Corneal Epithelial Autograft for LSCD

August 7, 2019 updated by: Chunxiao Wang

A Randomized Controlled Clinical Trial of Corneal Epithelial Autograft for the Treatment of Limbal Stem Cell Deficiency

The purpose of the study is to explore whether femtosecond laser-assisted corneal epithelial autograft is more effective than limbal conjunctival autograft for ocular surface reconstruction in patients with limbal stem cell deficiency (LSCD).

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Guangdong
      • Guanzhou, Guangdong, China, 510000
        • Recruiting
        • Zhongshan Ophthalmic Center, Sun Yat-sen Univerisity

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years to 80 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Unilateral LSCD secondary to ocular burns, with the duration of disease of at least 24 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 patient or legal guardian. 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 pterygium;
  3. Eyelids malposition;
  4. The center corneal thickness<450µm, the depth of corneal opacity > 150µm;
  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 Hemoglobin A1c greater than 8.5%;
  9. Renal failure with creatinine clearance< 25ml/min;
  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;
  21. Active immunological diseases;
  22. History of allo-limbal transplantation, penetrating keratoplasty or anti-glaucoma filtering surgeries.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Corneal epithelial autograft
Femtosecond laser assisted corneal epithelial autograft from the other eye in the treatment of LSCD
A commercial femtosecond laser to create a particular shaped graft for transplantation
Epithelial tissue, equal in area to the diseased eye's cornea bed, will be obtained from the fellow eye using femtosecond laser technology. This corneal epithelial autograft is then ready for transplantation on the disease eye, following removal of scarred and diseased epithelium.
Active Comparator: Limbal conjunctival autograft
Diamond knife assisted limbal conjunctival autograft from the other eye in the treatment of LSCD
A diamond knife to create a particular shaped limbal graft for transplantation
A 3- to 5- clock hour limbal-conjunctival autograft will be obtained from the fellow eye. This is then ready for transplantation on the disease eye following removal of scarred and diseased epithelium.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Restoration of corneal surface in the diseased eye
Time Frame: 1 year
Restoration of a completely epithelized, stable, and avascular corneal surface in the diseased eye.
1 year
Restoration of corneal surface in the fellow eye
Time Frame: 1 year
Restoration of a completely epithelized, stable, and avascular corneal surface in the fellow eye.
1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Uncorrected and best-corrected visual acuity in both eyes
Time Frame: 1 year
To measure changes of uncorrected and best-corrected visual acuity using ETDRS chart.
1 year
Corneal power, astigmatism and aberration in both eyes
Time Frame: 1 year
To changes of corneal power, astigmatism and aberration using autorefractor keratometer and wavefront aberrometer respectively.
1 year
Corneal sensation in both eyes
Time Frame: 1 year
To assess corneal sensation using Cochet-Bonnet esthesiometer.
1 year
Corneal thickness in both eyes
Time Frame: 1 year
To measure corneal thickness using anterior segment optical coherence tomography (AS-OCT).
1 year
Density of stromal nerve and stromal keratocytes in both eyes
Time Frame: 1 year
To assessing density of stromal nerve and stromal keratocytes using in vivo confocal microscopy.
1 year
Reconstruction of limbal palisades of Vogt in the diseased eye
Time Frame: 1 year
To assessing reconstruction of limbal palisades of Vogt using in vivo confocal microscopy.
1 year
Corneal haze in both eyes
Time Frame: 1 year
To measuring corneal haze using in vivo confocal microscopy.
1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 25, 2017

Primary Completion (Anticipated)

October 30, 2019

Study Completion (Anticipated)

December 30, 2019

Study Registration Dates

First Submitted

July 12, 2017

First Submitted That Met QC Criteria

July 12, 2017

First Posted (Actual)

July 14, 2017

Study Record Updates

Last Update Posted (Actual)

August 9, 2019

Last Update Submitted That Met QC Criteria

August 7, 2019

Last Verified

August 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • 2017KYPJ051

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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