- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05436665
The Belgian Endothelial Surgical Transplant of the Cornea (BESTCornea)
The Belgian Endothelial Surgical Transplant of the Cornea:Clinical and Patient-reported Outcomes of Descemet Stripping Automated Endothelial Keratoplasty(DSAEK) Versus Descemet Membrane Endothelial Keratoplasty(DMEK)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The current problem concerns variability in the provision of corneal endothelial keratoplasties available to patients in Belgium. Some patients receive DSAEK and some (albeit fewer) receive DMEK. Currently the type of corneal graft that a patient receives depends on the treating surgeon opinions.
In this study 220 patients in 11 surgical centres will be recruited and allocated to one of the two surgical options. Both the Ultrathin DSAEK and DMEK grafts will be prepared by corneal banks in the University Hospital of Liege and University Hospital of Antwerp respectively. Patients will be examined preoperatively and postoperatively at 3, 6 and 12 months. Clinical information such as best-corrected visual acuity and refraction will be collected as well as quality of life information based on the EQ-5D-5L and the VFQ 25 assessment tools. These data be used to compare the interventions both on the clinical level as well as from the patient perspective.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Veerle Van Gerwen, BSc
- Phone Number: 5271 +3238210000
- Email: bestcornea@uza.be
Study Contact Backup
- Name: Ann Deconinck, BSc
- Phone Number: 2466 +3238210000
- Email: bestcornea@uza.be
Study Locations
-
-
-
Bonheiden, Belgium
- Recruiting
- AZ Imelda
-
Contact:
- Leslie Deroy
- Email: leslie.deroy@imelda.be
-
Principal Investigator:
- Karolien Termote, MD
-
Brussel, Belgium
- Recruiting
- UZ Brussel
-
Principal Investigator:
- Karolien Termote, MD
-
Contact:
- Bert Verhelst
- Email: bert.verhelst@uzbrussel.be
-
Sub-Investigator:
- Sorcha Ni Dhubhghaill, PhD
-
Brussel, Belgium
- Recruiting
- Erasmus ziekenhuis Brussel
-
Principal Investigator:
- Marc Schrooyen, PhD
-
Sub-Investigator:
- Pauline Le Roux, MD
-
Contact:
- Pauline Le Roux
- Email: pauline.leroux@hubruxelles.be
-
Deurne, Belgium
- Recruiting
- AZ Monica (campus Deurne)
-
Contact:
- Caroline Lamoen
- Email: caroline.lamoen@azmonica.be
-
Principal Investigator:
- Isabel Bleyen, MD
-
Genk, Belgium
- Recruiting
- Ziekenhuis Oost-Limburg (ZOL)
-
Contact:
- Frauke Somers
- Email: frauke.somers@zol.be
-
Principal Investigator:
- Sacha Gast, MD
-
Gent, Belgium
- Recruiting
- UZ Gent
-
Contact:
- Julie Sambaer
- Email: octu@uzgent.be
-
Principal Investigator:
- Dimitri Roels, MD
-
Leuven, Belgium
- Recruiting
- UZ Leuven
-
Principal Investigator:
- Heleen Delbeke, PhD
-
Sub-Investigator:
- Isabelle Saelens, PhD
-
Contact:
- Martine Spaas
- Email: martine.spaas@uzleuven.be
-
Liège, Belgium
- Recruiting
- CHU Liege
-
Contact:
- Séverine Camby
- Email: s.camby@chuliege.be
-
Principal Investigator:
- Bernard Duchense, PhD
-
-
Antwerp
-
Edegem, Antwerp, Belgium, 2650
- Recruiting
- Antwerp University Hospital
-
Contact:
- veerle Van Gerwen, BSc
- Email: veerle.vangerwen@uza.be
-
Principal Investigator:
- Carina Koppen, PhD
-
-
Oost-Vlaanderen
-
Gent, Oost-Vlaanderen, Belgium
- Recruiting
- AZ Maria Middelares
-
Contact:
- Ilse Claerhout, PhD
- Email: Ilse.Claerhout@azmmsj.be
-
Principal Investigator:
- Ilse Claerhout, PhD
-
-
West-Vlaanderen
-
Brugge, West-Vlaanderen, Belgium
- Recruiting
- AZ Sint-Jan Brugge
-
Contact:
- Liesbeth Laloo
- Email: Liesbeth.Laloo@azsintjan.be
-
Principal Investigator:
- Sophie De Craene, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Fuchs Endothelial Dystrophy (FED);
- Bullous Keratopathy (BK);
- Other miscellaneous causes of endothelial dysfunction including decompensation of a previous corneal graft;
- Pseudophakic (post cataract surgery);
- Patients over 18 with the capacity to read and to understand the study information and to give informed consent, as well as study quality of life questionnaires;
- Patients willing and capable to attend the 3, 6, and 12-month follow-up appointments.
