Study of the MEL 80 Excimer Laser Using LASIK in the Treatment of Moderate to High Myopia

A Prospective Multicenter Trial To Evaluate The Safety And Effectiveness Of The MEL 80 Excimer Laser Using LASIK (Laser In Situ Keratomileusis) For The Correction Of > -7.00 D to -12.00 D Of Myopia With Up To -6.00 D Of Astigmatism, and Maximum MRSE of ≤ -12.00 D

The purpose of this study is to determine whether the MEL 80 Excimer Laser is effective in the treatment of moderate to high myopia (nearsightedness), when used as part of the Laser In Situ Keratomileusis (LASIK) procedure.

Study Overview

• Status: Completed
• Conditions: Myopia
• Intervention / Treatment: Device: MEL 80 Treatment of High Myopia

Detailed Description

LASIK has become one of the most common refractive eye procedures performed in the country. Currently the MEL 80 Excimer Laser System is approved for the elimination of myopia of less than or equal to -7.0 D with or without refractive astigmatism of less than or equal to -3.0 D, with a maximum MRSE of -7.00 D. The goal of this study is to assess the safety and effectiveness information on the treatment of moderate to high magnitudes of myopia.

• Study Type: Interventional
• Enrollment (Actual): 129
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • San Diego, California, United States, 92106
      • US Navy Refractive Surgery Center
  • Colorado
    • Greenwood Village, Colorado, United States, 80111
      • Dishler Laser Institute
  • Missouri
    • Kansas City, Missouri, United States, 64055
      • Discover Vision Centers
  • Oregon
    • Eugene, Oregon, United States, 97401
      • Fine, Hoffman, and Packer
  • Wisconsin
    • Madison, Wisconsin, United States, 53717
      • Davis Duehr Dean Eye Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Myopia > -7.00 D to -12.00 D, and astigmatism less than or equal to -6.00 D at the spectacle plane, with a maximum MRSE ≤-12.00 D.
• Stable refraction for at least the last twelve months, as demonstrated by a change of less than 1.00 D of the spherical equivalent during the twelve months prior to the baseline examination of the eye to be treated, documented by previous clinical records.
• Discontinue use of contact lenses at least 2 weeks for hard contacts and 3 days for soft lenses prior to the preoperative examination.
• 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.
• UCVA of 20/40 or worse in the operative eye.
• At least 18 years of age.
• Operative eye must be targeted for emmetropia.
• Have a normal corneal topography.
• Willing and able to return for scheduled follow up examinations for twelve months after surgery.
• Sign and be given a copy of the written Informed Consent form.

Exclusion Criteria:

• History of anterior segment pathology, including cataracts (in the operative eye).
• Clinically significant 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 progressive or unstable myopia or 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 surgery for either refractive or therapeutic purposes.
• History of ocular Herpes zoster or Herpes simplex keratitis.
• History of steroid-responsive rise in intraocular pressure, glaucoma, or preoperative IOP >21 mm Hg.
• Must not have diabetes, diagnosed autoimmune disease, connective tissue disease, or clinically significant atopic syndrome.
• Must not be immunocompromised or use chronic systemic corticosteroid or other immunosuppressive therapy.
• Patients must not be pregnant, lactating, or of child-bearing potential and not practicing a medically approved method of birth control.
• Patients must not have a known sensitivity to planned study medications.
• Patients must not be participating in any other ophthalmic drug or device clinical trial during the time of this clinical investigation.
• 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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
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.	Point of stability
At the point of stability, for myopes > 7 D spherical equivalent (SE), a minimum of 30% should have an achieved refraction within ± 0.50 D of the intended outcome, and 60% should have an achieved refraction within ± 1.00 D of the intended outcome.	Point of stability
For myopes > 7 D spherical equivalent (SE), a minimum of 75% of eyes should have an uncorrected visual acuity of 20/40 or better at the postoperative interval at which stability has been established.	Point of stability
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.	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% of eyes that had a BSCVA of 20/20 or better before surgery.	Point of stability
Loss of more than 2 lines of BSCVA should occur in less than 5% of eyes	Point of stability
Incidence of Adverse Events to occur in less than 1% of eyes	Postopertive visits

Secondary Outcome Measures

Outcome Measure	Time Frame
Subject Satisfaction: As measured by a subjective questionnaire, and will be considered as a secondary efficacy variable.	Postoperative visits 3, 6, 9 and 12 months
Incidence of Complications	Postoperative visits
Patient Symptoms: As measured by a subjective questionnaire, will be considered as a secondary safety variable	Preoperative and Postoperative visits 3, 6, 9 and 12 months

Collaborators and Investigators

• Sponsor: Carl Zeiss Meditec, Inc.
• Investigators: Principal Investigator: John Doane, MD, Discover Vision Centers; Principal Investigator: Richard Hoffman, MD, FIne, Hoffman, and Packer LLC; Principal Investigator: Howard Fine, MD, FIne, Hoffman, and Packer LLC; Principal Investigator: Mark Packer, MD, FIne, Hoffman, and Packer LLC; Principal Investigator: David Tanzer, MD, US Navy Refractive Surgery Center, San Diego, CA; Principal Investigator: John Vukich, MD, Davis Duehr Dean Eye Clinic; Principal Investigator: Jon Dishler, MD, Dishler Laser Institute

Study record dates

Study Major Dates

• Study Start: October 1, 2006
• Primary Completion (Actual): July 1, 2008
• Study Completion (Actual): July 1, 2009

Study Registration Dates

• First Submitted: September 26, 2008
• First Submitted That Met QC Criteria: September 26, 2008
• First Posted (Estimate): September 30, 2008

Study Record Updates

• Last Update Posted (Actual): July 19, 2018
• Last Update Submitted That Met QC Criteria: July 17, 2018
• Last Verified: July 1, 2018

More Information

Terms related to this study

• Keywords: Therapeutics; Myopia; Laser Therapy; Laser In Situ Keratomileusis; Laser Corneal Surgery; Refractive Surgical Procedures; Ophthalmologic Surgical Procedure; Operative Surgical Procedures
• Additional Relevant MeSH Terms: Eye Diseases; Refractive Errors; Myopia
• Other Study ID Numbers: MEL 80-2006-1