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Active, Not Recruiting

NCT Number: NCT01604135

Collagen Crosslinking for Keratoconus - a Randomized Controlled Clinical Trial

The purpose of this study is to determine whether corneal collagen crosslinking is effective in the treatment of progressive keratoconus.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Keratoconus Corneal Diseases Eye Diseases

Age range

18 year–30 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Department of Ophthalmology, Sahlgrenska University Hospital

Mölndal, Västra Götalandsregionen, 43180, Sweden

About this study

Keratoconus is a noninflammatory, asymmetrical, progressive corneal ectasia caused by biomechanical instability of the corneal stroma. Treatment modalities are primarily glasses or contact lenses. It has been estimated that one out of five patients will progress to such an extent that a corneal transplant is necessary to regain useful vision.

Corneal collagen crosslinking (CXL) is a treatment modality that intends to halt progression of keratoconus. This study investigates the efficacy av CXL in stabilizing the cornea in keratoconus by means of a randomized controlled clinical trial.

Participants are eligible for inclusion if progressive keratoconus is confirmed and the inclusion criteria are met. Follow-up after inclusion is at 1 week (treatment group), 1, 3, 6 and 12 months. Pre- and post-inclusion examinations include measurement of uncorrected distance visual acuity (UCDVA), best spectacle corrected distance visual acuity (BSCDVA), Scheimpflug-topography and slitlamp examination.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Keratoconus diagnosis determined clinically and topographically (KISA%- index)
  • Significant progression is defined as change (increase) of Kmax by at least

1D from baseline at 6 months and/or change (increase) of Sim-K-ast by at least 1D from baseline at 6 months. Kmax is defined as the steepest radius of curvature (either the maximum simulated K-reading or the maximum K-reading in the 3-mm zone or the 5-mm zone) of the anterior corneal surface that progressed the most during 6 months observation

  • Ability to stop contact lens (rigid and soft) wear at least two weeks prior to next exam
  • Signed written informed consent

Exclusion criteria

  • Age < 18 years
  • Pregnancy
  • Breast feeding
  • History of corneal surgery
  • History of ocular herpes simplex infection
  • Minimal corneal thickness < 300 micrometers
  • Recurrent corneal erosions
  • Other corneal (e g endothelial) or conjunktival diseases
  • Neurodermatitis
  • Severe forms av atopic disease
  • Collagenoses, autoimmune or other systemic disease
  • Systemic treatment with high doses of steroids
  • Severe scarring och striae of the cornea

Relative exclusion criteria:

  • Kmax > 58D
  • Minimal corneal thickness < 400 micrometers (a modified CXL-treatment will be used swelling the cornea before UV-illumination treatment).

Treatment and study plan

Corneal Collagen Crosslinking

Device

Keratoconic corneas that show significant progression as specified in the inclusion criteria section will receive one single treatment with CXL if randomized to the treatment arm. A treatment protocol based on 30 minutes dropping with riboflavin/dextran solution and 10 minutes UV-illumination treatment will be used.

Other names: Cross-Linking Procedure UV-X 2000, UV-X 2000 Illumination system, Innocross-R 0.1% dextran 20% solution, Innocross-R hypotonic riboflavin 0.1%

Primary outcomes

  1. Kmax

    Time frame: 12 months

    Kmax is defined as the steepest radius of curvature of the anterior corneal surface. It is measured by Scheimpflug-topography (Pentacam, Oculus Inc.). An increase of less than 1 diopter (D) from baseline at 12 months is defined as non-progression.

Secondary outcomes

  1. Sim-K-astigmatism

    Time frame: 12 months

    Sim-K-astigmatism (Sim-K-ast) is defined as the absolute amount of anterior corneal astigmatism related to the Sim-Ks as measured by Scheimpflug-topography (Pentacam, Oculus Inc.). An increase of less than 1 D from baseline at 12 months is defined as non progression.

  2. MRSE

    Time frame: 12 months

    Manifest Refractive Spherical Equivalent. The spherical equivalent is calculated by algebraic addition of the spherical power and half the cylindrical power of an eye. An eye with a specific spherical equivalent power has the closest overall effect to a given toric lens. A decrease of less than 0.5 D from baseline at 12 months is defined as non-progression.

  3. UCDVA

    Time frame: 12 months

    UCDVA is defined as the uncorrected distance visual acuity measured with an Early Treatment of Diabetic Retinopathy Study (ETDRS)-chart and expressed in numbers of letters. A decrease of less than 5 letters (one line) from baseline at 12 months is defined as stable BCDVA.

  4. BSCDVA

    Time frame: 12 months

    BSCDVA is defined as the the best spectacle corrected distance visual acuity measured with an ETDRS-chart and expressed in numbers of letters. A decrease of less than 5 letters (one line) from baseline at 12 months is defined as stable BCDVA.

Sponsors and collaborators

Lead sponsor

Sahlgrenska University Hospital

Other

Collaborators

  • Göteborg University

Registry information

Acronym: CXL-RCT

Important dates

Study start
2012
Primary completion
2027
Study completion
2027
First posted
May 23, 2012
Registry last updated
May 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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