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ExCrossV Multi Site Trial for Vascularized High Risk Keratoplasty (ExCrossV)

17. september 2026 opdateret af: Joseph B. Ciolino, MD, Massachusetts Eye and Ear Infirmary

Multicenter klinisk forsøg til evaluering af sikkerheden og effektiviteten af ​​ex vivo hornhinde-tværbinding af donor hornhindevæv brugt til vaskulariseret højrisiko-keratoplastik

The main objective of this study is to determine the safety of Ex Vivo Cross Linking (CXL) of donor corneal tissue in participants who have undergone high-risk penetrating keratoplasty.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a randomized, double-masked, multi site clinical trial to determine the safety of Ex Vivo CXL of donor corneal tissue in 96 participants who have undergone high-risk penetrating keratoplasty.

Participants will be randomized to receive either a corneal tissue that has been untreated vs. a corneal tissue that has been treated with Photrexa® Viscous & Photrexa® and UV light. The tissue will be prepared by a Corneal Tissue Bank under Current-Good-Tissue-Practice (CGTP) and delivered to the respective institutions for transplantation. Participants will be monitored up to 24 months post-transplantation to assess for adverse events of the randomized tissue.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

96

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

  • Navn: Nikolay Boychev, OD, PhD

Studiesteder

    • California
      • Irvine, California, Forenede Stater, 92617
        • Ikke rekrutterer endnu
        • University of California Irvine - Gavin Herbert Eye Institute
        • Ledende efterforsker:
          • Marjan Farid, MD
      • Los Angeles, California, Forenede Stater, 90095
        • Ikke rekrutterer endnu
        • The University of California Los Angeles - Doris Stein Eye Research Center
        • Ledende efterforsker:
          • Anthony Aldave, MD
      • San Francisco, California, Forenede Stater, 94158
        • Ikke rekrutterer endnu
        • University of California San Francisco - Wayne and Gladys Valley Center for Vision
        • Kontakt:
        • Ledende efterforsker:
          • Julie Schallhorn, MD
    • Florida
      • Miami, Florida, Forenede Stater, 33136
        • Rekruttering
        • University of Miami - Bascom Palmer Eye Institute
        • Ledende efterforsker:
          • Guillermo Amescua, MD
        • Kontakt:
        • Kontakt:
    • Indiana
      • Indianapolis, Indiana, Forenede Stater, 46260
        • Rekruttering
        • Price Vision Group
        • Ledende efterforsker:
          • David Price, MD
        • Kontakt:
        • Kontakt:
    • Kansas
      • Overland Park, Kansas, Forenede Stater, 66204
        • Rekruttering
        • Kansas City Eye Clinic
        • Ledende efterforsker:
          • Christopher Ketcherside, MD
        • Underforsker:
          • Megan Haghnegahdar, MD
        • Kontakt:
    • Maryland
      • Towson, Maryland, Forenede Stater, 21204
        • Rekruttering
        • Mid-Atlantic Cornea Consultant
        • Ledende efterforsker:
          • Sudeep Pramanik, MD
        • Ledende efterforsker:
          • Alexander Altman, MD
        • Kontakt:
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02114
    • Michigan
      • Ann Arbor, Michigan, Forenede Stater, 48015
        • Rekruttering
        • University of Michigan - Kellogg Eye Center
        • Ledende efterforsker:
          • Shahzad Mian, MD
        • Kontakt:
    • North Carolina
      • Bermuda Run, North Carolina, Forenede Stater, 27006
        • Ikke rekrutterer endnu
        • Wake Forest Baptist Eye Center
        • Ledende efterforsker:
          • Matthew Giegengack, MD
        • Kontakt:
      • Durham, North Carolina, Forenede Stater, 27705
        • Rekruttering
        • Duke University - Duke Eye Center
        • Ledende efterforsker:
          • Esen Akpek, MD
        • Kontakt:
        • Kontakt:
    • Ohio
      • Cincinnati, Ohio, Forenede Stater, 45242
        • Rekruttering
        • Cincinnati Eye Institute
        • Ledende efterforsker:
          • Kavitha Sivaraman, MD
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age 18 and older
  • Willing and able to provide written informed consent
  • Willing and able to comply with study assessments for the full duration of the study
  • Patients undergoing high-risk penetrating keratoplasty, defined as corneal neovascularization (NV) in 1 or more quadrants ≥2 mm from the limbus or extension of corneal NV to the graft-host junction in a previously failed graft
  • Superficial vessels are defined as those within the anterior one-third of the cornea and deep vessels within the posterior two-thirds of the cornea (i.e., deep stroma).

Superficial CNV involving ≤2 quadrants (equivalent to ≤6 clock hours) without deep CNV are classified as mild. CNV with >2 quadrants of superficial vessels (>6 clock hours) or 1 quadrant of deep vessels (>3 clock hours) as severe (36).

