Safety and Effectiveness of the PXL Platinum 330 System With Riboflavin Solution for Previously Untreated Corneal Ulcers

Last updated: October 26, 2022
Sponsor: Peschke GmbH
Overall Status: Active - Recruiting

Phase

2/3

Condition

Eye Disorders/infections

Treatment

N/A

Clinical Study ID

NCT05255107
PXL-330-02B
  • Ages > 18
  • All Genders

Study Summary

This study is being conducted to evaluate the safety and effectiveness of using the PXL Platinum 330 System with riboflavin solution for performing corneal collagen crosslinking (CXL) for the treatment of previously untreated corneal ulcers. The PXL Platinum 330 System is a combination product consisting of an ultraviolet A (UV-A) 365 nm wavelength light source (PXL Platinum 330 Illumination System) and riboflavin (Riboflavin 0.23% PESCHKE-L Solution) administered in conjunction with the UV-A light as a photosensitizer. The PXL Platinum 330 System is intended to induce corneal collagen CXL to improve the biomechanical properties of the cornea by strengthening the corneal tissue in the anterior stroma. Corneal collagen CXL is performed by pretreating the cornea with riboflavin ophthalmic solution beginning 40 min before UV-A light exposure to saturate the corneal tissue with the riboflavin photosensitizer. The cornea is then irradiated with UV-A light (365 nm) at an irradiance of 18 mW/cm2 (5 seconds on, 5 seconds off) for 10 min. Exposure of the cornea to this UV-A light regimen after topical administration of riboflavin ophthalmic solution has been shown to induce CXL of the corneal collagen fibrils, with a resultant increase in tensile strength and diameter of the collagen fibrils. Clinically, CXL has been shown to stabilize the corneal curvature in eyes with progressive keratoconus, with no significant change in the refractive index of the cornea. Numerous reports and a few clinical trials have also shown benefit in aiding resolution of infective corneal ulcers.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Subjects who have one or both eyes that meet the following criteria will be consideredcandidates for this study:
  1. 18 years of age or older
  2. Ulcers that have not been treated with ophthalmic antibiotic eyedrops (eg,quinolone, polymyxin/trimethoprim, erythromycin, vancomycin, tobramycin,cefazolin, or other ophthalmic antimicrobials) in the preceding 30 dayserythromycin, vancomycin, tobramycin, cefazolin, or other ophthalmicantimicrobials) in the preceding 30 days
  3. Consent to a corneal culture for suspected bacterial keratitis (defined as acorneal epithelial defect of any size with an infiltration of the underlyingstroma)
  4. Signed written informed consent
  5. Willingness and ability to comply with schedule for follow-up visits
  6. Minimum corneal thickness >300 μm

Exclusion

Exclusion Criteria:

  • All subjects meeting any of the following criteria will be excluded from this study:
  1. Presence of a perforated corneal ulcer
  2. Presence of a corneal ulcer that had produced a descemetocele
  3. Presence of a corneal ulcer deeper than 50% depth or 275 μm in the cornea
  4. Any active ocular infection other than the corneal ulcer to be treated
  5. Suspicion of amoebic or viral keratitis requiring treatment with topicalanti-amoebic or topical antiviral ophthalmic medications
  6. Previous ocular condition (other than refractive error) in the eye(s) to betreated that may predispose the eye(s) for future complications. This may includehistory of or active corneal disease (eg, herpes simplex, herpes zosterkeratitis, recurrent erosion syndrome, acanthamoeba, etc.)
  7. Uncontrolled systemic disease, especially a collagen-vascular or rheumatologiccondition that could be contributing to the corneal condition
  8. Pregnancy (or plan to become pregnant) or lactation during the course of thestudy
  9. A known sensitivity to study medications
  10. Presence of nystagmus or any other condition that would prevent a steady gazeduring the CXL treatment or other diagnostic tests

Study Design

Total Participants: 468
Study Start date:
March 14, 2022
Estimated Completion Date:
February 24, 2024

Study Description

This is a prospective, 2-arm parallel-group, single-masked, randomized multicenter study to determine the safety and effectiveness of the PXL Platinum 330 System for performing CXL in eyes with previously untreated corneal ulcers. Subjects with documented infectious corneal ulcers that have not been treated (treatment na ve) will be evaluated initially for suitability as candidates for CXL. Subjects who are candidates for CXL will be asked to participate in this study and will undergo the required screening procedures to determine study eligibility. Informed consent will be obtained from each subject before performance of any required study procedures that are not part of the investigator's routine examination. After completing screening procedures, the diagnosis for each eligible eye will be confirmed. Subjects will be randomized to 1 of 2 groups, both including standard of care (SOC) treatment:

  1. SOC: Moxifloxacin 0.5% eyedrop therapy every 1 hour (q1h) while awake; to be tapered at treating physician's discretion

  2. CXL + SOC: Moxifloxacin 0.5% eyedrop therapy + CXL

Eyes undergoing CXL will have topical anesthetic administered and then have topical riboflavin instilled onto the cornea every 2 min (or longer as needed to assure adequate corneal penetration), after which the cornea will be exposed to UV-A pulsed light 18 mW/cm2 for 10 min. Riboflavin instillation will continue every 2 min during CXL. The CXL procedures will be performed on an outpatient basis using the PXL Platinum 330 System (UV-A light source and riboflavin solution). All use of the PXL Platinum 330 System will be in accordance with this protocol and the general instructions provided by the manufacturer (PESCHKE) in the PXL Platinum 330 Illumination System Operator's Manual. All subjects will be evaluated at Screening/Baseline, Day 0 (Randomization/Treatment), Day 1, Day 3 ( 1 day), Week 1 ( 2 days), Week 2 ( 2 days), and Week 4 ( 3 days) after treatment. Efficacy monitoring throughout the study will include observations at appropriate times for re-epithelialization, size of infection, and corneal culture results. Safety monitoring throughout the study will include observations at appropriate times for pain, IOP, BSCVA, corneal scar size, AEs, clinically significant findings on ophthalmic examination, dilated fundus examination, and slit lamp examination. After treatment, subjects will be followed at the treating physician's discretion.

Connect with a study center

  • Colorado Eye Consultants

    Littleton, Colorado 80120
    United States

    Active - Recruiting

  • Gorovoy M.D Eye Specialists

    Fort Myers, Florida 33907
    United States

    Active - Recruiting

  • Bay Area Eye Institute

    Tampa, Florida 33613
    United States

    Active - Recruiting

  • Price Vision Group

    Indianapolis, Indiana 46260
    United States

    Active - Recruiting

  • The cornea & Laser Eye Institute-NJ

    Teaneck, New Jersey 07666
    United States

    Active - Recruiting

  • SightMD

    Babylon, New York 11702
    United States

    Active - Recruiting

  • Prisma Health Opthalmology

    Columbia, South Carolina 29203
    United States

    Active - Recruiting

  • Woolfson Eye

    Chattanooga, Tennessee 37421
    United States

    Active - Recruiting

  • Houston Eye Associates

    Houston, Texas 77008
    United States

    Active - Recruiting

  • San Antonio Eye Center

    Lackland Air Force Base, Texas 78236
    United States

    Active - Recruiting

  • Milwaukee Eye Surgeons

    Milwaukee, Wisconsin 53203
    United States

    Active - Recruiting

  • Valley Eye

    Oshkosh, Wisconsin 54901
    United States

    Active - Recruiting

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