96 Participants Needed

Cross Linking for Corneal Transplant

(ExCrossV Trial)

Recruiting at 10 trial locations
MC
NB
Overseen ByNikolay Boychev, OD, PhD
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method for preparing corneal tissue for individuals who have undergone a corneal transplant and face a high risk of complications. The study compares two groups: one receiving corneal donor tissue with cross-linking, treated with a combination of riboflavin (Vitamin B2) and dextran, followed by UV light, and the other receiving untreated tissue. The primary goal is to assess the safety of this treatment method. Individuals who have had a corneal transplant and are experiencing new blood vessel growth in the cornea may be suitable candidates for this trial. As a Phase 2 trial, this research focuses on evaluating the treatment's effectiveness in an initial, smaller group, offering participants an opportunity to contribute to significant advancements in corneal transplant care.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, if you are using systemic immunosuppressive drugs for reasons other than corneal graft rejection, you may not be eligible to participate.

What prior data suggests that Ex Vivo Cross Linking is safe for corneal transplants?

Research shows that corneal cross-linking (CXL) is generally safe, with a low risk of serious problems. Although rare, some possible issues include infections, blurry vision, or corneal scarring, but these are uncommon.

CXL strengthens the cornea (the clear front part of the eye) using a mix of riboflavin (Vitamin B2) and UV light. Most patients tolerate this treatment well. It is commonly used for conditions like keratoconus, which alters the shape of the cornea.

This trial focuses on using CXL with donor corneal tissue. This method resembles current CXL treatments, suggesting it might also be safe. The trial is in Phase 2, indicating some early evidence of safety, but more research is needed for confirmation.12345

Why do researchers think this study treatment might be promising?

Researchers are excited about this treatment because it introduces a novel approach to corneal transplants by using cross-linking with riboflavin (Vitamin B2) and UV light. This method aims to strengthen the corneal tissue, potentially reducing the risk of rejection and improving transplant success rates. Unlike traditional corneal transplants, which may not address issues of tissue stability, this cross-linking technique offers a promising way to enhance the durability and integration of donor tissue, providing a more robust solution for patients with corneal conditions.

What evidence suggests that Ex Vivo Cross Linking is effective for corneal transplant?

Research has shown that treating corneal donor tissue outside the body (ex vivo) with a process called cross-linking (CXL) can improve the success of corneal transplants, especially in more challenging cases. In this trial, participants will receive either treated or untreated cross-linked corneal tissue. Studies have found that CXL strengthens the corneal tissue, potentially helping transplanted tissue last longer. This treatment uses a mix of riboflavin (Vitamin B2), a sugar solution called dextran, and UV light to strengthen the cornea. Previous results suggest that this method can stop the progression of conditions like keratoconus, which often leads to the need for a corneal transplant. Overall, early findings indicate that CXL-treated tissue might provide better long-term results for patients receiving corneal transplants.678910

Who Is on the Research Team?

JC

Joseph Ciolino, MD

Principal Investigator

Massachusetts Eye and Ear

Are You a Good Fit for This Trial?

This trial is for adults over 18 who need a high-risk corneal transplant due to significant blood vessel growth into the cornea. They must be able to follow the study plan and not have had recent eye surgery, uncontrolled glaucoma, active uveitis, ocular infections or malignancies, certain systemic diseases like Stevens-Johnson syndrome, or be pregnant.

Inclusion Criteria

Willing and able to provide written informed consent
Willing and able to comply with study assessments for the full duration of the study
I need a high-risk cornea transplant due to significant blood vessel growth.
See 1 more

Exclusion Criteria

I haven't changed my steroid cream use in the last 2 weeks.
I have glaucoma that is not well-managed.
Participation in another simultaneous medical investigation or trial
See 10 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either treated or untreated corneal tissue for high-risk penetrating keratoplasty

Immediate post-surgery

Follow-up

Participants are monitored for safety and effectiveness after transplantation, including ocular safety and graft rejection

24 months

What Are the Treatments Tested in This Trial?

Interventions

  • Corneal Donor Tissue with Cross Linking
Trial Overview The trial is testing if treating donor corneas with Ex Vivo Cross Linking (CXL) before transplantation is safe compared to using untreated donor tissue. Participants are those undergoing high-risk penetrating keratoplasty.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Participants Receiving Treated Cross Linked Corneal TissueExperimental Treatment1 Intervention
Group II: Participants Receiving Untreated Cross Linked Corneal TissuePlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Massachusetts Eye and Ear Infirmary

Lead Sponsor

Trials
115
Recruited
15,000+

Published Research Related to This Trial

Corneal cross-linking (CXL) has been established as a safe and effective treatment for keratoconus and corneal ectasias, supported by numerous laboratory and clinical studies.
Recent research is paving the way for advancements in CXL techniques, including accelerated methods and epithelium-sparing protocols, which may enhance treatment outcomes and broaden the applications of CXL.
Current and future applications of corneal cross-linking.Khandelwal, SS., Randleman, JB.[2018]

Citations

Clinical Efficacy of Ex Vivo Cross-Linking on ...These results suggest that ex vivo CXL of donor tissue may be a particularly promising option to improve the survival rates of keratoplasties that are defined ...
The role of graft cross-linking during keratoplasty in ...This is a retrospective case series reporting the clinical outcomes of patients who received a crosslinked corneal graft during penetrating or ...
Review Article Corneal Crosslinking: Present and FutureCorneal crosslinking (CXL) has emerged as an effective method to halt the progression of keratoconus and reduce the number of patients requiring keratoplasty.
A Randomized Clinical Trial of Ex Vivo Corneal Cross ...This randomized clinical trial will assess corneal astigmatism and visual outcomes in participants who have undergone corneal transplantation for ...
Economics of Corneal Cross-Linking for Keratoconus TreatmentModel outcomes per patient with updated corneal transplant cost and age-based progression. CXL. No CXL. Difference. Total Costs. $39,336.
Corneal Crosslinking (CXL) For Keratoconus | Risks & ...CXL is a safe and widely recognized procedure with a low risk of complications, but there are a few potential risks you should know about.
Severe Complications after Corneal Collagen Cross-Linking ...In general, CXL is an effective and safe procedure with a very low rate for severe complications , . The rare severe complications that occur ...
Corneal Cross-Linking (Collagen Cross-Linking)Other risks may include infection of the cornea by bacteria or viruses, corneal opacity, decreased vision, blurred vision, scarring, and corneal striae (the ...
Managing Cross-linking ComplicationsCorneal collagen cross-linking can be used to prevent progression. This treatment is a particularly safe and effective procedure, and rarely do complications ...
Corneal Cross-LinkingCXL is surgery to treat a weakened or warped cornea. Disease or sometimes surgery can harm collagen, an important substance that holds the cornea together.
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