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Safety and Effectiveness Study of the MEL 80 Excimer Laser Using LASIK in the Treatment of Hyperopia

Primary Purpose

Hyperopia

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
MEL 80 Hyperopic LASIK Treatment
Sponsored by
Carl Zeiss Meditec, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hyperopia focused on measuring Hyperopia, Laser In Situ Keratomileusis, Laser Therapy, Laser Corneal Surgery, Refractive Surgical Procedures, Ophthalmologic Surgical Procedure, Operative Surgical Procedures, Therapeutics

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Naturally occurring hyperopia up to +6.0 D, with or without astigmatism of +0.50 D to +3.50 D at the spectacle plane, and MRSE ≤ +6.50 D;
  • Have ≤ 0.75 D of latent hyperopia as determined by the difference between the preoperative MRSE and CRSE;
  • A stable refraction for at least the last 12 months as documented by previous clinical records, i.e., the spherical and cylindrical portions of the manifest refraction have not progressed at a rate of more than 0.50 D during the year prior to the baseline examination in the eye to be treated;
  • Hard contact lens wearers must have two central keratometry readings and two manifest refractions taken at least one week apart that do not differ by more than 0.50 D;
  • Visual acuity correctable to at least 20/40 in both eyes;
  • Operative eye must be targeted for emmetropia;
  • At least 21 years of age;
  • Willing and able to return for scheduled follow up examinations for 24 months after surgery;
  • Sign and be given a copy of the written Informed Consent form.

Exclusion Criteria:

  • A history of anterior segment pathology, including cataracts (in the operative eye);
  • Severe dry eye syndrome unresolved by treatment;
  • Residual, recurrent, active ocular or uncontrolled eyelid disease, corneal scars within the ablation zone or other corneal abnormality such as recurrent corneal erosion or severe basement membrane disease;
  • Ophthalmoscopic signs of keratoconus (or keratoconus suspect);
  • An ablation deeper than 250 microns from the corneal endothelium;
  • Irregular or unstable (distorted/not clear) corneal mires on central keratometry readings;
  • Blind in the fellow eye;
  • Undergone previous intraocular or corneal surgery of any kind in the operative eye(s), including any type of excimer laser surgery for either refractive or therapeutic purposes;
  • A history of ocular Herpes zoster or Herpes simplex keratitis;
  • A history of steroid-responsive rise in intraocular pressure, glaucoma, or preoperative IOP >21 mm Hg;
  • Diabetes, diagnosed autoimmune disease, connective tissue disease, or clinically significant atopic syndrome;
  • Immunocompromised or use chronic systemic corticosteroid or other immunosuppressive therapy;
  • Pregnant, lactating, or be of childbearing potential and not practicing a medically approved method of birth control;
  • A known sensitivity to planned study medications;
  • Participating in any other ophthalmic drug or device clinical trial during the time of this clinical investigation;
  • At risk for angle closure or for developing strabismus postoperatively.
  • For Fellow (Second) Eyes in Simultaneous Bilateral Treatment Procedures
  • 1. Flap complications during the first eye's surgery such as a free cap, partial flap, thin flap, or irregular flap.
  • 2. Epithelial defect exceeding 2 mm x 2 mm in dimension, or clinically significant debris in the interface between the flap and underlying stroma for the first eye.
  • 3. Severe blepharospasm in the first eye that may have prevented or impeded the completion of the keratectomy and/or the laser ablation procedure.
  • 4. Poor subject cooperation with instructions for the first eye's surgery and/or poor subject fixation on the laser fixation target.
  • 5. Aborted LASIK procedure in the first eye or PRK was performed in the first eye because LASIK was not possible.

Sites / Locations

  • US Navy Refractive Surgery Center
  • Dishler Laser Institute
  • Discover Vision Centers
  • Fine, Hoffman, and Packer
  • Texan Eye Care
  • Davis Duehr Dean Eye Clinic

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Treatment of Hyperopic LASIK

Arm Description

Treatment of Hyperopic corrections ≤ +6.0 D with or without Astigmatism of +0.50 to +3.50 D and MRSE ≤ +6.50 D.

