Optical Coherence Tomography Guided Transepithelial Phototherapeutic Keratectomy
Optical Coherence Tomography (OCT) machines are non-contact instruments that can measure the depth of scars and other causes of cloudiness in the front of the cornea. The purpose of this study is to determine whether OCT-guided settings for the lasers used for removal of corneal scars and other partial-thickness corneal defects result in improved vision in patients receiving these procedures.
|Study Design:||Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Optical Coherence Tomography Guided Transepithelial Phototherapeutic Keratectomy|
- Improvement in best spectacle-corrected visual acuity (BSCVA) after PTK [ Time Frame: 3-4, 6-8, and 12-14 months after the PTK procedure ] [ Designated as safety issue: No ]The primary goal of the trial is to determine the efficacy of the OCT-guided PTK treatment of corneal opacities. During the course of the trial, we will compare the predictive accuracy of the original OCT-guided PTK planning system to the OCT topography-guided system.
- Improvement in uncorrected visual acuity (UCVA), refractive error, and higher order aberrations [ Time Frame: 3-4, 6-8, and 12-14 months after the PTK procedure ] [ Designated as safety issue: No ]A second goal is to develop a more sophisticated OCT guidance system incorporating OCT topography of anterior and posterior corneal surfaces and to develop a mathematical model that relates epithelial thickness variation to corneal mean curvature. During the course of the trial, we will compare the predictive accuracy of the original OCT-guided PTK planning system to the OCT topography-guided system.
|Study Start Date:||June 2011|
|Estimated Study Completion Date:||July 2016|
|Estimated Primary Completion Date:||July 2016 (Final data collection date for primary outcome measure)|
OCT is assisting in surgery guidance.
Drug: OCT-guided laser phototherapeutic keratectomy
Preoperative measurements from the OCT are used to assist the calculation in deciding the laser depth settings for removal of anterior corneal opacities and defects in the phototherapeutic PTK procedure. The surgeon uses the OCT data to plan a range of treatment parameters to remove most of the opacity while preserving at least 250 microns of residual corneal stroma.
The long-term goal of this project is to utilize newly available very high-speed OCT technology to guide surgical treatments of corneas with superficial opacities and irregularities. OCT is well known for its exquisite resolution, but until recently it has not had sufficient speed to capture the shape of the cornea because of eye motion during OCT scanning. The development of Fourier-domain OCT (FD-OCT) technology has made the requisite speed possible.
Eyes with superficial opacities (corneal scars and stromal dystrophies) can be treated by phototherapeutic keratectomy (PTK). Currently, many surgeons rely on subjective slit-lamp impression of opacity depth to guide PTK and repeat slit-lamp examinations during surgery to determine if the opacity has been sufficiently reduced. Unpredictable hyperopic shifts can occur after PTK. The aim of this project is to develop methods for imaging the cornea with an FD-OCT system that will precisely measure corneal shape and use this information to guide surgery. Patients with irregularly shaped corneas could have their vision restored by reshaping the corneas with a procedure that combines the precision of OCT and lasers.
|Contact: Janice Ladwigfirstname.lastname@example.org|
|United States, Oregon|
|Casey Eye Institute, Oregon Health & Science University||Recruiting|
|Portland, Oregon, United States, 97239|
|Contact: Janice Ladwig 503-494-8024 email@example.com|
|Contact: Denny Romfh 503-494-4351 firstname.lastname@example.org|
|Principal Investigator: Frederick (Rick) W. Fraunfelder, MD|
|Principal Investigator:||Frederick (Rick) W. Fraunfelder, MD||Casey Eye Institute, Oregon Health & Science University|