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Modified Corneal EA With Middle LKP for Severe Corneal Burn

Primary Purpose

Corneal Burn

Status
Unknown status
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Modified EA and AMLK
LA and AMLK
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Corneal Burn

Eligibility Criteria

4 Years - 80 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Unilateral severe corneal burn with more than half limbal stem cells deficiency (LSCD). The history of the disease is at least 12 months at the time of screening visit.
  2. Presence of superficial neo-vascularization affecting at least 2 cornea quadrants and involving central cornea.
  3. Informed consent signed by a patient or legal guardian, or having the ability to comply with study assessments for the full duration of the study.

Exclusion Criteria:

  1. LSCD of mild degree, with less than 2 quadrants of neo-vessel invasion and without central cornea involvement.
  2. LSCD by ocular surface disorders other than ocular burns.
  3. Eyelids malposition.
  4. The center corneal thickness<450µm, the depth of corneal opacity<150µm or the full corneal lamellar opacity.
  5. High myopia with a spherical equivalent of -15.0 D or less.
  6. Corneal or ocular surface infection within 30 days prior to study entry.
  7. Ocular surface malignancy.
  8. Uncontrolled diabetes with most recent HgA1c greater than 8.5%.
  9. Renal failure with creatinine clearance ≤ 25mL/min per 1.73 m2.
  10. Alanine aminotransferase > 40IU/L, or aspartate aminotransferase > 40IU/L.
  11. Platelet levels < 150,000 or > 450,000 per microliter.
  12. Hemoglobin < 12.0 g/dL (male) or < 11.0 g/dL (female);
  13. Prothrombin time > 16s and activated partial thrombin time > 35s in patients not accepting anticoagulant therapy; An international normalized ratio greater than 3 in patients accepting anticoagulant therapy.
  14. Pregnancy (positive test) or lactation.
  15. Participation in another simultaneous medical investigation or clinical trial.
  16. Severe cicatricial eye disease; Conjunctival scarring with fornix shortening.
  17. Ocular comorbidities that affect the prognosis of transplantation, such as advanced glaucoma or retinal diseases.
  18. Severe dry eye disease as determined by Schirmer's test < 2mm at least in one eye.
  19. Any medical or social condition that in the judgment of the investigator would interfere with or serve as a contraindication to adherence to the study protocol or ability to give informed consent.
  20. Signs of current infection, including fever and treatment with antibiotics.

Sites / Locations

  • Zhognshan Ophthalmic Center, Sun Yat-sen UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Modified EA and AMLK

LA and AMLK

Arm Description

Modified corneal epithelial autograft (EA) combined with allogeneic middle lamellar keratoplasty (AMLK) is used for the treatment of patients with severe corneal burn.

Limbal autograft (LA) combined with AMLK is used for the treatment of patients with severe corneal burn.

Outcomes

Primary Outcome Measures

Success rate of corneal reepithelialization in disease eyes
The success rate of patients with completely epithelized and avascular corneal surface in disease eyes

Secondary Outcome Measures

Full Information

First Posted
April 7, 2018
Last Updated
September 5, 2019
Sponsor
Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT03498846
Brief Title
Modified Corneal EA With Middle LKP for Severe Corneal Burn
Official Title
Modified Corneal Epithelial Autograft With Middle Lamellar Keratoplasty for Severe Corneal Burn
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Unknown status
Study Start Date
May 10, 2018 (Actual)
Primary Completion Date
December 9, 2019 (Anticipated)
Study Completion Date
May 9, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this pilot study is to explore whether modified corneal epithelial autograft (EA) combined with allogeneic middle lamellar keratoplasty (AMLK) is more effective than limbal autograft (LA) with AMLK for ocular surface reconstruction in patients with severe corneal burn.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Corneal Burn

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Modified EA and AMLK
Arm Type
Experimental
Arm Description
Modified corneal epithelial autograft (EA) combined with allogeneic middle lamellar keratoplasty (AMLK) is used for the treatment of patients with severe corneal burn.
Arm Title
LA and AMLK
Arm Type
Active Comparator
Arm Description
Limbal autograft (LA) combined with AMLK is used for the treatment of patients with severe corneal burn.
Intervention Type
Procedure
Intervention Name(s)
Modified EA and AMLK
Intervention Description
Two pieces of corneal epithelial tissue with 2mmx3mm will be obtained from the fellow eye using femtosecond laser technology. This epithelial autograft (EA) is then ready for transplantation on the disease eye, following the procedure of allogeneic middle lamellar keratoplasty (AMLK).
Intervention Type
Procedure
Intervention Name(s)
LA and AMLK
Intervention Description
A 3-clock-hour limbal autograft (LA) will be obtained from the fellow eye. This is then ready for transplantation on the disease eye following the procedure of AMLK.
Primary Outcome Measure Information:
Title
Success rate of corneal reepithelialization in disease eyes
Description
The success rate of patients with completely epithelized and avascular corneal surface in disease eyes
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Unilateral severe corneal burn with more than half limbal stem cells deficiency (LSCD). The history of the disease is at least 12 months at the time of screening visit. Presence of superficial neo-vascularization affecting at least 2 cornea quadrants and involving central cornea. Informed consent signed by a patient or legal guardian, or having the ability to comply with study assessments for the full duration of the study. Exclusion Criteria: LSCD of mild degree, with less than 2 quadrants of neo-vessel invasion and without central cornea involvement. LSCD by ocular surface disorders other than ocular burns. Eyelids malposition. The center corneal thickness<450µm, the depth of corneal opacity<150µm or the full corneal lamellar opacity. High myopia with a spherical equivalent of -15.0 D or less. Corneal or ocular surface infection within 30 days prior to study entry. Ocular surface malignancy. Uncontrolled diabetes with most recent HgA1c greater than 8.5%. Renal failure with creatinine clearance ≤ 25mL/min per 1.73 m2. Alanine aminotransferase > 40IU/L, or aspartate aminotransferase > 40IU/L. Platelet levels < 150,000 or > 450,000 per microliter. Hemoglobin < 12.0 g/dL (male) or < 11.0 g/dL (female); Prothrombin time > 16s and activated partial thrombin time > 35s in patients not accepting anticoagulant therapy; An international normalized ratio greater than 3 in patients accepting anticoagulant therapy. Pregnancy (positive test) or lactation. Participation in another simultaneous medical investigation or clinical trial. Severe cicatricial eye disease; Conjunctival scarring with fornix shortening. Ocular comorbidities that affect the prognosis of transplantation, such as advanced glaucoma or retinal diseases. Severe dry eye disease as determined by Schirmer's test < 2mm at least in one eye. Any medical or social condition that in the judgment of the investigator would interfere with or serve as a contraindication to adherence to the study protocol or ability to give informed consent. Signs of current infection, including fever and treatment with antibiotics.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yingfeng Zheng
Phone
+8613922286455
Email
zhyfeng@mail.sysu.edu.cn
Facility Information:
Facility Name
Zhognshan Ophthalmic Center, Sun Yat-sen University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yizhi Liu

12. IPD Sharing Statement

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Modified Corneal EA With Middle LKP for Severe Corneal Burn

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