Trial of the PresVIEW Implant for the Improvement of Near Vision in Patients With Presbyopia

Presbyopia Clinical Trial

Official title:

A Prospective, Multicenter Clinical Trial Of the PresVIEW Scleral Implant (PSI) For the Improvement Of Near Visual Acuity In Presbyopic Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01166568
• Other study ID #: P-277-5
• Status: Completed
• Phase: N/A
• Start date: December 2003
• Est. completion date: March 2015

Study information

• Verified date: August 2018
• Source: Refocus Group, Inc.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The primary objective of this study is to evaluate the safety and effectiveness of the PresVIEW™ Scleral Implant (PSI) for the improvement of near visual acuity in presbyopic patients.

Description:

The clinical investigation of the PresView™ Scleral Implant (PSI) is a prospective multicenter clinical trial in which a total of 330 subjects were enrolled and implanted with the PSI and followed for a period of 24 months at up to 14 clinical sites.

An additional randomized sub-study was performed on 48 subjects with the PSI Second Generation PresView™(SGP) implant, model number SGP-046. A 2:1 randomization was used to determine the 32 subjects assigned to be implanted and the 16 subjects assigned to the observation/deferred implantation control arm. Subjects randomized to the deferred implantation control arm were eligible to receive the PSI after completion of the 6 months of observation in the study.

All subjects interested in participating in the study were screened for eligibility, and informed consent was obtained from those who meet the inclusion/exclusion criteria. Eligible subjects were examined preoperatively to obtain a medical history and baseline ocular data.

Effectiveness: The following tests/measurements used to evaluate the effectiveness of the PSI procedure will be included in the study protocol:

• Near visual acuity of the operated eye/eyes as compared with baseline (uncorrected and distance corrected)

• Reading acuity of the operated eye/eyes as compared with baseline (uncorrected and distance corrected)

The PSI procedure will be defined as successful if a logMar equivalent to Snellen 20/40 or better (logMar 0.3) is achieved in ≥ 75% of patients or if 75% of patients realize an improvement ≥ 2 lines in distance corrected near visual acuity (DCNVA). For most patients, this will translate into the ability to read the majority of newspaper and magazine print without a near optical aid.

Safety: Primary safety outcomes for safety will include:

• Incidence of anterior segment ischemia

• Decrease in Best Corrected Distance Visual Acuity (BCDVA) of more than 2 lines from baseline at 1-month or more postoperatively

• Decrease in best distance corrected near acuity (with add) of more than 2 lines from baseline at 1-month or more postoperatively

• Intraocular Pressure (IOP) increase > 10mm Hg over baseline or IOP > 25mm Hg after 1 Day postoperative

• Signs of chronic inflammation (e.g. uveitis or chronic conjunctival hyperemia) at 2 months or more postoperatively

• Increase in axial length of ≥ 0.20mm accompanied by a > 0.5 diopter myopic shift in manifest spherical equivalent distance refraction.

• Incidence of adverse events: total not to exceed 5%, and the incidence of each event should not exceed 1-2%

Recruitment information / eligibility

• Status: Completed
• Enrollment: 337
• Est. completion date: March 2015
• Est. primary completion date: March 2015
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 50 Years to 60 Years

Eligibility

Inclusion Criteria:

• Subject must be between 50-60 years old

• Subject must have a best corrected distance visual acuity of 20/20 or better

• Subject must have SLOAN distance corrected near visual acuity @ 40cm in the operative eye/eyes of 20/50 to 20/100 (inclusive).

• Subject should have a manifest distance spherical equivalent refractive correction in the operative eye/eyes of from -0.50 to +0.75 diopters with no more than 1.00 diopter of astigmatism and should require at least a +1.50 diopter add. The distance manifest refraction spherical equivalent and the distance cycloplegic refraction spherical equivalent must be within 0.50 diopters of each other.

• Subject must be phakic in the study eye

• Subject must be mentally competent to understand and comply with the requirements of the study.

• Subject must be able to provide written informed consent.

Exclusion Criteria:

• Chronic uveitis or other recurrent anterior or posterior segment inflammation in either eye.

• Scleral thickness less than 530 µm in the operative eye/eyes.

• Any previous eye surgeries including cataract, LASIK, or Muscle surgery

• Any history of prior extraocular muscle surgery, specifically the recti or oblique muscles.

• Any chronic systemic diseases such as diabetes, heart disease, Lupus, etc.

• Any eye diseases such as eye inflammation, infection, cataract, or retinal diseases

• Allergic to any medications used in the study.

• The patient may not have participated in a device clinical study for the operative eye within the last 3 months and may not have been implanted with PSI devices in this or any other study.

Related Conditions & MeSH terms

• Presbyopia

Intervention

Device:
• PresVIEW Scleral Implants
Subjects are implanted with the PresView Scleral Spacing Implants and followed for 24 months.