Outcomes

Primary Outcome Measures

At the point of stability, a minimum of 75% of eyes should have an achieved refraction within ± 1.00 D of the intended outcome, and at least 50% of eyes should be within ± 0.50 D of the intended outcome.
A minimum of 85% of eyes targeted for emmetropia should have an uncorrected visual acuity of 20/40 or better at the postoperative interval at which stability has been established.
A minimum of 95% of eyes should have a change of < 1.00 D in manifest refraction spherical equivalent (MRSE) between 2 refractions performed at least 3 months apart, and the mean rate of MRSE change per month should be < 0.04 D.
75% of eyes undergoing astigmatic treatment should be within ± 1.00 D of the attempted astigmatism correction by the point of stability.
Distance BSCVA of worse than 20/40 at the postoperative interval at which stability has been established should occur in less than 1.0% of eyes that had a BSCVA of 20/20 or better before surgery.
Loss of more than 2 lines of BSCVA should occur in less than 5.0% of eyes.
Less than 5% of eyes treated for sphere only should have a magnitude of postoperative manifest refractive astigmatism that varies from baseline cylinder by greater than 2.00 D at the postoperative interval at which stability has been established.
Incidence of Adverse Events to occur in less 1% of eyes

Secondary Outcome Measures

Subject Satisfaction: As measured by a subjective questionnaire, and will be considered as a secondary efficacy variable.
Incidence of Complications
Patient Symptoms: As measured by a subjective questionnaire, will be considered as a secondary safety variable.

Full Information

First Posted
September 26, 2008
Last Updated
August 9, 2012
Sponsor
Carl Zeiss Meditec, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00762281
Brief Title
Safety and Effectiveness Study of the MEL 80 Excimer Laser Using LASIK in the Treatment of Hyperopia
Official Title
A Prospective, Randomized, Multicenter Trial To Evaluate The Safety And Effectiveness Of The MEL 80 Excimer Laser Using LASIK (Laser In Situ Keratomileusis) For The Correction Of ≤ +6.0 D Of Hyperopia With Or Without Astigmatism Of +0.50 D To +3.50 D And MRSE ≤ +6.50 D
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Completed
Study Start Date
July 2004 (undefined)
Primary Completion Date
October 2006 (Actual)
Study Completion Date
October 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Carl Zeiss Meditec, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether the MEL 80 Excimer Laser is effective in the treatment of hyperopia, when used as part of the Laser In Situ Keratomileusis (LASIK) procedure.
Detailed Description
LASIK has become one of the most common refractive eye procedures performed in the country. In the hyperopia procedure, a steepening occurs on the corneal surface, rather than the flattening procedure (myopic treatment). The surgeon will produce a standard keratomileusis flap using a microkeratome, exposing the corneal stroma. Recontouring under the flap is then accomplished by the removal of tissue from the stroma with the laser. This recontouring results in an altering of effective lens power of the central cornea, measured in diopters (D). The MEL 80 Excimer Laser System will be evaluated for its ability to create accurate and stable hyperopic refractive correction results.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hyperopia
Keywords
Hyperopia, Laser In Situ Keratomileusis, Laser Therapy, Laser Corneal Surgery, Refractive Surgical Procedures, Ophthalmologic Surgical Procedure, Operative Surgical Procedures, Therapeutics

