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Cornea Preservation Time Study (CPTS)

Primary Purpose

Cornea Preservation Time, Endothelial Keratoplasty, Transplant Success

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Cornea tissue transplant
Cornea tissue transplant
Sponsored by
Case Western Reserve University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cornea Preservation Time focused on measuring cornea, transplant, preservation, endothelial keratoplasty

Eligibility Criteria

30 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Study Participant Eligibility Criteria

  • Study Participant Inclusion Criteria

    1. Age range 30-<91 years with minimum life expectancy of at least 3 years.
    2. Willingness to return for follow-up study visits at 1 day, 1 week, 1 month, 6 months, 1 year, 2 years and 3 years.
    3. Fluent in English or Spanish.
  • Study Participant Exclusion Criteria 1) Decisionally and/or cognitively impaired

Study Eye Eligibility Criteria

  • Study Eye Inclusion Criteria

    1. 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.
    2. 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

    1. Prior EK
    2. Indication for surgery that is not suitable for EK (e.g, keratoconus, stromal dystrophies and scars)
    3. 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)
    4. Other primary endothelial dysfunction conditions including posterior polymorphous corneal dystrophy and congenital hereditary corneal dystrophy
    5. Anterior chamber IOL in study eye prior to or anticipated during EK
    6. Planned intraocular lens exchange of an anterior chamber IOL with a posterior chamber IOL in study eye at time of study EK
    7. Pre-operative central sub-epithelial or stromal scarring that the investigator believes is visually significant and could impact post-operative stromal clarity assessment
    8. Stromal vascularization that is visually significant (by investigator's judgment)
    9. Presence of anterior synechiae (iris to cornea)
    10. Peripheral anterior synechiae (iris to angle) in the angle greater than a total of three clock hours
    11. Hypotony (Intraocular pressure <10 mm Hg)
    12. 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.
    13. 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
    14. Fellow eye visual acuity < 20/200 that is not correctable with EK

Eligibility Criteria for Second Study Eye

  1. Study participant has already enrolled one eye
  2. The second eye meets all study eye inclusion and exclusion criteria (2.2.2 and 2.2.3)
  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

Arm Type

Other

Other

Arm Label

0-7d Preservation Time Group

8-14d Preservation Time Group

Arm Description

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.

Outcomes

Primary Outcome Measures

Number of Eyes With Corneal Graft Failure Within 3 Years of Surgery
Graft failure, defined as the occurrence of one of the following within 3 years of surgery: Regrafting of the study eye for any reason Cornea which remains cloudy without clearing, according to the following: cloudy cornea on the first postoperative day which does not clear within 8 weeks OR cloudy cornea which was initially clear postoperatively but becomes and remains cloudy for 3 months without clearing.
Endothelial Cell Density (ECD)
Endothelial cell density at 3 years from surgery, conditional on graft survival at 3 years from surgery.

Secondary Outcome Measures

Full Information

First Posted
February 15, 2012
Last Updated
April 19, 2018
Sponsor
Case Western Reserve University
Collaborators
National Eye Institute (NEI), Jaeb Center for Health Research
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1. Study Identification

Unique Protocol Identification Number
NCT01537393
Brief Title
Cornea Preservation Time Study
Acronym
CPTS
Official Title
Effect of Corneal Preservation Time on Long-Term Graft Success
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
April 16, 2012 (Actual)
Primary Completion Date
June 30, 2017 (Actual)
Study Completion Date
June 30, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Case Western Reserve University
Collaborators
National Eye Institute (NEI), Jaeb Center for Health Research

