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NCT Number: NCT01243931

Optical Coherence Tomography Guided Transepithelial Phototherapeutic Keratectomy

Optical Coherence Tomography (OCT) machines are non-contact instruments that can measure the depth of scars and other causes of cloudiness in the front of the cornea. The purpose of this study is to determine whether OCT-guided settings for the lasers used for removal of corneal scars and other partial-thickness corneal defects result in improved vision in patients receiving these procedures.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Casey Eye Institute, Oregon Health & Science University

Portland, Oregon, 97239, United States

Location status: Recruiting

Location contact

Afshan Nanji, MD

SUB_INVESTIGATOR

David Huang, MD, PhD

PRINCIPAL_INVESTIGATOR

Denny Romfh, OD

CONTACT

[email protected]

503-494-4351

Ellen Davis, MD

SUB_INVESTIGATOR

Humberto Martinez, COT

CONTACT

[email protected]

503-494-7712

Richard Stutzman, MD

SUB_INVESTIGATOR

Seema Gupta, MD

SUB_INVESTIGATOR

Winston Chamberlain, MD, PhD

SUB_INVESTIGATOR

Yan Li, PhD

SUB_INVESTIGATOR

About this study

The long-term goal of this project is to utilize newly available very high-speed OCT technology to guide surgical treatments of corneas with superficial opacities and irregularities. OCT is well known for its exquisite resolution, but until recently it has not had sufficient speed to capture the shape of the cornea because of eye motion during OCT scanning. The development of Fourier-domain OCT (FD-OCT) technology has made the requisite speed possible.

Eyes with superficial opacities (corneal scars and stromal dystrophies) can be treated by phototherapeutic keratectomy (PTK). Currently, many surgeons rely on subjective slit-lamp impression of opacity depth to guide PTK and repeat slit-lamp examinations during surgery to determine if the opacity has been sufficiently reduced. Unpredictable hyperopic shifts can occur after PTK. The aim of this project is to develop methods for imaging the cornea with an FD-OCT system that will precisely measure corneal shape and use this information to guide surgery. Patients with irregularly shaped corneas could have their vision restored by reshaping the corneas with a procedure that combines the precision of OCT and lasers.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Patients with vision primarily limited by superficial opacities and irregularities that could be removed by PTK while leaving at least 250 µm.

Exclusion criteria

  • Inability to give informed consent
  • Inability to maintain stable fixation for OCT imaging
  • Inability to commit to required visits to complete the study
  • Deep corneal opacities and irregularities
  • Cataracts, retinal disease, glaucoma, or other eye conditions that may limit the visual outcome after surgery

Treatment and study plan

OCT-guided laser phototherapeutic keratectomy

Drug

Preoperative measurements from the OCT are used to assist the calculation in deciding the laser depth settings for removal of anterior corneal opacities and defects in the phototherapeutic PTK procedure. The surgeon uses the OCT data to plan a range of treatment parameters to remove most of the opacity while preserving at least 250 microns of residual corneal stroma.

Other names: Manufacturer/Name OCT Technology 510(K), Optovue/RTVue-CAM Fourier-domain K071250, Bioptigen/Bioptigen Fourier-domain K063343, Zeiss/Visante Time-domain K051789

Primary outcomes

  1. Improvement in best spectacle-corrected visual acuity (BSCVA) after PTK

    Time frame: 12 months post-procedure

    The primary goal of the trial is to determine the efficacy of the OCT-guided PTK treatment of corneal opacities. During the course of the trial, we will compare the predictive accuracy of the original OCT-guided PTK planning system to the OCT topography-guided system. BSCVA will be measured in typical Snellen acuity notation as 20/xx (feet)

Secondary outcomes

  1. Improvement in uncorrected visual acuity (UCVA), refractive error, and higher order aberrations

    Time frame: 12 months post-procedure

    A second goal is to develop a more sophisticated OCT guidance system incorporating OCT topography of anterior and posterior corneal surfaces and to develop a mathematical model that relates epithelial thickness variation to corneal mean curvature. During the course of the trial, we will compare the predictive accuracy of the original OCT-guided PTK planning system to the OCT topography-guided system. UCVA will be measured in typical Snellen acuity notation as 20/xx (feet)

Study contacts

Contact information is provided by the study sponsor or research team.

Denny Romfh, OD

CONTACT

[email protected]

503-494-4351

Humberto Martinez, COT

CONTACT

[email protected]

503-494-7712

Sponsors and collaborators

Lead sponsor

Oregon Health and Science University

Other

Collaborators

  • National Eye Institute (NEI)

Registry information

Important dates

Study start
2011
Primary completion
2026
Study completion
2026
First posted
Nov 19, 2010
Registry last updated
Feb 12, 2024

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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