NCT07135167

Brief Summary

The goal of this clinical trial is to study the effects of an experimental (not Food and Drug Administration (FDA)-approved) treatment called corneal crosslinking (CXL) for conditions in which the cornea becomes progressively thin, steep, and misshapen, causing vision to be blurred. CXL is performed by putting riboflavin (vitamin B2) drops onto the eye and then exposing it to ultraviolet (UVA) light at about the same intensity as you get outdoors on a bright, sunny day. It is designed to stop the progression of disease by strengthening the cornea. Study participants will be 8 years of age or older and have a diagnosis of Down syndrome. The main question it aims to answer is:

  • Does CXL help prevent or slow the progression of someone's corneal condition and vision loss? Participants will:
  • Attend up to a total of 7 in office visits over the course of 6 months, where several eye and vision tests will be given. Receive CXL (applying riboflavin (Vitamin B2 eye drops) to the eye, then exposing the eye to ultraviolet (UV-A) light for 20 minutes).

Trial Health

77
On Track

Trial Health Score

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

Enrollment
225

participants targeted

Target at P25-P50 for phase_3

Timeline
33mo left

Started Aug 2025

Typical duration for phase_3

Geographic Reach
1 country

12 active sites

Status
recruiting

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

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress22%
Aug 2025Dec 2028

Study Start

First participant enrolled

August 1, 2025

Completed
4 days until next milestone

First Submitted

Initial submission to the registry

August 5, 2025

Completed
16 days until next milestone

First Posted

Study publicly available on registry

August 21, 2025

Completed
3.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2028

Expected
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2028

Last Updated

February 2, 2026

Status Verified

January 1, 2026

Enrollment Period

3.3 years

First QC Date

August 5, 2025

Last Update Submit

January 29, 2026

Conditions

Keywords

corneal crosslinking (CXL)corneariboflavinvitamin B2ultraviolet

Outcome Measures

Primary Outcomes (2)

  • The primary outcome measures for efficacy is corneal curvature, as measured by Kmax with the Pentacam, in the treated eyes.

    Primarily using measurements to assess improvement of vision.

    From enrollment to the end of treatment at 6 months.

  • Improvement of vision as assessed by corrected distance visual acuity (CDVA).

    Change in CDVA compared to the baseline examination will be evaluated at 6 months postoperatively. Data will be summarized using descriptive statistics and experimental groups will be compared using nonparametric tests.

    From enrollment to the end of treatment at 6 months.

Secondary Outcomes (3)

  • Improvement in vision as measured by high order aberrations (HOA).

    From enrollment until end of follow-up period at 6 months.

  • Improvement in vision as assessed by change in coma.

    Enrollment through the follow-up phase at 6 months.

  • Improved vision as assessed by Uncorrected Visual Acuity (UCVA).

    Enrollment through the end of the follow-up period at 6 months.

Study Arms (1)

Enrolled and treated subject arm

EXPERIMENTAL

Epi-ON corneal cross-linking (CXL)

Combination Product: Epi-ON corneal cross-linking (CXL)

Interventions

Corneal cross-linking involves the following steps: * applying riboflavin (Vitamin B2 eye drops) to the eye, then * exposing the eye to ultraviolet (UV-A) light for 20 minutes.

Enrolled and treated subject arm

Eligibility Criteria

Age8 Years+
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Be at least 8 years of age or older, male or female, of any race.
  • Have a diagnosis of Down syndrome or other cognitive, developmental, or medical conditions that precludes the subject from reliably following instructions or performing some of the study examination procedures.
  • Have a diagnosis of keratoconus, pellucid marginal degeneration, progressive ectasia after previous CXL treatment, other ectatic condition, or forme fruste keratoconus based on topography, tomography, and slit lamp examination.
  • Provide written informed consent and a signed HIPAA form. Pediatric subjects less than 14 years of age must sign an assent, and a parent or legal guardian must sign an informed consent. If the subject has impaired consent capacity, determined by the consenter, the consent form must be signed by the subject's legally authorized representative on behalf of the subject.
  • Satisfactory completion of the standardized clinical decision tool evaluation of patient suitability for CXL. (See Section 7.2.3)
  • Be willing and able to follow all instructions to the best of his/her abilities and comply with the schedule for follow-up visits.

You may not qualify if:

  • Normal corneal topography.
  • A history of previous corneal transplant in the study eye.
  • Minimum corneal thickness \< 300 (measured by Pentacam and Ultrasound) at the screening exam.
  • Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye to future complications or prevent the possibility of improved vision, for example:
  • History of, or active, corneal disease (e.g., herpes simplex, herpes zoster keratitis, etc.)
  • Clinically significant corneal scarring in the central cornea that, in the investigator's opinion, will not allow the subject to achieve functional vision, even with contact lens correction, after the crosslinking procedure.
  • A known contraindication, sensitivity, or allergy to the test article or its components or to study medications.
  • Nystagmus or any other condition that would prevent a steady gaze during the crosslinking treatment or other diagnostic tests.
  • If female, pregnant, lactating or planning a pregnancy, or having a positive urine pregnancy test prior to the randomization of, or treatment of either eye during the course of the study. \[NOTE: If female and capable of becoming pregnant, must agree to use a medically acceptable form of birth control for at least one week prior to the treatment visit and to continue one month following treatment. \]
  • \. Inability to remove soft or scleral contact lenses at least 3 days before initial and follow-up examinations.
  • \. Inability to remove rigid gas-permeable contact lenses at least 2 weeks before initial and follow-up examinations.
  • \. Inability to return for required postoperative examinations. 10. Presence or history or any other condition or finding that, in the investigator's opinion, makes the subject unsuitable as a candidate for crosslinking or study participation or may confound the outcome of the study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (12)

Woolfson Eye Institute

Atlanta, Georgia, 30328, United States

RECRUITING

Woolfson Eye Institute

Atlanta, Georgia, 30349, United States

RECRUITING

Woolfson Eye Institute

Canton, Georgia, 30114, United States

RECRUITING

Woolfson Eye Institute

Cumming, Georgia, 30041, United States

RECRUITING

Woolfson Eye Institute

Douglasville, Georgia, 30134, United States

RECRUITING

Woolfson Eye Institute

Lawrenceville, Georgia, 30043, United States

RECRUITING

Woolfson Eye Institute

Marietta, Georgia, 30066, United States

RECRUITING

Woolfson Eye Institute

Snellville, Georgia, 30078, United States

RECRUITING

Woolfson Eye Institute

Asheville, North Carolina, 28803, United States

RECRUITING

Woolfson Eye Institute

Chattanooga, Tennessee, 37421, United States

RECRUITING

Woolfson Eye Institute

Johnson City, Tennessee, 37615, United States

RECRUITING

Woolfson Eye Institute

Knoxville, Tennessee, 37922, United States

RECRUITING

MeSH Terms

Conditions

Down SyndromeKeratoconusCorneal Diseases

Interventions

Corneal Cross-Linking

Condition Hierarchy (Ancestors)

Intellectual DisabilityNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesAbnormalities, MultipleCongenital AbnormalitiesCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesChromosome DisordersGenetic Diseases, InbornEye Diseases

Intervention Hierarchy (Ancestors)

PhotochemotherapyCombined Modality TherapyTherapeuticsDrug TherapyPhototherapy

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 3
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 5, 2025

First Posted

August 21, 2025

Study Start

August 1, 2025

Primary Completion (Estimated)

November 1, 2028

Study Completion (Estimated)

December 31, 2028

Last Updated

February 2, 2026

Record last verified: 2026-01

Locations