Exclusion Criteria:
- Inability to provide informed consent;
- Patients unable to attend the proposed follow up;
- Inclusion of the fellow eye in the study;
- Complex surgery combined with multiple pathologies (i.e., glaucoma surgery);
- Other contraindications to lamellar corneas surgery;
- Patients who elect not to participate;
- Patients under 18 years of age;
- Patients that are currently pregnant or breastfeeding;
- Phakic patients with no direct plan to perform cataract surgery.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: UT-DSAEK
Ultra-thin Descemet Stripping Automated Endothelial Keratoplasty refers to the use of a corneal endothelial/Descemet graft with a thin layer of stroma (<110um) attached.
|
The main incision (3.5-5mm) is created at the corneal limbus or via a cornea-scleral tunnel with 2-3 smaller (approx. 1mm) paracentesis incisions. An ophthalmic viscosurgical device (OVD) or a continuous infusion of water or air can be used to maintain the stability of the anterior chamber, according to the surgeon's preference. The corneal endothelium is scored using a scoring instrument and the central diseased corneal endothelium is removed. Once the anterior chamber is prepared, OVD or air has been removed, then the eye is ready for the new corneal graft. The pre-cut corneal tissue delivered by the bank is then gently rinsed and may be stained with 0.06% trypan blue if required. The tissue is loaded into a glide or injector, and pulled into the anterior chamber using a smooth-tipped micro-forceps (e.g., Busin forceps). Once the graft enters the eye, it is lifted to the posterior cornea. The graft is further centred using air (or SF6 Gas) in the anterior chamber.
Other Names:
|
Active Comparator: DMEK
Descemet membrane endothelial keratoplasty refers to the use of a corneal endothelial/Descemet graft with no layer of associated stroma (15-20um thick)
|
The main incision (2.8-3mm) is created superior or temporally at the corneal limbus and is accompanied by 2-3 smaller paracentesis incisions. An ophthalmic viscosurgical device (OVD) or a continuous infusion of water or air can be used to maintain the stability of the anterior chamber. The corneal endothelium is scored using a scoring instrument and the central diseased corneal endothelium is removed. The DMEK roll is poured into a basin and rinsed. The graft is then stained with 0.06% trypan blue to aid in graft visualization. The graft is loaded into an injector and introduced into the anterior chamber. The graft is unrolled using external manoeuvres and once unrolled, it is lifted to the back of the cornea. The eye is then pressurised with a full air fill from 10 to 120 minutes. The pressure is then reduced and the case is completed by suturing any incisions required.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
BCVA 12m
Time Frame: 12 months
|
Best-corrected visual acuity expressed in LogMAR
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
BCVA 3 and 6m
Time Frame: 3 and 6 months
|
Best-corrected visual acuity expressed in LogMAR
|
3 and 6 months
|
UCVA 3,6 and12m
Time Frame: 3, 6 and 12 months
|
Uncorrected visual acuity expressed in LogMAR
|
3, 6 and 12 months
|
Change in refraction
Time Frame: 3, 6 and 12 months
|
Change in objective refraction - spectacle correction
|
3, 6 and 12 months
|
Proportion of high vision
Time Frame: 12 months
|
Proportion of patients to achieve 0.2 LogMAR visual acuity or less
|
12 months
|
EQ-5D-5L
Time Frame: 3, 6 and 12 months
|
Quality of life measured by the fifth level EuroQol (EQ-5L) instrument where five dimensions are scored at 5 levels - the higher the level, the worse the health state.
The digits for the five dimensions can be combined to a 5-digit number to describe the patient's health state
|
3, 6 and 12 months
|
VFQ 25
Time Frame: 3, 6 and 12 months
|
Vision related quality of life measured by the Visual Function Questionnaire(VFQ-25) scored on a scale of 0-100, with a higher score reporesenting higher quality of vision related quality of life.
|
3, 6 and 12 months
|
ECC
Time Frame: 3, 6 and 12 months
|
Endothelial cell count
|
3, 6 and 12 months
|
CCT
Time Frame: 3, 6 and 12 months
|
Central corneal thickness
|
3, 6 and 12 months
|
Complications
Time Frame: 12 months
|
Complications associated with the intervention
|
12 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Carina Koppen, MD, PhD, University Hospital, Antwerp
- Study Chair: Bernard Duchesne, MD, PhD, University Hospital Liege
- Study Director: Sorcha Ni Dhubhghaill, MBBCh, PhD, Universitair Ziekenhuis Brussel
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UZAntwerpen
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Data sharing of the final trial dataset will be offered in the following manner:
The Chief Investigator, Trial Steering Committee, and the Sponsor (including data monitors) will have access to the trial dataset, but a site's Prinicpal Investigator may submit a request for data access.
This will be discussed and approved by the Trial Steering Committee. Upon conclusion of the trial, individual participant data that underlie the results reported in the article (after deidentification) will be shared upon the request of any relevant interested party.
Access to the final trial dataset by other parties: reasonable requests for access to trial data from other parties will be considered and approved in writing where appropriate, following formal application to the Trial Steering Committee (bestcornea@uza.be).
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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