Transepithelial Corneal Collagen Cross-linking (CXL) in Treatment of Keratoconus
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Purpose
Transepithelial CXL (performed without epithelial removal) seem to have similar clinical effect on keratoconic eyes compared to the standard CXL (which includes epithelial removal). The current study attempts to prove that hypothesis.
A prospective, controlled, randomized, contralateral trial, will involve one eye of the patient to be treated with transepithelial CXL, while the control eye will be treated with the standard CXL. Totally 20 patients (age >18 and <40 years) referred by an ophthalmologist to the eye department of the University Hospital North Norway for CXL treatment of bilateral progressive keratoconus, will be recruited.
| Condition | Intervention | Phase |
|---|---|---|
|
Keratoconus |
Procedure: CXL without epithelial removal Procedure: CXL with epithelial removal |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Behandling av Keratoconus Med "Cornea Collagen Cross-linking" Uten Hornhinneepitelfjerning |
- Best corrected distant visual acuity (BCDVA) [ Time Frame: One year ] [ Designated as safety issue: Yes ]
- Corneal topographic keratoconus features [ Time Frame: One year ] [ Designated as safety issue: Yes ]Corneal topographic features (and indices) showing keratectatic development will be followed (K-values, optical asymmetry, posterior surface protrusion and thickness).
| Estimated Enrollment: | 20 |
| Study Start Date: | July 2010 |
| Estimated Study Completion Date: | May 2013 |
| Primary Completion Date: | May 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: CXL without epithelial removal |
Procedure: CXL without epithelial removal
UV-radiation of a Riboflavin saturated cornea without prior epithelial removal
|
| Active Comparator: CXL with epithelial removal |
Procedure: CXL with epithelial removal
UV-radiation of a Riboflavin saturated cornea after surgical epithelial removal has been performed
|
Detailed Description:
CXL appears to hinder the development of keratoconus by strengthening the cross-bindings in the corneal stroma with a resultant increase in corneal biomechanical strength of up to 300%. The method was introduced in the mid-nineties and has been approved for use in the EU countries since 2007. Standard treatment protocol, involving the removal of the corneal epithelium before the Riboflavin application, has been used. In order to avoid potential complications following removal of the epithelium (infection, delayed healing, scar formation, as well as discomfort and pain), a modified procedure where the epithelium is kept intact, so called transepithelial CXL, has been suggested. According to the preliminary results of the published retrospective studies, no significant difference in the clinical effect between the standard CXL with epithelial removal and the transepithelial CXL was found.
Eligibility| Ages Eligible for Study: | 18 Years to 40 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Documented keratoconus progression in both eyes during the last 12 months before the treatment - decrease in best spectacle-corrected visual acuity (BSCVA) and/or increase in cornea curvature or asymmetry
- Corneal thickness ≥400μm at the thinnest point
- Age range from 18 to 40
- Amsler-Krumeich classification graded stage I to III
Exclusion Criteria:
- Corneal thickness <400μm at the thinnest point
- History of viral keratitis
- Severe dry eye
- Concurrent corneal infections
- Previous ocular surgery
- Hard contact lens wear for ≤4 weeks before baseline examination
Contacts and Locations| Norway | |
| University Hospital North Norway | |
| Tromsoe, Troms, Norway, 9000 | |
| Principal Investigator: | Aleksandar Stojanovic, MD | University Hospital North Norway |
More Information
No publications provided
| Responsible Party: | University Hospital of North Norway |
| ClinicalTrials.gov Identifier: | NCT01181219 History of Changes |
| Other Study ID Numbers: | CXL-TE UNN2010 |
| Study First Received: | August 12, 2010 |
| Last Updated: | May 30, 2012 |
| Health Authority: | Norway: Norwegian Social Science Data Services |
Additional relevant MeSH terms:
|
Keratoconus Corneal Diseases Eye Diseases |
ClinicalTrials.gov processed this record on June 17, 2013