Individualized Refractive Surgery
Conditions
Brief summary
Justification: Although great strides have been made in the past to develop VEMoS software, it has not yet been validated with actual clinical data from patients who have undergone cataract or refractive surgery. There are some fundamental questions that must be addressed to validate and update the software, such as the objective visual quality metrics that best predict the patient's post-surgical subjective vision from the predictions of the optical properties of the eye. The VEMoS software must be adjusted for different types of inputs and eye parameters: Corneal tomography of MS39-AXL MS39-AXL corneal tomography + biometric data from the IOL Master MS39-AXL corneal tomography + IOL Master biometric data + total aberrometry Combinations of any of the above with the optical properties of a specific IOL, etc. Objective The main objective is to standardize the selection of parameters to personalize refractive surgery, based on the biometric data of each patient. The objectives necessary to achieve such an ambitious goal are: 1. Redesign VEMoS software 2. Determine which biometric data, diagnostic tools, and objective and subjective metrics of visual quality are best for the selection of optimal refractive parameters for surgery 3. Optimize the combined use of biometric data, VEMoS software, and visual quality metrics Study design The proposed multicenter clinical trial is observational and prospective. There will be three arms within the clinical trial, a no-treatment arm, a refractive surgery arm, and a cataract surgery arm. Participants in the untreated arm will undergo an ophthalmic exam only once. Participants in the other two arms will undergo two ophthalmic exams, one before and one after surgery. For all participants, cataract or refractive surgery will be performed as part of routine clinical practice. Other additional tests performed are all non-invasive. Study population Untreated eye arm patients 18 to 40 years of age. Refractive surgery arm patients who are planned and have consented to a corneal refractive procedure to gain spectacle independence. Cataract surgery arm patients older than 50 years who are planned and have consented to cataract surgery. Sample size The sample sizes for each arm of the clinical trial are as follows. Untreated eye arm: The goal is to recruit 600 eyes from 300 patients, 100 patients in each of these groups: Myopia (from -10 D to -0.75 D) Emmetropia (from -0.5 D to + 0.5 D) Hyperopia (from 0.75 D to 5 D) Refractive surgery arm: For LASIK, the goal is to recruit 800 eyes from 400 patients, 100 patients in each of these groups: High myopia (from -10 D to -6 D) Medium myopia (from -6 D to -3 D) Low myopia (from -3 D to -1 D) Hyperopia (from +1 D to +4 D) For SMILE, the goal is to recruit 400 eyes from 200 patients, 100 patients in each of these groups: High myopia (from -10 D to -6 D) Average myopia (from -6 D to -3 D) For the cataract surgery arm: The goal is to recruit 400 eyes from 200 patients, 100 patients in each of these groups Zeiss monofocal IOLs multifocal IOL A total of 500 patients are expected between the Vissum, IMO and IOA clinics in Miranza. A total of 250 patients are expected between hospital and university of Coimbra epe (Portugal). A total of 350 patients are expected at Aarhus universitetshospital (Denmark).
Interventions
DEVICESoftware development for individualized refractive surgery
Software development for individualized refractive surgery
Sponsors
COSTRUZIONI STRUMENTI OFTALMICI C.S.O. SRL
Unidade Local de Saúde de Coimbra, EPE
Aarhus University Hospital
Vissum, Instituto Oftalmológico de Alicante
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
For the untreated eyes arm, the inclusion criterion is: • patients from 18 to 40 years of age and with less than 2 D of astigmatism. For the refractive surgery arm, the inclusion criteria are: * for LASIK: sphere between -10 D and +4 D and with less than 3 D of astigmatism. * for SMILE: sphere between -10 D and -3 D, with less than 3 D of astigmatism. For the cataract surgery arm, the inclusion criterion is: • patients older than 50 years old without any active ocular pathologies affecting visual capabilities except cataract and with less than 1 D of astigmatism.
Exclusion criteria
For the untreated eyes and the refractive surgery arms, the
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Variables to run the VEMoS software and obtain estimates and simulations Corneal Topography | 3 months | To evaluate the keratomery in diopters |
| Variables to run the VEMoS software and obtain estimates and simulations Pupil size | 3 months | To evaluate pupil size at different illumination in milimeters |
| Variables to run the VEMoS software and obtain estimates and simulations anterior chamber depth | 3 months | To obtain the anterior chamber depth in milimeters |
| Variables to run the VEMoS software and obtain estimates and simulations, crystalline lens thickness | 3 months | To obtain the crystalline lens thickness in milimeters |
| Variables to run the VEMoS software and obtain estimates and simulations, axial length | 3 months | To obtain the axial length in milimeters |
Countries
Spain
Outcome results
None listed