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Completed

NCT Number: NCT04075591

Wavefront-guided LASIK for Monovision Treatment of Myopic Subjects With Presbyopia

This study will be a 12-month, prospective, multicenter, open-label, non-comparative, non-randomized clinical investigation conducted at 8 to 14 sites. A total of 383 subjects will be enrolled to achieve approximately 268 treated subjects, resulting in at least 241 evaluable subjects at the point of refractive stability. After signing the informed consent, subjects meeting all inclusion and exclusion criteria in both eyes may be scheduled for surgery. The follow-up visit schedule will be the same for each operative eye.

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Key information

Conditions

Refractive Error Eye Diseases Refractive Errors

Age range

40 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Maloney Vision Institute, Los Angeles, California, United States

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Signed informed consent and HIPAA authorization.
  • At least 40 years of age at enrollment (date informed consent signed).
  • The refractive error of both subject's eyes, based on the iDesign refraction selected for treatment ("4.0 mm Rx calc" at 12.5 mm), must be myopic with or without astigmatism up to -6.00 D spherical equivalent (SE), with cylinder up to -3.00 D and minimum pre-operative myopia in their non-dominant eye at least as great as their targeted myopic retention.
  • At least one eye must require a myopic treatment.
  • Anticipated stromal bed thickness of at least 250 microns based on preoperative central corneal pachymetry minus the maximum treatment depth to be ablated (as calculated by the iDesign plus the intended flap thickness).
  • Distance Best Spectacle Corrected Visual Acuity (BSCVA) of 20/20 or better.
  • Require an add power of +1.25 D or more but not greater than +2.00 D at 40 cm.
  • Less than or equal to ±0.50 D difference between cycloplegic and manifest refraction sphere.
  • A stable refractive error (based on a previous exam, medical records, lensometry, or prescription that is at least 12 months prior to the preoperative manifest refraction), as defined by a change of less than or equal to
  • 0.50 D in MRSE (sphere and cylinder).
  • Subjects with a history of contact lens wear within the last 4 weeks must discontinue lens wear in order to demonstrate refractive stability according to the following (refractive stability is defined as a change of not more than 0.50 D in manifest refraction sphere and cylinder as well as mean keratometry between measurements): After the Informed Consent process has been completed and subjects are enrolled in the study:
  • Rigid or extended wear contact lenses (toric or spherical) must be removed for at least 3 weeks and soft contact lenses (toric or spherical) for at least 2 weeks prior to the first refraction used to establish stability.
  • After abstaining from contact lens wear for designated time, two consecutive manifest refractions and keratometric readings must be conducted at least 7 days apart
  • I If the subject/eye meets the refractive stability criteria, contact lens wear is not permitted for 2 weeks prior to surgery except as required to test monovision acceptance as described below in the Study Procedures, Contact Lens Trial section NOTE: Refractive stability needs to be confirmed only once during preoperative assessment
  • Agreement between manifest refraction (adjusted for optical infinity) and iDesign System refraction chosen for treatment, as follows:
  • Spherical Equivalent: magnitude of the difference is less than 0.625 D.
  • Cylinder: magnitude of the difference is less than or equal to 0.5 D.
  • Cylinder Axis Tolerance: If either the manifest cylinder entered into the iDesign System or the iDesign cylinder selected for treatment is less than 0.5 D, there is no requirement for axis agreement. When both cylinders have a magnitude of at least 0.5 D, the axis tolerance as determined by the iDesign system is linearly reduced from 15 degrees (0.5 D) to 7.5 degrees (7.0 D) based on the average magnitude of both cylinders. Note: If the axis tolerance is not in the calculated range, the iDesign system will produce a warning and this exam may not be used for treatment planning.
  • Willing and capable of complying with follow-up examinations for the duration of the study.

Exclusion criteria

  • Women who are pregnant, breast-feeding, or intend to become pregnant during the study.

Note: Women who were pregnant or nursing may not be enrolled until 6 months after either delivery or have stopped nursing and there is documented refractive stability.

  • Concurrent use of systemic (including inhaled) medications that may impair healing, including but not limited to: antimetabolites, isotretinoin (Accutane®) within 6 months of treatment, and amiodarone hydrochloride (Cordarone®) within 12 months of treatment. NOTE: The use of inhaled or systemic corticosteroids, whether chronic or acute, within the past 6 months is deemed to adversely affect healing and subjects using such medications are specifically excluded from eligibility.
  • History of any of the following medical conditions, or any other condition that could affect wound healing: collagen vascular disease, autoimmune disease, immunodeficiency diseases, ocular herpes zoster or herpes simplex, endocrine disorders (including, but not limited to unstable thyroid disorders and diabetes), lupus, and rheumatoid arthritis.

NOTE: The presence of diabetes (either type 1 or 2), regardless of disease duration, severity, or control, will specifically exclude subjects from eligibility.

