A Randomized Controlled Clinical Trial of Corneal Epithelial Autograft for the Treatment of Limbal Stem Cell Deficiency
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Restoration of corneal surface in the diseased eye
Study Overview
Brief Summary
The purpose of the study is to explore whether femtosecond laser-assisted corneal epithelial autograft is more effective than limbal conjunctival autograft for ocular surface reconstruction in patients with limbal stem cell deficiency (LSCD).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 14 Years to 80 Years (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Unilateral LSCD secondary to ocular burns, with the duration of disease of at least 24 months at the time of screening visit;
- •Presence of superficial neo-vascularization affecting at least 2 cornea quadrants and involving central cornea;
- •Informed consent signed by patient or legal guardian. Having the ability to comply with study assessments for the full duration of the study.
Exclusion Criteria
- •LSCD of mild degree, with less than 2 quadrants of neo-vessel invasion and without central cornea involvement;
- •LSCD by ocular surface disorders other than pterygium;
- •Eyelids malposition;
- •The center corneal thickness<450µm, the depth of corneal opacity > 150µm;
- •High myopia with a spherical equivalent of -15.0 D or less;
- •Corneal or ocular surface infection within 30 days prior to study entry;
- •Ocular surface malignancy;
- •Uncontrolled diabetes with most recent Hemoglobin A1c greater than 8.5%;
- •Renal failure with creatinine clearance< 25ml/min;
- •Alanine aminotransferase > 40IU/L, or aspartate aminotransferase > 40IU/L;
- •Platelet levels < 150,000 or > 450,000 per microliter;
- •Hemoglobin < 12.0 g/dL (male) or < 11.0 g/dL (female);
- •Prothrombin time > 16s and activated partial thrombin time > 35s in patients not accepting anticoagulant therapy; An international normalized ratio greater than 3 in patients accepting anticoagulant therapy;
- •Pregnancy (positive test) or lactation;
- •Participation in another simultaneous medical investigation or clinical trial;
- •Severe cicatricial eye disease; Conjunctival scarring with fornix shortening;
- •Ocular comorbidities that affect the prognosis of transplantation, such as advanced glaucoma or retinal diseases;
- •Severe dry eye disease as determined by Schirmer's test < 2mm at least in one eye;
- •Any medical or social condition that in the judgment of the investigator would interfere with or serve as a contraindication to adherence to the study protocol or ability to give informed consent;
- •Signs of current infection, including fever and treatment with antibiotics;
- •Active immunological diseases;
- •History of allo-limbal transplantation, penetrating keratoplasty or anti-glaucoma filtering surgeries.
Arms & Interventions
Corneal epithelial autograft
Femtosecond laser assisted corneal epithelial autograft from the other eye in the treatment of LSCD
Intervention: Corneal epithelial autograft (Procedure)
Corneal epithelial autograft
Femtosecond laser assisted corneal epithelial autograft from the other eye in the treatment of LSCD
Intervention: Femtosecond laser (Device)
Limbal conjunctival autograft
Diamond knife assisted limbal conjunctival autograft from the other eye in the treatment of LSCD
Intervention: Limbal conjunctival autograft (Procedure)
Limbal conjunctival autograft
Diamond knife assisted limbal conjunctival autograft from the other eye in the treatment of LSCD
Intervention: Diamond knife (Device)
Outcomes
Primary Outcomes
Restoration of corneal surface in the diseased eye
Time Frame: 1 year
Restoration of a completely epithelized, stable, and avascular corneal surface in the diseased eye.
Restoration of corneal surface in the fellow eye
Time Frame: 1 year
Restoration of a completely epithelized, stable, and avascular corneal surface in the fellow eye.
Secondary Outcomes
- Uncorrected and best-corrected visual acuity in both eyes(1 year)
- Corneal power, astigmatism and aberration in both eyes(1 year)
- Corneal sensation in both eyes(1 year)
- Corneal thickness in both eyes(1 year)
- Density of stromal nerve and stromal keratocytes in both eyes(1 year)
- Reconstruction of limbal palisades of Vogt in the diseased eye(1 year)
- Corneal haze in both eyes(1 year)
Investigators
Chunxiao Wang
Clinical investigator
Sun Yat-sen University