Cornea Preservation Time Study (CPTS)
Cornea Preservation Time, Endothelial Keratoplasty, Transplant Success
About this trial
This is an interventional treatment trial for Cornea Preservation Time focused on measuring cornea, transplant, preservation, endothelial keratoplasty
Eligibility Criteria
Study Participant Eligibility Criteria
Study Participant Inclusion Criteria
- Age range 30-<91 years with minimum life expectancy of at least 3 years.
- Willingness to return for follow-up study visits at 1 day, 1 week, 1 month, 6 months, 1 year, 2 years and 3 years.
- Fluent in English or Spanish.
- Study Participant Exclusion Criteria 1) Decisionally and/or cognitively impaired
Study Eye Eligibility Criteria
Study Eye Inclusion Criteria
Endothelial keratoplasty (EK) is scheduled between 10 and 60 days after enrollment
- The 10-day requirement relates to the need to be able to randomly assign the eye to either intervention group.
- The 60-day requirement relates to the need to have current eligibility and enrollment data at the time of surgery. If surgery is postponed to >60 days after the initial enrollment visit, a new Baseline Visit and eligibility assessment will have to be performed.
- Presence of a condition related to endothelial dysfunction which will be treated by EK.
Eligible indications for EK include:
Presence of Fuchs endothelial corneal dystrophy (FECD) meeting at least one of the following:
- Phakic FECD
Phakic FECD with cataract
- Triple procedure including EK for FECD, cataract extraction and posterior chamber intraocular lens implantation (IOL) is allowed
- Aphakic FECD
- Pseudophakic FECD with posterior capsule supported, suture-fixated, or sulcus-supported posterior chamber IOL
- Aphakic or pseudophakic corneal edema with posterior capsule supported, suture-fixated, or sulcus-supported posterior chamber IOL without FECD
Study Eye Exclusion Criteria
- Prior EK
- Indication for surgery that is not suitable for EK (e.g, keratoconus, stromal dystrophies and scars)
- Presence of a condition that has a very high probability for failure (e.g., failed EK or Penetrating Keratoplasty (PKP), heavily vascularized cornea, uncontrolled uveitis)
- Other primary endothelial dysfunction conditions including posterior polymorphous corneal dystrophy and congenital hereditary corneal dystrophy
- Anterior chamber IOL in study eye prior to or anticipated during EK
- Planned intraocular lens exchange of an anterior chamber IOL with a posterior chamber IOL in study eye at time of study EK
- Pre-operative central sub-epithelial or stromal scarring that the investigator believes is visually significant and could impact post-operative stromal clarity assessment
- Stromal vascularization that is visually significant (by investigator's judgment)
- Presence of anterior synechiae (iris to cornea)
- Peripheral anterior synechiae (iris to angle) in the angle greater than a total of three clock hours
- Hypotony (Intraocular pressure <10 mm Hg)
Uncontrolled (defined as intraocular pressure > 25mm Hg) glaucoma with or without prior filtering surgery or shunt or mini-shunt placement.
- A shunt or mini-shunt is any device implanted to lower intraocular pressure through an external route (e.g Ahmed) or internal route (e.g. Glaukos) that is present in the anterior chamber angle or extends into the anterior chamber.
Controlled glaucoma with prior shunt or mini-shunt placement for glaucoma
- Note: FECD or pseudophakic/aphakic corneal edema with posterior chamber IOL that also have undergone filtering surgery (without shunt or mini-shunt) in which glaucoma is currently considered under control will be eligible
- Fellow eye visual acuity < 20/200 that is not correctable with EK
Eligibility Criteria for Second Study Eye
- Study participant has already enrolled one eye
- The second eye meets all study eye inclusion and exclusion criteria (2.2.2 and 2.2.3)
- EK surgery in second eye is not planned within 6 weeks of EK on first study eye
Sites / Locations
- Keck Medical Center
- Jules Stein Eye Institute
- Eye Care of San Diego
- University of California, San Francisco
- Bascom Palmer Eye Institute
- Center for Sight
- Woolfson Eye Institute
- Eye Consultants of Atlanta
- University of Illinois Eye and Eye
- NorthShore University Health System
- University of Iowa Hospitals and Clinics
- University of Kentucky Ophthalmology
- Mid-Atlantic Cornea Consultants
- Johns Hopkins/Wilmer Eye Institute
- Eye Consultants of Maryland
- Ophthalmic Consultants of Boston
- University of Michigan/Kellogg Eye Center
- Verdier Eye Center
- Michigan Cornea Consultants
- Minnesota Eye Consultants
- Mayo Clinic
- Ophthalmology Associates
- Mercy Medical Research Institute
- New York Eye and Ear Infirmary
- Cornea Consultants of Albany
- Cincinnati Eye Institute
- University Hospitals Case Medical Center Eye Institute
- Ohio State Medical Center
- Northeast Ohio Eye Surgeons
- Medical Eye Center
- Devers Eye Institute
- Ophthalmic Partners of PA
- Central Pennsylvania Eye Institute
- Sadeer Hannush, MD
- Corneal Associates, PC, Wills Eye Institute
- Cornea Associates of Texas
- Focal Point Vision
- University of Utah, Moran Eye Center
- Eye Associates Northwest
- Dean Medical Center
Arms of the Study
Arm 1
Arm 2
Other
Other
0-7d Preservation Time Group
8-14d Preservation Time Group
Subjects in this arm will receive cornea tissue transplant with cornea tissue preserved for 0 to 7 days prior to transplant.
Subjects in this arm will receive cornea tissue transplant with cornea tissue preserved for 8 to 14 days prior to transplant.