Validation of Innovative Scheimpflug Topography Derived RGP Contact Lens Designs In Optometry Network (VISION)

The goal of this Prospective, single-site, cohort study is to validate rigid gas permeable corneal contact lens (RGP) designs for keratoconus derived from combining the data from corneal topography scans and contact lenses ordered in patients with keratoconus (KC) attending a UK tertiary NHS Hospital contact lens clinic. The main questions it aims to answer are:

  • Does a Scheimpflug topography derived RGP contact lens design for keratoconus have the equivalent overall contact lens fit as the patients' own lens?
  • Is the number of trial lenses required to fit a patient is reduced compared to standard practice?
  • Is the time taken to fit a contact lens is reduced compared to standard practice?
  • Is there user acceptance of the new lens?
  • Are the Axial ege lift (AEL) changes clinically significant?

There will be 3 work packages

WP1: For each participant data collection will take place over two visits.

• Visit 1: Pentacam topography scans and optimal 'virtual' lens selection will take place. • • Visit 2: Participants are fitted with 4 contact lenses (i) the optimal lens design as specified by the virtual fitting module, (ii) a contact lens with a clinically significant step flatter AEL (iii) a contact lens steeper in axial edge lift (AEL) (iv) the participant's own contact lens.

Each CL fit will be assessed with slit lamp photography according to the standardised method proposed by Wolffsohn et al. (2013), Anterior segment OCT MS39) (CSO Hansom Instruments, UK) and best-corrected visual acuity with each lens design using high-contrast logMAR .

WP2. Participants will attend one appointment where a traditional lens fit, and a lens fitted using the topography guided 'virtual' module will be undertaken (with the fitting method selected for each eye randomised). For each fitting method the total fitting time will be measured and the total number of trial contact lenses used. Patients will be invited to complete a questionnaire that probes their satisfaction of this process.

WP3. Clinicians not involved in the study will be invited to examine a demo version of the virtual fitting module and complete the validated system usability scale tool.

Study Overview

Study Type

Observational

Enrollment (Actual)

120

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

      • London, United Kingdom, EC1V 2PD
        • Moorfields Eye Hospital NHS Foundation Trust

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Patients with keratoconus (KC) attending Moorfields contact lens clinics

Description

Inclusion Criteria:

  • - WP1:
  • (a) Presence of keratoconus in either eye
  • (b) Currently using a rigid gas permeable contact lens correction
  • (c) Male or female, aged 18 years or older
  • (d) The absence of significant media opacities
  • (e) No ocular pathology other than keratoconus
  • (f) Ability to understand nature/purpose of the study and to provide informed consent
  • (g) Ability to follow instructions and complete the study
  • (h) Ability to speak English
  • WP2:
  • (a) Presence of keratoconus in both eyes
  • (b) Male or female, aged 18 years or older
  • (c) The absence of significant media opacities
  • (d) No ocular pathology other than keratoconus
  • (e) Ability to understand nature/purpose of the study and to provide informed consent
  • (f) Ability to follow instructions and complete the study
  • (g) Ability to speak English
  • WP3:
  • (a) Optometrist, dispensing optician or ophthalmologist registered with the General Optical Council
  • (b) Works within contact lens service at Moorfields Eye Hospital
  • (c) Ability to understand nature/purpose of the study and to provide informed consent
  • (d) Ability to follow instructions and complete the study
  • (e) Ability to speak English .

Exclusion Criteria:

  • - WP1:
  • (a) Any systemic disease likely to affect visual performance
  • (b) Any ocular disease that may affect visual performance, other than keratoconus
  • (c) Hearing impairment sufficient to interfere with hearing instructions
  • (d) Poor understanding of English language and/or alphabet
  • (e) Any condition which, in the investigator's opinion, would conflict or otherwise prevent the participant from
  • complying with the required procedures, schedule, or other study conduct.
  • (f) Not currently using a rigid gas permeable contact lens or a contraindication to this
  • (g) A history of corneal graft surgery (keratoplasty) in the eye under investigation.
  • (h) A recent history (in preceding 12 months) of corneal abrasions in the designated study eye
  • (i) A recent history (in preceding 1 month) of corneal cross linking for keratoconus
  • WP2:
  • (a) Any systemic disease likely to affect visual performance
  • (b) Any ocular disease that may affect visual performance, other than keratoconus
  • (c) Hearing impairment sufficient to interfere with hearing instructions
  • (d) Poor understanding of English language and/or alphabet
  • (e) Any condition which, in the investigator's opinion, would conflict or otherwise prevent the participant from
  • complying with the required procedures, schedule, or other study conduct.
  • (f) A contraindication to rigid gas permeable contact lens wear
  • (g) A history of corneal graft surgery (keratoplasty) in the eye under investigation.
  • (h) A recent history (in preceding 12 months) of corneal abrasions in the either eye
  • (i) A recent history (in preceding 1 month) of corneal cross linking for keratoconus
  • WP3:
  • (a) An optometrist dispensing optician or ophthalmologist not fully registered with the General Optical Council (e.g., a pre-registration optometrist)
  • (b) Hearing impairment sufficient to interfere with hearing instructions
  • (c) Poor understanding of English language and/or alphabet
  • (d) Any condition which, in the investigator's opinion, would conflict or otherwise prevent the participant from complying with the required procedures, schedule, or other study conduct.

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
ARM1
The contact lens to be investigated in this study (Scheimpflug topography derived corneal RGP contact lens design)
The participants will be fitted with (i) the optimal lens design as specified by the virtual fitting module, in addition to (ii) lenses that are one clinically significant step (0.12 mm) flatter and (iii) steeper in axial edge lift (AEL).
Arm2
The patient's own corneal RGP lens - CE (UKCA) marked class 2 medical devices.
The participants will be fitted with (i) the optimal lens design as specified by the virtual fitting module, in addition to (ii) lenses that are one clinically significant step (0.12 mm) flatter and (iii) steeper in axial edge lift (AEL).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rigid gas permeable contact lens fit
Time Frame: 18 months
The CL fit will be assessed through (i) slit lamp photography according to the standardised method proposed by Wolffsohn et al. (2013), (ii) slit lamp video of lens movement following blink in the primary position and horizontal version movements, and (iii) Anterior segment OCT MS39) (CSO Hansom Instruments, UK).
18 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The changes in contact lens fit from increased and decreased Axial Edge lift
Time Frame: 18 months
Fluorescein intensity measures Wolffsohn et al. (2013) will be used to examine the predicted vs. observed alterations in contact lens fit when AEL is varied
18 months
Best corrected Visual Acuity
Time Frame: 18 months
Best-corrected visual acuity with each lens design (incorporating an over-refraction where needed) will be measured using high-contrast logMAR in a forced-choice manner.
18 months
Clinician Usability Assessment
Time Frame: 18 Months
Clinician Usability Assessment of topography guided virtual contact lens selection module
18 Months

Collaborators and Investigators

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

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)

June 6, 2022

Primary Completion (Actual)

December 15, 2023

Study Completion (Actual)

December 15, 2023

Study Registration Dates

First Submitted

March 8, 2024

First Submitted That Met QC Criteria

March 8, 2024

First Posted (Actual)

March 15, 2024

Study Record Updates

Last Update Posted (Actual)

March 15, 2024

Last Update Submitted That Met QC Criteria

March 8, 2024

Last Verified

March 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • EHRD1001

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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