Cataract Surgery, Dry Eye Disease (DED)
Conditions
Brief summary
Cataract surgery is one of the most frequent and successful interventions currently undertaken in medicine. However, a significant number of patients who underwent cataract surgery still complain about postoperative symptoms, such as irritation, pain, dryness, burning sensation, and foreign body sensation. Dry eye disease (DED) is a common postoperative symptom, with a prevalence fluctuating from 9.8% to 34% depending on the studies. The onset, or the worsening, of DED signs and symptoms usually occurs in the first postoperative week and may last for months affecting the satisfaction and quality of life of the patient. The reasons of dry eye development after cataract surgery include thermal and light toxicity from the microscope, corneal epithelial damage, repeated drying and irrigation of ocular surface during operation, sterilization of conjunctival sac and eyelid with chemicals, transection of the corneal nerves by corneal incision, use of topical anaesthetics, and preservatives in topical eye drops. The mainstay of post-cataract surgery DED prevention and management is the treatment with non-preserved artificial tears, which has shown good results in terms of the reduction in postoperative DED signs and symptoms in previous clinical studies. NOX-01 Ocular Drops is a medical device not already CE-marked. It is a preservative-free ophthalmic lubricant solution intended to be used in cases of moderate to severe dry eye in adults, regardless of gender. NOX-01 is a biomimetic emulsion which lubricates and protects the corneal surface, limiting the inflammation due to dry eye and stabilizing the tear film. The primary objective of this pilot and pre-market study is to assess the tolerance of NOX-01 on eye dryness syndrome before and after a cataract surgery, in patients with pre-existing mild to moderate DED, during 84 days of use (12 weeks). The performance of the product, used 4 times per day, in improving signs of symptoms of DED, will also be assessed before and after cataract surgery, as well as subject and investigator satisfaction.
Interventions
DEVICENOX-01
1 drop per eye, four times per day, in the operated eye
Sponsors
NOXELIS
Eurofins Dermscan Pharmascan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 78 Years
Healthy volunteers
No
Inclusion criteria
* 2\. Age: \> 18 years and less than 78 years old. 3. Subject who requires a unilateral cataract surgery (phacoemulsification and intra ocular lens implantation) or bilateral cataract surgery with delay of maximum 4 days between two eyes operation. 4\. Subject with mild to moderate dry eye at the pre-operative visit with the following scores: * OSDI (Ocular Surface Disease Index) ≥ 13 and ≤ 32 * Schirmer test in the operated eye ≥ 5 mm/5min and ≤ 15 mm/5min And/or * Non-invasive break-up time (NIBUT) in the operated eye: sum of 3 measurement ≥ 5 sec and ≤ 15 sec 5. Patient who did not use artificial tears 1 week before the screening visit. 6. Patient having given freely and expressly his informed consent. 7. Patient psychologically able to understand the study related information and to give a written informed consent. 8\. Female of childbearing potential should use a contraceptive regimen recognized as effective since at least 12 weeks before screening visit, during all the study and at least 1 month after the study end.