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine if the 3-year graft failure rate following endothelial keratoplasty performed with donor corneas with a preservation time of 8 to 14 days is non-inferior to the failure rate when donor corneas with a preservation time of 7 or fewer days are used.
Detailed Description
When the donor cornea is removed from the person who died, it is prepared for transplantation by an eye bank. The donor cornea is placed into a liquid that helps preserve the cornea until it is transplanted. The Food and Drug Administration (FDA) has approved storage of the cornea in this liquid for up to 14 days before the transplant. The purpose of this study is to see if the length of time the donor cornea is kept in the preservation liquid before the transplant affects the likelihood of the transplant being successful. We will follow participants for 3 years after transplant to see if there are any differences in transplant success or in the number of transplanted endothelial cells (the layer of cells that line the undersurface of the cornea) on the corneas that were preserved for 7 days or less compared to those preserved between 8 and 14 days. We have no reason to believe that there is any greater risk for transplant failure with either preservation time group.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cornea Preservation Time, Endothelial Keratoplasty, Transplant Success, Endothelial Cell Density
Keywords
cornea, transplant, preservation, endothelial keratoplasty

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
1174 (Actual)

8. Arms, Groups, and Interventions

Arm Title
0-7d Preservation Time Group
Arm Type
Other
Arm Description
Subjects in this arm will receive cornea tissue transplant with cornea tissue preserved for 0 to 7 days prior to transplant.
Arm Title
8-14d Preservation Time Group
Arm Type
Other
Arm Description
Subjects in this arm will receive cornea tissue transplant with cornea tissue preserved for 8 to 14 days prior to transplant.
Intervention Type
Biological
Intervention Name(s)
Cornea tissue transplant
Intervention Description
Cornea tissue preserved 0 to 7 days
Intervention Type
Biological
Intervention Name(s)
Cornea tissue transplant
Intervention Description
Cornea tissue preserved 8 to 14 days.
Primary Outcome Measure Information:
Title
Number of Eyes With Corneal Graft Failure Within 3 Years of Surgery
Description
Graft failure, defined as the occurrence of one of the following within 3 years of surgery: Regrafting of the study eye for any reason Cornea which remains cloudy without clearing, according to the following: cloudy cornea on the first postoperative day which does not clear within 8 weeks OR cloudy cornea which was initially clear postoperatively but becomes and remains cloudy for 3 months without clearing.
Time Frame
Study eye will be assessed for this outcome for 3 years following surgery
Title
Endothelial Cell Density (ECD)
Description
Endothelial cell density at 3 years from surgery, conditional on graft survival at 3 years from surgery.
Time Frame
3 years from surgery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jonathan Lass, MD
Organizational Affiliation
Case Western Reserve University
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Allison Ayala, MS
Organizational Affiliation
Jaeb Center for Health Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Keck Medical Center
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211
Country
United States
Facility Name
Jules Stein Eye Institute
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Eye Care of San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94110
Country
United States
Facility Name
Bascom Palmer Eye Institute
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Center for Sight
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34239
Country
United States
Facility Name
Woolfson Eye Institute
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30328
Country
United States
Facility Name
Eye Consultants of Atlanta
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30339
Country
United States
Facility Name
University of Illinois Eye and Eye
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
NorthShore University Health System
City
Glenview
State/Province
Illinois
ZIP/Postal Code
60026
Country
United States
Facility Name
University of Iowa Hospitals and Clinics
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
University of Kentucky Ophthalmology
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40503
Country
United States
Facility Name
Mid-Atlantic Cornea Consultants
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States
Facility Name
Johns Hopkins/Wilmer Eye Institute
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Eye Consultants of Maryland
City
Owings Mills
State/Province
Maryland
ZIP/Postal Code
21117
Country
United States