  • Subjects with a cardiac pacemaker, implanted defibrillator or other implanted electronic device.
  • History of prior intraocular or corneal surgery (including cataract extraction), active ophthalmic disease or abnormality (including, but not limited to, symptomatic blepharitis, recurrent corneal erosion, dry eye syndrome, neovascularization > 1 mm from limbus), retinal detachment/repair, clinically significant lens opacity, clinical evidence of trauma, corneal opacity within the central 9 mm and visible on topography, prior strabismus surgery, strabismus, or at risk for developing strabismus, or with evidence of glaucoma or propensity for narrow angle glaucoma or suspected glaucoma.

NOTE: Subjects with glaucoma, regardless of medication regimen or control, or an IOP greater than 21 mmHg at screening, are specifically excluded from eligibility.

  • Evidence of keratoconus, corneal dystrophy or irregularity, or abnormal topography.
  • Known sensitivity or inappropriate responsiveness to any of the medications used in the postoperative course.
  • Intolerance to monovision correction based on questionnaire responses to contact lens trial (refer to section Study Procedures, Contact Lens Trial below).
  • Concurrent participation in any other clinical trial, or participation in any other clinical trial within the last 14 days.

Treatment and study plan

iDesign Refractive Studio with STAR S4 IR® Excimer laser System

Device

Surgeons will perform wavefront-guided monovision LASIK for the treatment of myopic subjects with presbyopia based upon measurements obtained with an iDesign Refractive Studio.

Primary outcomes

  1. Change in Driving Scale Score From Preoperative to Postoperative as Measured by Driving Scale Within Patient-Reported Outcomes With LASIK for Monovision (PROWL-M)

    Time frame: From preoperative (within 120 to 14 days prior to surgery on Day 0) to 12 month postoperative (operated on Day 0)

    Change in driving scale score from preoperative to postoperative as measured by driving scale within PROWL-M was reported. PROWL-M driving scale consists of three driving related items that were used to generate the driving scale score. Each item response was converted to a 0 to 100 scale so that the lowest and highest possible scores were set at 0 (not functioning) and 100 (functioning) points. A high score represents better functioning. The composite driving scale score was calculated by averaging the scores of all the three items, resulting in a total score ranging from 0 to 100 where higher score represent better functioning. Change in driving scale score was defined as the driving scale score at 12-month visit minus the driving scale score at preoperative visit.

  2. Percentage of Participants Who Required Secondary Surgery to Reverse Monovision

    Time frame: At 12 month postoperative (operated on Day 0)

    Percentage of participants who required secondary surgery to reverse monovision was reported.

Secondary outcomes

  1. Percentage of Participants Who Experienced Bothersome Visual Symptom (Double Image) as Assessed by PROWL-M: In Last 7 Days, How Bothersome Have the Symptoms Been When Wearing the Best Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (double image) as assessed by PROWL-M (in Last 7 Days, how bothersome have the symptoms been when wearing the best vision correction [glasses or contact lenses]) was reported. The PROWL-M questionnaire was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In last 7 days how bothersome have the double images symptoms been when wearing the best vision correction" of double images was categorize as: (1) participant do not use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  2. Percentage of Participants Who Experienced Bothersome Visual Symptom (Double Image) as Assessed by PROWL-M: In Last 7 Days, How Bothersome Have the Symptoms Been When Not Wearing Any Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (double image) as assessed by PROWL-M questionnaire (in last 7 days, how bothersome have the symptoms been when not wearing any vision correction [glasses or contact lenses]) was reported. The PROWL-M questionnaire was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In the last 7 days how bothersome have the double images been symptoms been when not wearing any vision correction (glasses or contact lenses)" was categorize as: (1) participant always use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  3. Percentage of Participants Who Experienced Bothersome Visual Symptom (Glare) as Assessed by PROWL-M: In the Last 7 Days How Bothersome Have the Symptoms Been When Wearing the Best Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (glare) as assessed by PROWL-M questionnaire (in last 7 days, how bothersome have the symptoms been when wearing the best vision correction [glasses or contact lenses]) was reported. The PROWL-M questionnaire was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In the last 7 days how bothersome have the glare been when wearing the best vision correction (glasses or contact lenses)" was categorize as: (1) participant do not use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  4. Percentage of Participants Who Experienced Bothersome Visual Symptom (Glare) as Assessed by PROWL-M: In the Last 7 Days How Bothersome Have the Symptoms Been When Not Wearing Any Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (glare) as assessed by PROWL-M questionnaire was reported. The PROWL-M questionnaire (in last 7 days, how bothersome have the symptoms been when not wearing any vision correction [glasses or contact lenses]) was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In the last 7 days how bothersome have the glare been when not wearing any vision correction (glasses or contact lenses)" was categorize as: (1) participant always use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  5. Percentage of Participants Who Experienced Bothersome Visual Symptom (Halo) as Assessed by PROWL-M: In the Last 7 Days How Bothersome Have the Symptoms Been When Wearing the Best Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (halo) as assessed by PROWL-M questionnaire (in last 7 days, how bothersome have the symptoms been when wearing the best vision correction [glasses or contact lenses]) was reported. The PROWL-M questionnaire was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In the last 7 days how bothersome have the Halos been when wearing the best vision correction (glasses or contact lenses)" was categorize as: (1) participant do not use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  6. Percentage of Participants Who Experienced Bothersome Visual Symptom (Halo) as Assessed by PROWL-M: In the Last 7 Days How Bothersome Have the Symptoms Been When Not Wearing Any Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, and 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (halo) as assessed by PROWL-M questionnaire (in last 7 days, how bothersome have the symptoms been when not wearing any vision correction [glasses or contact lenses]) was reported. The PROWL-M questionnaire was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In the last 7 days how bothersome have the halos been when not wearing any vision correction (glasses or contact lenses)" was categorize as: (1) participant always use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  7. Percentage of Participants Who Experienced Bothersome Visual Symptom (Starbursts) as Assessed by PROWL-M: In the Last 7 Days How Bothersome Have the Symptoms Been When Wearing the Best Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, and 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (starbursts) as assessed by PROWL-M questionnaire (in last 7 days, how bothersome have the symptoms been when wearing the best vision correction [glasses or contact lenses]) was reported. The PROWL-M questionnaire was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In the last 7 days how bothersome have the starbursts been when wearing the best vision correction (glasses or contact lenses)" was categorize as: (1) participant do not use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  8. Percentage of Participants Who Experienced Bothersome Visual Symptom (Starbursts) as Assessed by PROWL-M: In the Last 7 Days How Bothersome Have the Symptom Been When Not Wearing Any Vision Correction (Glasses or Contact Lenses)?

