NCT00411827

Brief Summary

Purpose: To develop a screening metric by examining both the characteristics of the preoperative tear film and the intracellular signaling pathways of conjunctival goblet cells in order to determine if there are certain characteristics which might predict those patients who will experience serious dry eye symptoms and complications after refractive surgery. Research Design: This study is a twelve-month prospective non-randomized investigation. Methodology: In conjunction with psychometric questionnaires and various measures of tear film quality (e.g. Schirmer's test, tear break up time, etc), impression cytology will be used to assess the intracellular signaling pathways of conjunctival goblet cells and to determine if alterations in this pathway exist. Alterations in this pathway would result in a reduced response by the mucin secreting conjunctival goblet cells thereby promoting the development of dry eye after refractive surgery.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
146

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jan 2008

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 13, 2006

Completed
2 days until next milestone

First Posted

Study publicly available on registry

December 15, 2006

Completed
1 year until next milestone

Study Start

First participant enrolled

January 1, 2008

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2011

Completed
5.2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2016

Completed
Last Updated

September 20, 2024

Status Verified

September 1, 2024

Enrollment Period

3.1 years

First QC Date

December 13, 2006

Last Update Submit

September 17, 2024

Conditions

Keywords

CytologyKeratomileusis, Laser In SituKeratectomy, Photorefractive, Excimer Laser

Outcome Measures

Primary Outcomes (1)

  • Dry eye

    one year after surgery

Study Arms (2)

1

ACTIVE COMPARATOR

PRK

Procedure: PRK with conjunctival impression cytology before and after surgery

2

ACTIVE COMPARATOR

LASIK

Procedure: LASIK with conjunctival impression cytology before and after surgery

Interventions

Eligibility Criteria

Age21 Years - 40 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Subjects will be recruited from those active duty soldiers that have requested refractive surgery. Subjects must be eligible for medical care at WRAMC.
  • Male or female, of any race, and at least 21 years old and not older than 40 years old at the time of the pre-operative examination, and have signed an informed consent. The lower age limit of 21 years is intended to ensure documentation of refractive stability and is the minimal age required by the FDA for informed consent for LASIK surgery.
  • Manifest refractive spherical equivalent (MSE) of up to 10.00 diopters at the spectacle plane with refractive cylinder up to 3.00 D.
  • Best spectacle corrected visual acuity of 20/20 or better in both eyes.
  • Patients who are willing to fill out dry eye questionnaires.
  • Demonstrated refractive stability, confirmed by clinical records. Neither the spherical nor the cylindrical portion of the refraction may have changed more than 0.50D during the 12- month period immediately preceding the baseline examination, as confirmed by clinical records.
  • All patients must be willing to return to the WRAMC Center for Refractive Surgery for follow up visits on Day1, Day 3, Day 7, and 1, 3, 6, and 12 months after their surgery.
  • Located in the greater Washington DC area for a 14-month period.
  • Consent of the subject's command (active duty) to participate in the study.
  • Access to transportation to meet follow-up requirements.

You may not qualify if:

  • Previous surgery or trauma to the study eye.
  • Dry eye as reflected by Schirmer's test with anesthesia of 0, subjective complaints or symptoms of dry eye, findings during the slit lamp exam that would be consistent with dry eye (e.g. superficial punctuate keratitis).
  • Concurrent topical or systemic medications that may impair healing, including corticosteroids, antimetabolites, isotretinoin (Accutane), amiodarone hydrochloride (Cordarone) and/or sumatriptan (Imitrex).
  • Medical condition(s), which, in the judgment of the investigator, may impair healing, including but not limited to: collagen vascular disease, autoimmune disease, immunodeficiency diseases, and ocular herpes zoster or simplex.
  • Active ophthalmic disease, neovascularization of the cornea within 1mm of the intended ablation zone, or clinically significant lens opacity.
  • Evidence of glaucoma or an intraocular pressure greater than 22 mm Hg at baseline.
  • Evidence of keratoconus, corneal irregularity, or abnormal videokeratography in either eye.
  • History of recurrent erosions or epithelial basement dystrophy.
  • Patients with known sensitivity or inappropriate responsiveness to any of the medications used in the post-operative course.
  • Any physical or mental impairment that would preclude participation in any of the examinations.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Walter Reed Army Medical Center

Washington D.C., District of Columbia, 20307, United States

Location

MeSH Terms

Conditions

Keratoconjunctivitis Sicca

Interventions

Postoperative PeriodKeratomileusis, Laser In Situ

Condition Hierarchy (Ancestors)

KeratoconjunctivitisConjunctivitisConjunctival DiseasesEye DiseasesKeratitisCorneal DiseasesDry Eye SyndromesLacrimal Apparatus Diseases

Intervention Hierarchy (Ancestors)

Perioperative PeriodSurgical Procedures, OperativePatient CareHealth ServicesHealth Care Facilities Workforce and ServicesCorneal Surgery, LaserLaser TherapyTherapeuticsAblation TechniquesKeratectomyRefractive Surgical ProceduresOphthalmologic Surgical Procedures

Study Officials

  • Richard D Stutzman, MD

    WRNMMC

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
FED
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Director, Warfighter Refractive Eye Surgery Program and Research Center at FT Belvoir

Study Record Dates

First Submitted

December 13, 2006

First Posted

December 15, 2006

Study Start

January 1, 2008

Primary Completion

February 1, 2011

Study Completion

May 1, 2016

Last Updated

September 20, 2024

Record last verified: 2024-09

Locations