Facility Name
Ophthalmic Consultants of Boston
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
University of Michigan/Kellogg Eye Center
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48105
Country
United States
Facility Name
Verdier Eye Center
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49546
Country
United States
Facility Name
Michigan Cornea Consultants
City
Southfield
State/Province
Michigan
ZIP/Postal Code
48034
Country
United States
Facility Name
Minnesota Eye Consultants
City
Bloomington
State/Province
Minnesota
ZIP/Postal Code
55431
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Ophthalmology Associates
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63131
Country
United States
Facility Name
Mercy Medical Research Institute
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65804
Country
United States
Facility Name
New York Eye and Ear Infirmary
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
Cornea Consultants of Albany
City
Slingerlands
State/Province
New York
ZIP/Postal Code
12159
Country
United States
Facility Name
Cincinnati Eye Institute
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45242
Country
United States
Facility Name
University Hospitals Case Medical Center Eye Institute
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Ohio State Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43212
Country
United States
Facility Name
Northeast Ohio Eye Surgeons
City
Kent
State/Province
Ohio
ZIP/Postal Code
44240
Country
United States
Facility Name
Medical Eye Center
City
Medford
State/Province
Oregon
ZIP/Postal Code
97504
Country
United States
Facility Name
Devers Eye Institute
City
Portland
State/Province
Oregon
ZIP/Postal Code
97210
Country
United States
Facility Name
Ophthalmic Partners of PA
City
Bala-Cynwyd
State/Province
Pennsylvania
ZIP/Postal Code
19053
Country
United States
Facility Name
Central Pennsylvania Eye Institute
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Sadeer Hannush, MD
City
Langhorne
State/Province
Pennsylvania
ZIP/Postal Code
19047
Country
United States
Facility Name
Corneal Associates, PC, Wills Eye Institute
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Cornea Associates of Texas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Facility Name
Focal Point Vision
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
University of Utah, Moran Eye Center
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
Eye Associates Northwest
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Dean Medical Center
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53715
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29127431
Citation
Rosenwasser GO, Szczotka-Flynn LB, Ayala AR, Liang W, Aldave AJ, Dunn SP, McCall T, Navarro LC, Pramanik S, Ross KW, Stulting RD, Terry MA, Tu EY, Verdier DD, Kollman C, Gal RL, Beck RW, Lass JH; Cornea Preservation Time Study Group. Effect of Cornea Preservation Time on Success of Descemet Stripping Automated Endothelial Keratoplasty: A Randomized Clinical Trial. JAMA Ophthalmol. 2017 Dec 1;135(12):1401-1409. doi: 10.1001/jamaophthalmol.2017.4989.
Results Reference
result
PubMed Identifier
29127432
Citation
Lass JH, Benetz BA, Verdier DD, Szczotka-Flynn LB, Ayala AR, Liang W, Aldave AJ, Dunn SP, McCall T, Mian SI, Navarro LC, Patel SV, Pramanik S, Rosenwasser GO, Ross KW, Terry MA, Kollman C, Gal RL, Beck RW; Cornea Preservation Time Study Group. Corneal Endothelial Cell Loss 3 Years After Successful Descemet Stripping Automated Endothelial Keratoplasty in the Cornea Preservation Time Study: A Randomized Clinical Trial. JAMA Ophthalmol. 2017 Dec 1;135(12):1394-1400. doi: 10.1001/jamaophthalmol.2017.4970.
Results Reference
result
PubMed Identifier
36036663
Citation
Lass JH, Bailey RJ, Szczotka-Flynn LB, Benetz BA, Soper M, Titus MS, Kollman C, Beck RW; Cornea Preservation Time Study Group. Comparison of Graft Outcomes Reusing Original Intermediate-Term Cold Storage Solution for Entire Corneal Donor Storage Period With Exchanged Fresh Storage Solution After Donor Preparation in the Cornea Preservation Time Study. Cornea. 2022 Dec 1;41(12):1539-1544. doi: 10.1097/ICO.0000000000003108. Epub 2022 Sep 9.
Results Reference
derived
PubMed Identifier
25850706
Citation
Lass JH, Szczotka-Flynn LB, Ayala AR, Benetz BA, Gal RL, Aldave AJ, Corrigan MM, Dunn SP, McCall TL, Pramanik S, Rosenwasser GO, Ross KW, Terry MA, Verdier DD; Writing Committee for the Cornea Preservation Time Study Group. Cornea preservation time study: methods and potential impact on the cornea donor pool in the United States. Cornea. 2015 Jun;34(6):601-8. doi: 10.1097/ICO.0000000000000417.
Results Reference
derived
Links:
URL
http://cpts.jaeb.org/
Description
Public website

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Cornea Preservation Time Study

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