Clinical Trials Logo

Clinical Trial Summary

Descemet's stripping automated endothelial keratoplasty (DSAEK) and Descemet's membrane endothelial keratoplasty (DMEK) are becoming increasingly popular as treatments for Fuchs' endothelial dystrophy. However, despite several years of use the incidence of cystoid macular edema and damage related to increased intraocular pressure (IOP), and the forward scattering of light through the eye following DSAEK or DMEK have to our knowledge not been prospectively described. Therefore, this project will be a randomized controlled trial investigating these matters.


Clinical Trial Description

Purpose: To investigate 3 different side-effects after DSAEK, DMEK, and cataract extraction (CE) in a randomized controlled trial with 12 months follow-up with CE as an additional control group. 1. To investigate the extend of subclinical cystoid macular edema (CME) and epiretinal membrane (ERM) after DSAEK, DMEK, and CE. 2. To investigate IOP-related changes after DSAEK, DMEK, and CE in means of pupil diameter and cpRNFLT. Further, to describe iris alterations including Urrets-Zavalia Syndrome (UZS). 3. To compare the difference in forward scatter, visual acuity (VA), and low-contrast VA after DSAEK, DMEK, and CE and relate this to the best corrected visual acuity (BCVA). Further, to investigate changes in higher-order aberrations, patient reported outcome measures (PROM), and total corneal refraction after the procedures. Hypotheses: 1. Subclinical CME and ERM are adverse effects that occur equally often following DSAEK, DMEK, and CE. 2. Following DSAEK, DMEK, and CE, there are no differences in the amount of IOP-related changes in means of pupil diameter,cpRNFLT thinning or iris alterations. 3. Changes in OSI, HOA, PROM, VA, contrast sensitivity, and total corneal refraction occur to the same extend after DSAEK, DMEK, and CE. Materials and Methods: Patients referred to the Department of Ophthalmology at Aarhus University Hospital (AUH) for EK or CE will be assessed in order to identify suitable study subjects. Only patients with primary endothelial failure (Fuchs endothelial dystrophy) and a concomitant need for CE will be considered eligible for randomization to either the DSAEK or the DMEK study groups. Patients included in the study will be randomized 1:1 to the DSAEK or DMEK study groups. Patients referred for CE will be offered to participate in the project and will be included in the CE group. Based on power calculations, it is planned to include 40 patients in each of the 3 groups. Subject and donor characteristics will be gathered. Subjects with prior uveitis, severe vitreous opacities, diabetes, retinal vein occlusion, glaucoma, age-related macular degeneration, macular atrophy, trauma or corneal grafting will be excluded from the study. Data collection will be conducted at AUH before the interventions and in the follow-up period. Donor tissue will be prepared in the Danish Cornea Bank, either pre-pealed for DMEK or pre-cut for DSAEK. Measurements as described below will be conducted both prior to the surgical intervention and 3, 6, and 12 months after this. Patients lost to follow-up during the project will only be used for analysis at the time-point they have attended. Therefore, for all time-points after the loss to follow-up these subjects will be excluded from our investigation. In case of capsule rupture where the intraocular lens still is positioned into the lens bag during CE or if rebubbling is needed after DSAEK or DMEK, the subjects will still be eligible for further participation in the project. Adverse events such as primary graft failure or rejection is considered to be rare events for both DSAEK and DMEK and subjects with these will be excluded from our final estimates. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04417959
Study type Interventional
Source University of Aarhus
Contact
Status Active, not recruiting
Phase N/A
Start date July 1, 2020
Completion date July 1, 2024

See also
  Status Clinical Trial Phase
Completed NCT03248037 - Trial of Netarsudil for Prevention of Corticosteroid-induced Intraocular Pressure Elevation Phase 3
Recruiting NCT03275896 - Evaluation of the Efficacy of Descemet Membrane Transplantation for the Treatment of Fuchs' Endothelial Dystrophy Early Phase 1
Completed NCT02332109 - ODM 5 in the Treatment of Corneal Edematous Fuchs' Endothelial Dystrophy N/A
Completed NCT02470793 - Technique And Results In Endothelial Keratoplasty N/A
Recruiting NCT01206127 - DSAEK- Postoperative Positioning and Transplant Dislocation N/A
Recruiting NCT03407755 - Air Versus SF6 for Descemet's Membrane Endothelial Keratoplasty (DMEK) N/A
Completed NCT04140422 - Eye Drops for Early Morning-Associated Corneal Swelling of the Cornea N/A
Recruiting NCT06048380 - The Effects of Ripasudil in Patients With FED Undergoing Femtosecond Laser Assisted Cataract Surgery Phase 3
Completed NCT02793310 - DMEK Versus DSAEK Study N/A
Completed NCT01795001 - The Molecular Pathogenesis of Late-onset Fuchs' Endothelial Corneal Dystrophy
Completed NCT04057053 - Netarsudil Use After Descemetorhexis Without Endothelial Keratoplasty Early Phase 1
Terminated NCT01361282 - Using the Optovue OCT to Select IOL Power N/A
Completed NCT02542644 - Assessment of Corneal Graft Attachment in Patients With Fuchs Endothelial Corneal Dystrophy Following DMEK Using Ultra-high Resolution OCT N/A
Recruiting NCT04191629 - Phase 1 Study to Evaluate the Safety and Tolerability of EO1404 in the Treatment of Corneal Edema Phase 1
Completed NCT05399095 - Supine Positioning for Graft Attachment After Descemet Membrane Endothelial Keratoplasty N/A
Completed NCT04752020 - Netarsudil Use After Descemtorhexis Without Endothelial Keratoplasty Early Phase 1
Not yet recruiting NCT05716945 - The OPTIMISE Study Phase 4
Recruiting NCT03575130 - Ripasudil 0.4% Eye Drops in Fuchs Endothelial Corneal Dystrophy Phase 2
Recruiting NCT02118922 - A Study to Test the Diagnostic Potential of Brillouin Microscopy for Corneal Ectasia
Completed NCT04420429 - The Effect Of Preoperative Parameters On Success After DMEK Surgery