outcome after CLEAR using the FEMTO LDV Z8 in myopia and astigmatic myopia at the time point, when stability of manifest refraction spherical equivalent (MRSE) is reached. The corresponding hypothesis is that the percentage of treated eyes with satisfactory Uncorrected Distance Visual Acuity (UCDVA) at the point when stability of MRSE is reached after CLEAR is at least 85% of all treated eyes. This hypothesis has been chosen in line with the recommendations of the "Checklist of Information Usually Submitted in an Investigational Device Exemptions (IDE) Application for Refractive Surgery Lasers" issued by the FDA. The secondary objectives are to evaluate the efficacy and safety with respect to stability, predictability, device defects and adverse events of CLEAR using the FEMTO LDV Z8 in myopia and astigmatic myopia during follow-up.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myopic Astigmatism
Keywords
CLEAR, Ziemer, FEMTO LDV, Lenticule, Myopic 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
215 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Refractive correction using CLEAR
Arm Type
Experimental
Arm Description
Subjects 18+ years old with myopic (-0.50 to -10.00 D) astigmatism (up to -5.00 D) treated bilaterally with FEMTO LDV Z8 using CLEAR application.
Intervention Type
Device
Intervention Name(s)
CLEAR
Other Intervention Name(s)
Corneal lenticule extraction for advanced refractive correction
Intervention Description
FEMTO LDV Z8 Surgical Laser is intended for use in Corneal Lenticule Extraction for Advanced Refractive correction (CLEAR), also called Curved Lamellar Resection (CLR), for the reduction or elimination of myopia from -0.50 D to -10.00 D, with astigmatism of 0 D to -5.00 D or without astigmatism, and MRSE of -0.50 D to -12.50 D in the eye to be treated in patients who are 18 years of age or older with documentation of stable manifest refraction over the past year as demonstrated by a change in sphere and cylinder of ≤ 0.50 D in magnitude.
Primary Outcome Measure Information:
Title
UCDVA (with cycloplegia)
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
Pre-operative
Title
UCDVA (without cycloplegia)
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
Pre-operative
Title
UCDVA
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
day 1
Title
UCDVA
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
1 week
Title
UCDVA
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
1 month
Title
UCDVA
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
3 months
Title
UCDVA
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
6 months
Title
UCDVA
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
9 months
Title
UCDVA
Description
The primary outcome is the percentage of eyes that achieve satisfactory Uncorrected Distance Visual Acuity (UCDVA) after CLEAR using the FEMTO LDV Z8, at the time point, when stability of MRSE is reached. Satisfactory UCDVA is defined as 20/40, or better, as per Snellen chart lines.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Stability of MRSE
Description
The percentage of eyes with: a change of less than or equal to 1.00 D of MRSE between two refractions a change of less than or equal to 0.50 D of MRSE between two refractions will be reported for the corresponding time period.
Time Frame
Assessed at 3 months, 6 months, 9 months and 12 months post surgery.
Title
Predictability of MRSE
Description
Percentage of eyes achieving MRSE within ± 1.00 D and within ± 0.50 D of the intended outcome at the point at which MRSE stability is achieved.
Time Frame
Up to 12 months
Title
Efficacy Index
Description
Efficacy Index is defined as UCDVA at the time point, when stability of MRSE is reached, divided by CDVA at baseline: (UCDVA VX /CDVA V1). Note: "X" corresponds to the visit, when stability of MRSE will have been reached. The Efficacy Index being above the efficacy cut-off level 0.8 indicates loss of less than two lines of UCDVA
Time Frame
Up to 12 months
Title
Stability of MRCYL
Description
The stability of the manifest refractive cylinder (MRCYL) will be evaluated for the whole set of eyes treated for astigmatic myopia. The following statistics for the change in the MRCYL between two consecutive post-operative follow-up visits will be recorded: • percentage of eyes with a change in MRCYL within ±1.0 D and ±0.5 D Stability analyses will be performed on the eyes that had every follow-up exam from 1- month up to the stability time point (the Consistent Cohort), as well as on the eyes that had 2 consecutive post-op exams, but not necessarily every follow-up exam
Time Frame
Assessed at 3 months, 6 months, 9 months and 12 months post surgery.
Title
Predictability of MRCYL
Description
Percentage of eyes achieving MRCYL within ± 1.00 D of the intended outcome, and within ± 0.50 D of the intended outcome at the point at which stability of MRSE is achieved.
Time Frame
Up to 12 months
Title
Vector analysis (IRC)
Description
Intended Refractive Correction Vector (IRC) IRC = Preoperative cylinder - Target (attempted) cylinder
Time Frame
Pre-operative
Title
Vector analysis (SIRC)
Description
Assessment of change in the Surgically Induced Refractive Correction Vector (SIRC) during follow up; assessed until the MRSE stability is reached. SIRC = Preoperative cylinder - Postoperative cylinder
Time Frame
Assessed at 3 months, 6 months, 9 months and 12 months post surgery.
Title
Vector analysis (EV)
Description
Assessment of change in the Error Vector during follow up; assessed until the MRSE stability is reached. Error Vector (EV) EV = IRC - SIRC
Time Frame
Assessed at 3 months, 6 months, 9 months and 12 months post surgery.