Exclusion Criteria:

  • History of Stevens-Johnson syndrome or ocular pemphigoid
  • Ocular or periocular malignancy
  • Non-healing epithelial defect of at least 0.5x0.5 mm in host corneal bed lasting ≥6 weeks preoperatively
  • Uncontrolled glaucoma
  • Change in topical corticosteroid regimen within 14 days of transplantation
  • Use of systemic immunosuppressive for indication other than corneal graft rejection
  • Participation in another simultaneous medical investigation or trial
  • Pregnancy (positive pregnancy test) or lactating
  • Pre-menopausal women not using adequate contraception (Reliable intrauterine devices, hormonal contraception or a spermicide in combination with a barrier method)
  • Ocular infection within 30 days prior to study entry.
  • Presence of anterior chamber intraocular lens
  • Active uveitis within 90 days prior to the study entry.
  • No ocular surgery or procedure within 90 days prior to the study entry or concomitant to the study procedure.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Participants Receiving Treated Cross Linked Corneal Tissue

Participants in this group will receive tissue that has been treated with 0.1% riboflavin (Vitamin B2) and 20% dextran (Photrexa® viscous and Photrexa®) with UV light treatment. Participants will be monitored over a period of 24 months.

Participants are transplanted with corneal donor tissue that has been treated with 0.1% riboflavin (Vitamin B2) and 20% dextran (Photrexa® Viscous & Photrexa®) with UV light treatment.

Andre navne:
  • Behandling
Placebo komparator: Participants Receiving Untreated Cross Linked Corneal Tissue

Participants in this group will receive tissue that has has not been treated with 0.1% riboflavin (Vitamin B2) and 20% dextran (Photrexa® viscous and Photrexa®) without UV light treatment. Participants will be monitored over a period of 24 months.

Participants are transplanted with corneal donor tissue that has not been treated with the UV light and the 0.1% riboflavin (Vitamin B2) and 20% dextran (Photrexa® Viscous & Photrexa®) without UV light treatment, this is the control group.

Andre navne:
  • Styring

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Determining the Primary Safety of Corneal Cross Linking
Tidsramme: 24 Months

The occurrence of adverse events throughout study including:

  1. Ocular Safety per the incidences and severity of ocular adverse events during the study based on ophthalmic examination and participants' self-report.

  2. Short Term Safety Events (Post Surgery < 1 Month)

    • Post-Op Microbial Keratitis
    • Acute Rejection (Epithelial, Endothelial, Sub epithelial, or Mixed)
  3. Long Term Safety Events (Post Surgery > 1 Month)

    • Rejection (Epithelial, Endothelial, or Mixed)
    • Graft Failure
    • Ulcerative Keratitis
    • Persistent Epithelial Defect lasting more than 6 Weeks
24 Months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Measure of the Frequency of Graft Failures though Corneal Cross Linking
Tidsramme: 24 Months

To determine the efficacy of using cross linked tissue for the indicated keratoplasty for the prevention of corneal graft rejection and corneal neovascularization, by measuring the frequency of primary graft failures over 24 months.

24 Months
Measure of Time from Surgery to Overall Graft Failure for Corneal Cross Linking over 24 Months
Tidsramme: 24 Months

The efficacy of using cross linked tissue for the indicated keratoplasty for the prevention of corneal graft rejection and corneal neovascularization, by measuring the time from surgery to overall graft failure (regardless of cause).

24 Months
Measure of Time from Surgery to Graft Rejection for Corneal Cross Linking over 24 Months
Tidsramme: 24 Months

The efficacy of using cross linked tissue for the indicated keratoplasty for the prevention of corneal graft rejection and corneal neovascularization, by measuring the occurrence of any rejection episode. (Epithelial, Endothelia, Sub Epithelial, or Mixed) determined as either definite rejection, probably rejection, and possible rejection, from the time of surgery over 24 months.

24 Months
Measure of the Efficacy of Corneal Cross Linking Through Image Review
Tidsramme: 24 Months

The efficacy of using cross linked tissue for the indicated keratoplasty for the prevention of corneal graft rejection and corneal neovascularization.

1. Corneal Neovascularization (CNV) measured and analyzed from slit-lamp photography.

24 Months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Joseph Ciolino, MD, Massachusetts Eye and Ear

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. april 2025

Primær færdiggørelse (Anslået)

1. januar 2028

Studieafslutning (Anslået)

1. januar 2031

Datoer for studieregistrering

Først indsendt

19. september 2024

Først indsendt, der opfyldte QC-kriterier

20. december 2024

Først opslået (Faktiske)

31. december 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

21. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2023P002687

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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