Optimal keratoplasty for the correction of presbyopia and hypermetropia

ISRCTN ISRCTN22899379
DOI https://doi.org/10.1186/ISRCTN22899379
Secondary identifying numbers I-2014A27
Submission date
04/03/2017
Registration date
14/03/2017
Last edited
15/02/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Eye Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Presbyopia is a condition associated with aging of the eye that leads to s progressively worsening ability to focus clearly on close objects. In a younger person, the lens is soft and flexible so it can easily reshape the lens to focus on close and distant objects. With age, the lens becomes harder so it is unable to reshape as easily. Hyperopia, also known as farsightedness, is another forma of presbyopia which makes it difficult for people to focus on things that are close. Optimal keratoplasty is a new form of laser eye treatment to treat presbyopia. It works by remodeling the shape of the cornea (transparent layer forming the front of the eye) to help sharpen distance vision and near vision. The aim of this study is to investigate the safety and effectiveness of optimal keratoplasty in correcting hyperopia (long-sightedness) and presbyopia.

Who can participate?
Adults aged 40 years and over who have hyperopia and presbyopia

What does the study involve?
All participants receive optimal keratoplasty, which involves having a special laser applied to their eyes while they are lying down. The procedure takes around 10-15 minutes altogether. Before the procedure and then one hour, one day, one week and one, three and six months after the procedure, participants have an eye test in order to find out if there has been any improvement to their vision.

What are the possible benefits and risks of participating?
Participants may benefit from an improvement to their eyesight. There is a small risk that some participants may experience minor vision problems for a short time after the procedure, such as glare (light entering the eye and interfering with vision) and halos (bright circles that surround a light source).

Where is the study run from?
Istituto Europeo di Microchirurgia Oculare (Italy)

When is the study starting and how long is it expected to run for?
June 2014 to June 2016

Who is funding the study?
Istituto Europeo di Microchirurgia Oculare (Italy)

Who is the main contact?
Professor Paolo Lanzetta

Contact information

Prof Paolo Lanzetta
Public

Istituto Europeo di Microchirurgia Oculare
via Fiducio 8
Udine
33100
Italy

ORCiD logoORCID ID 0000-0003-3746-141X

Study information

Study designSingle-centre single-arm non-randomised study
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeQuality of life
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleIn patients with presbyopia and hypermetropia, do optimal keratoplasty improve near and distance visual acuity?
Study objectivesOptimal keratoplasty is safe and effective for the correction of hyperopia and presbyopia.
Ethics approval(s)Istituto Europeo di Microchirurgia Oculare (IEMO) Institutional Review Board, 22/03/2014, ref: I-2014A27
Health condition(s) or problem(s) studiedPresbyopia and hypermetropia
InterventionAll patients undergo laser irradiation of the corneal tissue using the NTK Optimal Keratoplasty (Opti-K) System.

While the patient is lying in a supine position, an output beam is directed onto the cornea in a symmetrical square ring pattern (6 and 7.2 mm diameter), so that the corneal epithelium is protected from thermal damage with a sapphire application window/suction ring. Thereafter, laser is applied at 1.93 μm wavelength. The laser is typically operated with a total delivered power of 0.80-1.28 W for a period of 150 ms. The duration of the entire procedure is approximately 10-15 minutes.

Patients are evaluated at baseline, 1 hour, 1 day, 1 week, 1 month, 3, and 6 months after treatment. The duration of a visit is about an hour. Baseline and follow-up examinations include measurement of uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), CDVA, manifest refraction, corrected near visual acuity (CNVA), presbyopic add, corneal optical coherence tomography (OCT), corneal pachymetry, slit lamp examination of the anterior segment, and dilated fundus examination.
Intervention typeProcedure/Surgery
Primary outcome measureMean uncorrected near visual acuity is measured by ETDRS charts and standardized procedures at baseline and 6 months.
Secondary outcome measuresUncorrected distance visual acuity in hypemetropic/presbyopic eyes is measured by ETDRS charts and standardized procedures at baseline and 6 months.
Overall study start date01/06/2014
Completion date01/06/2016

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants35
Key inclusion criteria1. Aged 40 years and over
2. Low to moderate hypermetropia (manifest refraction: sphere between +1 to +2.5 D, absolute cylinder ≤1 D) or presbyopia (with presbyopic adds between +1D to +2.75 D)
3. Documented stable refraction
4. Corrected distance visual acuity (CDVA) of 33 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or better
Key exclusion criteria1. Nystagmus
2. Corneal diameter ≤9 mm
3. Central corneal thickness ≤500 μm
4. Dry eye disease
5. Severe blepharitis
6. Residual, recurrent or active corneal disease or abnormality
Date of first enrolment01/07/2014
Date of final enrolment01/05/2016

Locations

Countries of recruitment

  • Italy

Study participating centre

Istituto Europeo di Microchirurgia Oculare
via Fiducio 8
Udine
33100
Italy

Sponsor information

Istituto Europeo di Microchirurgia Oculare
Other

via Fiducio 8
Udine
33100
Italy

ROR logo "ROR" https://ror.org/02t9kcf24

Funders

Funder type

Other

Istituto Europeo di Microchirurgia Oculare

No information available

Results and Publications

Intention to publish date31/08/2017
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryStored in repository
Publication and dissemination planPlanned publication in a Medline indexed peer reviewed journal.
IPD sharing planParticipant level data are stored as medical charts at the center. Charts are anonymised with a numeric code. Patients signed an informed consent allowing data storage.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 18/04/2017 15/02/2022 Yes No

Editorial Notes

15/02/2022: Publication reference added.