Title
Vector analysis (CR)
Description
Assessment of change in the Correction Rate during follow up; assessed until the MRSE stability is reached. Correction Ratio (CR) CR = magnitude of SIRC / magnitude of IRC
Time Frame
Assessed at 3 months, 6 months, 9 months and 12 months post surgery.
Title
Vector analysis (ER)
Description
Assessment of change in the Error Ratio during follow up; assessed until the MRSE stability is reached. Error Ratio (ER) ER = magnitude of EV/ magnitude of IRC
Time Frame
Assessed at 3 months, 6 months, 9 months and 12 months post surgery.
Title
Safety Index
Description
Safety Index defined as CDVA at the time point, when the stability of MRSE is reached, divided by CDVA at baseline (CDVA VX / CDVA V1).
Time Frame
Up to 12 months
Title
Number of Adverse Events observed in the study
Description
Complications, including all related (Serious) Adverse Events, during surgery day and follow-up.
Time Frame
Up to 12 months.
Title
Number of Device defects observed in the study
Description
Number of device defects observed during the clinical trial.
Time Frame
Up to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Medically suitable for corneal refractive surgery Signed informed consent form Age ≥ 18 years Pre-operative BCVA ≥ 5.0 (corresponding to 20/20 as per Snellen chart lines) Myopia sphere from -0.5 D to -10.00 D Maximum cylinder diopter of -5.00 D Maximum resulting MRSE of -12.5 D Calculated residual stromal thickness ≥ 250 microns Non-contact IOP < 21mmHg Stable refraction for the past year, as demonstrated by a change in manifest refraction spherical equivalent (MRSE) of ≤ 0.50 D A difference between cycloplegic refraction spherical equivalent and MRSE < 0.75 D. For contact lens wearers (where applicable) after pre-operative stop of contact lens wear: Stable refraction (within ±0.5 D), as determined by MRSE, on two consecutive examinations at least 1 week apart. Patient willing and able to return to the study site for the follow-up visits, in the judgement of the investigator. Exclusion Criteria: Wearing of contact lenses pre-operatively i) soft contact lenses: <2 weeks before Visit 1 OR from Visit 1 till the day of surgery ii) hard contact lenses: <1 month before Visit 1 OR from Visit 1 till the day of surgery iii) therapeutic contact lenses (such as Ortho-K): <3 months before Visit 1 OR from Visit 1 till the day of surgery Corneal disease or pathology, such as corneal scaring or opacity, that precludes transmission of laser wavelength or that distorts laser light Residual, recurrent, or active ocular disease or corneal abnormality (including, but not limited to ocular herpes zoster or simplex, active infections and inflammation) History of ocular herpes simplex or herpes zoster keratitis 3 months before the inclusion have taken systemic medication likely to negatively affect wound healing, such as glucocorticosteroide or antimetabolites Severe dry eye Glaucoma Nystagmus or hemofacial spasm preventing placement of the patient interface Previous corneal surgery of any kind, including any type of surgery for either refractive or therapeutic purposes Unstable central keratometry readings Mesopic pupil diameter > 8.0 mm Keratometry readings via Sim-K values less than 40.00 D Allergy to medications required in surgery, pre- and post-operative treatment Keratoconus or keratectasia, including patients with suspicion of keratoconus on corneal topography At the time of inclusion, participation in other medical device clinical trials within one month or in drug clinical trials within 3 months Diagnosis of autoimmune disease, connective tissue disease, clinically significant atopic disease, diabetes or AIDS and other acute or chronic illnesses that increases the risk to the subject or confounds the outcomes of this study in the opinion of the study principal investigator Known psychotic disorders associated with delusions (e.g. schizophrenia) Woman who is pregnant or nursing
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Olga Grossenbacher, MD, PhD
Phone
+41 79 671 67 25
Email
olga.grossenbacher@ziemergroup.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shi-hao Chen, MD
Organizational Affiliation
Eye Hospital, WMU
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Tongren Hospital
City
Beijing
State/Province
Bei-jing
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Changbin Zhai, MD
Phone
136 0108 9269
First Name & Middle Initial & Last Name & Degree
Changbin Zhai, MD
Facility Name
Guangzhou Aier Eye Hospital
City
Guangzhou
State/Province
Guangdong
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zheng Wang, MD
Phone
139 0300 2594
First Name & Middle Initial & Last Name & Degree
Zheng Wang, MD
Facility Name
Ineye Hospital of Chengdu University of TCM
City
Chengdu
State/Province
Sichuan
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yuehua Zhou, MD
Phone
139 1083 6019
First Name & Middle Initial & Last Name & Degree
Yuehua Zhou, MD
Facility Name
Eye Hospital, WMU
City
Wenzhou
State/Province
Zhejiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shi-hao Chen, MD
Phone
139 6887 8892
First Name & Middle Initial & Last Name & Degree
Shi-hao Chen, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Efficacy and Safety of CLEAR in Myopia and Astigmatism in Chinese Population

We'll reach out to this number within 24 hrs