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
189 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment of Hyperopic LASIK
Arm Type
Other
Arm Description
Treatment of Hyperopic corrections ≤ +6.0 D with or without Astigmatism of +0.50 to +3.50 D and MRSE ≤ +6.50 D.
Intervention Type
Device
Intervention Name(s)
MEL 80 Hyperopic LASIK Treatment
Intervention Description
Treatment of Hyperopic corrections ≤ +6.0 D with or without Astigmatism of +0.50 to +3.50 D and MRSE ≤ +6.50 D.
Primary Outcome Measure Information:
Title
At the point of stability, a minimum of 75% of eyes should have an achieved refraction within ± 1.00 D of the intended outcome, and at least 50% of eyes should be within ± 0.50 D of the intended outcome.
Time Frame
Point of stability
Title
A minimum of 85% of eyes targeted for emmetropia should have an uncorrected visual acuity of 20/40 or better at the postoperative interval at which stability has been established.
Time Frame
Point of stability
Title
A minimum of 95% of eyes should have a change of < 1.00 D in manifest refraction spherical equivalent (MRSE) between 2 refractions performed at least 3 months apart, and the mean rate of MRSE change per month should be < 0.04 D.
Time Frame
Point of stability
Title
75% of eyes undergoing astigmatic treatment should be within ± 1.00 D of the attempted astigmatism correction by the point of stability.
Time Frame
Point of stability
Title
Distance BSCVA of worse than 20/40 at the postoperative interval at which stability has been established should occur in less than 1.0% of eyes that had a BSCVA of 20/20 or better before surgery.
Time Frame
Point of stability
Title
Loss of more than 2 lines of BSCVA should occur in less than 5.0% of eyes.
Time Frame
Point of stability
Title
Less than 5% of eyes treated for sphere only should have a magnitude of postoperative manifest refractive astigmatism that varies from baseline cylinder by greater than 2.00 D at the postoperative interval at which stability has been established.
Time Frame
Point of stability
Title
Incidence of Adverse Events to occur in less 1% of eyes
Time Frame
Postoperative visits
Secondary Outcome Measure Information:
Title
Subject Satisfaction: As measured by a subjective questionnaire, and will be considered as a secondary efficacy variable.
Time Frame
Postoperative visits 3, 6, 9, 12, 18 and 24 months
Title
Incidence of Complications
Time Frame
Postoperative visits
Title
Patient Symptoms: As measured by a subjective questionnaire, will be considered as a secondary safety variable.
Time Frame
Preoperative and Postoperative visits 3, 6, 9, 12, 18 and 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Naturally occurring hyperopia up to +6.0 D, with or without astigmatism of +0.50 D to +3.50 D at the spectacle plane, and MRSE ≤ +6.50 D; Have ≤ 0.75 D of latent hyperopia as determined by the difference between the preoperative MRSE and CRSE; A stable refraction for at least the last 12 months as documented by previous clinical records, i.e., the spherical and cylindrical portions of the manifest refraction have not progressed at a rate of more than 0.50 D during the year prior to the baseline examination in the eye to be treated; Hard contact lens wearers must have two central keratometry readings and two manifest refractions taken at least one week apart that do not differ by more than 0.50 D; Visual acuity correctable to at least 20/40 in both eyes; Operative eye must be targeted for emmetropia; At least 21 years of age; Willing and able to return for scheduled follow up examinations for 24 months after surgery; Sign and be given a copy of the written Informed Consent form. Exclusion Criteria: A history of anterior segment pathology, including cataracts (in the operative eye); Severe dry eye syndrome unresolved by treatment; Residual, recurrent, active ocular or uncontrolled eyelid disease, corneal scars within the ablation zone or other corneal abnormality such as recurrent corneal erosion or severe basement membrane disease; Ophthalmoscopic signs of keratoconus (or keratoconus suspect); An ablation deeper than 250 microns from the corneal endothelium; Irregular or unstable (distorted/not clear) corneal mires on central keratometry readings; Blind in the fellow eye; Undergone previous intraocular or corneal surgery of any kind in the operative eye(s), including any type of excimer laser surgery for either refractive or therapeutic purposes; A history of ocular Herpes zoster or Herpes simplex keratitis; A history of steroid-responsive rise in intraocular pressure, glaucoma, or preoperative IOP >21 mm Hg; Diabetes, diagnosed autoimmune disease, connective tissue disease, or clinically significant atopic syndrome; Immunocompromised or use chronic systemic corticosteroid or other immunosuppressive therapy; Pregnant, lactating, or be of childbearing potential and not practicing a medically approved method of birth control; A known sensitivity to planned study medications; Participating in any other ophthalmic drug or device clinical trial during the time of this clinical investigation; At risk for angle closure or for developing strabismus postoperatively. For Fellow (Second) Eyes in Simultaneous Bilateral Treatment Procedures 1. Flap complications during the first eye's surgery such as a free cap, partial flap, thin flap, or irregular flap. 2. Epithelial defect exceeding 2 mm x 2 mm in dimension, or clinically significant debris in the interface between the flap and underlying stroma for the first eye. 3. Severe blepharospasm in the first eye that may have prevented or impeded the completion of the keratectomy and/or the laser ablation procedure. 4. Poor subject cooperation with instructions for the first eye's surgery and/or poor subject fixation on the laser fixation target. 5. Aborted LASIK procedure in the first eye or PRK was performed in the first eye because LASIK was not possible.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven Dell, MD
Organizational Affiliation
Texan Eye Care
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
John Doane, MD
Organizational Affiliation
Discover Vision Centers
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Richard Hoffman, MD
Organizational Affiliation
Fine, Hoffman, and Packer LLC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Howard Fine, MD
Organizational Affiliation
Fine, Hoffman, and Packer LLC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mark Packer, MD
Organizational Affiliation
FIne, Hoffman, and Packer LLC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
David Tanzer, MD
Organizational Affiliation
US Navy Refractive Surgery Center, San Diego, CA
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Steve Schallhorn, MD
Organizational Affiliation
US Navy Refractive Surgery Center, San Diego, CA
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
John Vukich, MD
Organizational Affiliation
Davis Duehr Dean Eye Clinic
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jon Dishler, MD
Organizational Affiliation
Dishler Laser Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
US Navy Refractive Surgery Center
City
San Diego
State/Province
California
ZIP/Postal Code
92106
Country
United States
Facility Name
Dishler Laser Institute
City
Greenwood Village
State/Province
Colorado
ZIP/Postal Code
80111
Country
United States
Facility Name
Discover Vision Centers
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64055
Country
United States
Facility Name
Fine, Hoffman, and Packer
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Facility Name
Texan Eye Care
City
Austin
State/Province
Texas
ZIP/Postal Code
78746
Country
United States
Facility Name
Davis Duehr Dean Eye Clinic
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53717
Country
United States

12. IPD Sharing Statement

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Safety and Effectiveness Study of the MEL 80 Excimer Laser Using LASIK in the Treatment of Hyperopia

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