    Time frame: 3 months, 6 months, and 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced bothersome visual symptom (starbursts) as assessed by PROWL-M questionnaire (in Last 7 Days, how bothersome have the symptoms been when not wearing any vision correction [glasses or contact lenses]) was reported. The PROWL-M questionnaire was designed to measure visual symptoms, patient satisfaction, and expectations for and following LASIK surgery. The response for question "In the last 7 days how bothersome have the starbursts been when not wearing any vision correction (glasses or contact lenses)" was categorize as: (1) participant always use glasses or contact lenses, (2) extremely bothersome, (3) very bothersome, (4) somewhat bothersome, (5) a little bothersome, (6) not at all bothersome.

  9. Percentage of Participants Who Experienced Moderate to Severe Difficulty in Activities

    Time frame: Preoperative (within 120 to 14 days prior to surgery on Day 0), 3 months, 6 months, and 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced moderate to severe difficulty in activities was reported. Participants were asked questions about the difficulty they faced with daily activities, work or hobbies, reading, and judging distances. Responses was collected in 6 categories: (1) No difficulty at all, (2) A little difficulty, (3) moderate difficulty, (4) a lot of difficulty, (5) never try to do these activities because of vision, (6) Never do these activities for other reasons. Categories with non-zero data values are reported.

  10. Percentage of Participants Who Experienced Satisfaction With Vision as Measured by PROWL-M Questionnaire

    Time frame: Preoperative (within 120 to 14 days prior to surgery on Day 0), 3 months, 6 months, and 12 months postoperative (operated on Day 0)

    Percentage of participants who experienced satisfaction with vision was reported. Satisfaction with vision was assessed using a single-item question in the PROWL-M questionnaire. Participants were asked a question "In general, how satisfied or dissatisfied are you with your present vision". Responses was collected in 6 categories: (1) completely satisfied, (2) very satisfied, (3) somewhat satisfied, (4) somewhat dissatisfied, (5) very dissatisfied, (6) completely dissatisfied. Categories with non-zero data values are reported.

  11. Subject Satisfaction Score With Surgery as Measured by PROWL-M Questionnaire

    Time frame: 3 months, 6 months, and 12 months postoperative (operated on Day 0)

    A questionnaire derived from the PROWL-M was given to participants after surgery. Satisfaction with LASIK via PROWL-M questionnaire was assessed with 8 items. Responses to individual items were linearly transformed to a 0 to 100 scale where 100 indicates best possible vision and satisfaction, while 0 indicates worst possible vision and satisfaction. Each item score was averaged together to produce a score ranging from 0 to 100. A higher score indicating greater satisfaction.

  12. Percentage of Participants Who Achieved 20/40 Or Better Simultaneous Binocular Uncorrected Visual Acuity (UCVA)

    Time frame: Preoperative (within 120 to 14 days prior to surgery on Day 0), 3 months, 6 months, and 12 months postoperative (operated on Day 0)

    Percentage of participants who achieved 20/40 or better simultaneous binocular UCVA measured using Good-Lite 100 percent (%) proportionally spaced SLOAN letter/ETDRS charts designed for 4.0 meter (m) and the Good-Lite self-illuminated and self-calibrated illumination box were reported.

Sponsors and collaborators

Lead sponsor

AMO Development, LLC

Industry

Registry information

Official study title

Post-approval Study of Wavefront-guided LASIK for Monovision Treatment of Myopic Subjects With Presbyopia

Important dates

Study start
2019
Primary completion
2025
Study completion
2025
First posted
Aug 30, 2019
Registry last updated
Jul 23, 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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