Topo-pachimetric Accelerated Epi-On Cross-linking Compared to Dresden Protocol Using Riboflavin With Vitamin E TPGS
Primary Purpose
Keratoconus
Status
Completed
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
accelerated custom-fast CXL
Standard CXL
Sponsored by
About this trial
This is an interventional treatment trial for Keratoconus
Eligibility Criteria
Inclusion Criteria:
- documented progressive keratoconus
- changes in uncorrected distance visual acuity (UDVA) above 1.00 D
- Corrected distance visual acuity (BCVA) above 1.00 D
- spherical equivalent greater than 0.50 D
Exclusion Criteria:
- Corneal pachymetry of less than 400 µm
- less than 2000 cells/cm2,
- corneal scarring,
- nystagmus or any motility disorder that prevented a fixed gaze during the examination
- Current contact lens use
Sites / Locations
- Pellegrini Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
sCXL
aCFXL
Arm Description
Standard protocol of Dresden Riboflavin-VEPTGS solution applied every 2 mins during UV UVA fluence of 3mW/cm2 UVA Irradiation time 30 minutes
Accelerated custom fast CXL protocol. The protocol has been developed on a published mathematical model that takes into consideration objective variables such as the equation governing the UVA-induced riboflavin con-sumption rate and the corneal thickness at its thinnest point. Riboflavin-VEPTGS solution: Epithelial lavage before UV UVA fluence of 1.8 ±0.9 mW/cm2 UVA Irradiation time 10 ± 1.5 minutes
Outcomes
Primary Outcome Measures
Topographical parameters
Maximum keratometry: diopters Mean keratometry: diopters Minimum corneal tickness: diopters
Secondary Outcome Measures
Refractive parameters
Corrected distance acuity (BCVA): Logarithm of the Minimum Angle of Resolution (logMAR)
Refractive parameters
Spherical equi-valent: diopters Refractive cylinder magnitude: diopters
Biomechanical parameters
Corneal hysteresis: mmHg
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05019768
Brief Title
Topo-pachimetric Accelerated Epi-On Cross-linking Compared to Dresden Protocol Using Riboflavin With Vitamin E TPGS
Official Title
Topo-pachimetric Accelerated Epi-On Cross-linking Compared to Dresden Protocol Using Riboflavin With Vitamin E TPGS: Results of a 2-year Randomized Study
Study Type
Interventional
2. Study Status
Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
September 1, 2017 (Actual)
Primary Completion Date
December 31, 2020 (Actual)
Study Completion Date
December 31, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Ciro Caruso
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 the present study the investigators compare the clinical outcome corneal cross linking with either the stand-ard Dresden (sCXL) or the accelerated custom-fast (aCFXL) ultraviolet A irradiation protocol using riboflavin-D-α-Tocopheryl polyethyleneglycol1000 succinate for progressive keratoconus.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Keratoconus
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
41 (Actual)
8. Arms, Groups, and Interventions
Arm Title
sCXL
Arm Type
Active Comparator
Arm Description
Standard protocol of Dresden Riboflavin-VEPTGS solution applied every 2 mins during UV UVA fluence of 3mW/cm2 UVA Irradiation time 30 minutes
Arm Title
aCFXL
Arm Type
Experimental
Arm Description
Accelerated custom fast CXL protocol. The protocol has been developed on a published mathematical model that takes into consideration objective variables such as the equation governing the UVA-induced riboflavin con-sumption rate and the corneal thickness at its thinnest point.
Riboflavin-VEPTGS solution: Epithelial lavage before UV UVA fluence of 1.8 ±0.9 mW/cm2 UVA Irradiation time 10 ± 1.5 minutes
Intervention Type
Other
Intervention Name(s)
accelerated custom-fast CXL
Intervention Description
The accelerated custom fast CXL (aCFXL) has been developed on a published mathematical model that takes into consideration objective variables such as the equation governing the UVA-induced riboflavin consumption rate and the corneal thickness at its thinnest point. By knowing both values, the mathematical model allows to objectively calculate both the exact UVA irradiation value (intensity), expressed in mW/cm2, and the irradiation time
Intervention Type
Other
Intervention Name(s)
Standard CXL
Intervention Description
The standard CXL procedure has been carried on following the Dresden protocol
Primary Outcome Measure Information:
Title
Topographical parameters
Description
Maximum keratometry: diopters Mean keratometry: diopters Minimum corneal tickness: diopters
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Refractive parameters
Description
Corrected distance acuity (BCVA): Logarithm of the Minimum Angle of Resolution (logMAR)
Time Frame
2 years
Title
Refractive parameters
Description
Spherical equi-valent: diopters Refractive cylinder magnitude: diopters
Time Frame
2 years
Title
Biomechanical parameters
Description
Corneal hysteresis: mmHg
Time Frame
2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
documented progressive keratoconus
changes in uncorrected distance visual acuity (UDVA) above 1.00 D
Corrected distance visual acuity (BCVA) above 1.00 D
spherical equivalent greater than 0.50 D
Exclusion Criteria:
Corneal pachymetry of less than 400 µm
less than 2000 cells/cm2,
corneal scarring,
nystagmus or any motility disorder that prevented a fixed gaze during the examination
Current contact lens use
Facility Information:
Facility Name
Pellegrini Hospital
City
Napoli
Country
Italy
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
26606293
Citation
Caruso C, Ostacolo C, Epstein RL, Barbaro G, Troisi S, Capobianco D. Transepithelial Corneal Cross-Linking With Vitamin E-Enhanced Riboflavin Solution and Abbreviated, Low-Dose UV-A: 24-Month Clinical Outcomes. Cornea. 2016 Feb;35(2):145-50. doi: 10.1097/ICO.0000000000000699.
Results Reference
background
PubMed Identifier
28257382
Citation
Caruso C, Epstein RL, Ostacolo C, Pacente L, Troisi S, Barbaro G. Customized Corneal Cross-Linking-A Mathematical Model. Cornea. 2017 May;36(5):600-604. doi: 10.1097/ICO.0000000000001160.
Results Reference
background
Learn more about this trial
Topo-pachimetric Accelerated Epi-On Cross-linking Compared to Dresden Protocol Using Riboflavin With Vitamin E TPGS
We'll reach out to this number within 24 hrs