Locations

Country	Name	City	State
United States	Fichte, Endl and Elmer Eyecare Creekside Center	Amherst	New York
United States	Boxer-Wachler Vision Institute	Beverly Hills	California
United States	The Midwest Center for Sight	Des Plaines	Illinois
United States	Southeastern Eye Center	Greensboro	North Carolina
United States	Jacksoneye	Lake Villa	Illinois
United States	Vision/Advanced Eye Center	Lombard	Illinois
United States	The Eye Care Institute	Louisville	Kentucky
United States	Wang Vision Institute	Nashville	Tennessee
United States	Cornea Associates	Omaha	Nebraska
United States	Braverman-Terry-Oei-Eye Associates	San Antonio	Texas
United States	The Center for Corrective Eye Surgery	San Antonio	Texas
United States	Gordon-Weiss-Schanzlin Vision Institute	San Diego	California
United States	Associated Vision Consultants	Southfield	Michigan
United States	Eye Associates of South Tulsa	Tulsa	Oklahoma

Sponsors (1)

Lead Sponsor	Collaborator
Refocus Group, Inc.

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Safety Parameter Point Estimate -- Anterior Segment Ischemia	All primary and fellow eyes implanted with the PSI were included in the safety analysis. Point estimates were calculated for the incidence of Anterior Segment Ischemia at the end of the study. Incidence of adverse event totals should not to exceed 5%, and the incidence of each event should not exceed 1-2% NOTE: Because the secondary outcome is a safety measure, both primary and fellow eyes were used for analysis.	From initiation of the implantation procedure (operative day) until study completion at 24 months or withdrawal from the study.
Other	Safety Parameter Point Estimate -- Decrease in BCDVA > 2 Lines	All primary and fellow eyes implanted with the PSI were included in the safety analysis. Point estimates were calculated for the incidence of Decrease in BCDVA > 2 lines at the end of the study. Incidence of adverse event totals should not to exceed 5%, and the incidence of each event should not exceed 1-2%.; NOTE: Because the secondary outcome is a safety measure, both primary and fellow eyes were used for analysis.	From initiation of the implantation procedure (operative day) until study completion at 24 months or withdrawal from the study.
Other	Safety Parameter Point Estimate -- Decrease in BCNVA > 2 Lines	All primary and fellow eyes implanted with the PSI were included in the safety analysis. Point estimates were calculated for the incidence of Decrease in BCNVA > 2 lines at the end of the study. Incidence of adverse event totals should not to exceed 5%, and the incidence of each event should not exceed 1-2%.; NOTE: Because the secondary outcome is a safety measure, both primary and fellow eyes were used for analysis.	From initiation of the implantation procedure (operative day) until study completion at 24 months or withdrawal from the study.
Other	Safety Parameter Point Estimate -- (IOP Increase > 10 mmHg) or (IOP > 25 mmHg)	All primary and fellow eyes implanted with the PSI were included in the safety analysis (i.e. both primary and fellow eyes). Point estimates were calculated for the incidence of (IOP Increase > 10 mmHg) or (IOP > 25 mmHg) at the end of the study. Incidence of adverse event totals should not to exceed 5%, and the incidence of each event should not exceed 1-2%.; NOTE: Because the secondary outcome is a safety measure, both primary and fellow eyes were used for analysis.	From initiation of the implantation procedure (operative day) until study completion at 24 months or withdrawal from the study.
Other	Safety Parameter Point Estimate -- Chronic Inflammation	All primary and fellow eyes implanted with the PSI were included in the safety analysis. Point estimates were calculated for the incidence of Chronic Inflammation at the end of the study. Incidence of adverse event totals should not to exceed 5%, and the incidence of each event should not exceed 1-2%.; NOTE: Because the secondary outcome is a safety measure, both primary and fellow eyes were used for analysis.	From initiation of the implantation procedure (operative day) until study completion at 24 months or withdrawal from the study.
Other	Safety Parameter Point Estimate -- (Axial Length Increase >= 0.20) AND (Myopic Shift > 0.50D MRSE)	All primary and fellow eyes implanted with the PSI were included in the safety analysis. Point estimates were calculated for the incidence of (Axial Length Increase >= 0.20) AND (Myopic Shift > 0.50D MRSE) at the end of the study. Incidence of adverse event totals should not to exceed 5%, and the incidence of each event should not exceed 1-2%.; NOTE: Because the secondary outcome is a safety measure, both primary and fellow eyes were used for analysis.	From initiation of the implantation procedure (operative day) until study completion at 24 months or withdrawal from the study.
Primary	Number of Primary Eyes With Distance Corrected Near Visual Acuity (DCNVA) to 20/40 or Better or Improvement of 2 or More Lines	Measurement of the Distance Corrected Near Visual Acuity at 40 centimeters achieving 20/40 or better or improvement of 2 or more lines at 24 months for the primary eye.	From date of baseline measurement until the date of study withdrawal or study completion, whichever came first, assessed up to 2 years.
Secondary	Presence of Significant Safety Events (SAEs).	The point estimate were calculated for clinically significant adverse events (SAE's) at the end of the study. Incidence of adverse event totals should not to exceed 5%, and the incidence of each event should not exceed 1-2%.; NOTE: Because the secondary outcome is a safety measure, both primary and fellow eyes were used for analysis.	From initiation of the implantation procedure (operative day) until study completion at 24 months or withdrawal from the study.

External Links

•   US Food and Drug Administration Website