Exclusion criteria
In terms of population 1. Pregnant or nursing woman or planning a pregnancy during the study. 2. Subject who had been deprived of their freedom by administrative or legal decision or who is under guardianship. 3. Subject in a social or sanitary establishment. 4. Subject suspected to be non-compliant according to the investigator's judgment. 5. Patient using contact lens during screening period and the entire study (even if prescribed by the investigator after surgery). In terms of associated pathology 6. Subject with a condition or receiving a medication which, in the investigator's judgment, put the subject at undue risk. 7. Subject with severe eye dryness 8. Patient with palpebral malposition with a tendency to incomplete blinking +/- scleral show 9. Patient with general pathologies that can cause dry eye syndrome like: thyroid disorder, cutaneous rosacea, acne and/or iatrogenic effects of isotretinoin treatment. 10. Presence of ocular comorbidities such as glaucoma, uveitis or cystoid macular oedema. 11. Neuropathic causes of dry eye ( long-standing contact lens wearing, previous ocular herpes infections) 12. Past or active ocular surface diseases (any corneal disease, cicatricial conjunctivitis, ocular surface burns, keratinization of the eyelid margin, Sjogren syndrome, corneal trauma) 13. Ocular or general factors predisposing the patient to an increased risk for intraoperative complications, according to investigator's evaluation 14. Know hypersensitivity to any component of the study product Relating to previous or ongoing treatment 15. Subject with other ocular surgery in the 12 previous months. 16. Subject with lid surgery in the 3 previous months 17. Subject who received systemic non-steroidal anti-inflammatory drugs, immunosuppressants, corticoids or any medication that could interfere with lacrimal function during the 3 weeks prior to the study. 18. Subject who received topical antibiotics, topical NSAIDs, topical steroid or topical cyclosporine in either eye in the past month.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Severe ocular symptoms | Day 1, Day 7, Day 28 and Day 84 | Tolerance of NOX-01 : Proportion of subject with at least one severe symptom. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Schirmer test result | 7 day before surgery, Day 1, Day 7, Day 28 and Day 84 | Change from baseline before cataract surgery (Day-7) and from baseline after cataract surgery (Day1) at each applicable time point for the following parameters, in the first operated eye The results are expressed in mm/5min |
| Cornea and conjunctiva staining (Oxford score) | 7 day before surgery, Day 1, Day 7, Day 28 and Day 84 | Change from baseline before cataract surgery (Day-7) and from baseline after cataract surgery (Day1) at each applicable time point for the following parameters, in the first operated eye Scale from 1 to 15 (worse) |
| OSDI score | 7 day before surgery, D1, Day 7, Day 28 and Day 84 | Change from baseline before cataract surgery (Day-7) and from baseline after cataract surgery (Day1) at each applicable time point for the following parameters, in the first operated eye Scale from 0 to 100 (worse) |
| Epithelial Thickening Mapping : Total pachymetry (total thickness of the cornea) | 7 day before surgery, Day 1, Day 7, Day 28 | Change from baseline before cataract surgery (Day-7) and from baseline after cataract surgery (Day1) at each applicable time point, in the first operated eye Express in micrometer |
| Intra-Ocular Pressure (IOP) | 7 day before surgery, Day 1, Day 84 | Change from baseline before cataract surgery (Day-7) and from baseline after cataract surgery (Day1) at each applicable time point for the following parameters, in the first operated eye |
| Symptoms evaluated by the patient using a VAS | Day 7, Day 28, Day 84 | Visual Analog Scale Symptom Index : from 0% to 100% (worse) |
| Global tolerance score evaluated by the investigator | Day 84 | On a 4-point scale (Unsatisfactory, Not very satisfactory, Satisfactory, Very satisfactory) |
| Global tolerance score evaluated by the patient | Day 84 | On a 4-point scale (Unsatisfactory, Not very satisfactory, Satisfactory, Very satisfactory) |
| Global performance score evaluated by the investigator | Day 84 | On a 4-point scale (Unsatisfactory, Not very satisfactory, Satisfactory, Very satisfactory) |
| Global performance score evaluated by the patient | Day 84 | On a 4-point scale (Unsatisfactory, Not very satisfactory, Satisfactory, Very satisfactory) |
| Patient satisfaction | Day 28 and Day 84 | Questionnaire |
| Adverse event | 7 day before surgery, Day 1, Day 7, Day 28, Day 84 | Adverse event collection |
| Non-invasive film Break-Up Time (NIBUT) | 7 day before surgery, Day 1, Day 7, Day 28 and Day 84 | Change from baseline before cataract surgery (Day-7) and from baseline after cataract surgery (Day1) at each applicable time point for the following parameters, in the first operated eye The specular image of a pattern projected onto the tear film, is examined with a corneal topographer. The time taken for the image to degrade, after the last blink, is the NIBUT, expressed in seconds. Each site will evaluate NIBUT according to their own device and procedure (Topcon CA-800 Catalog, Atlas 9000, Pentacam HD, Atlas 500 or Pentacam AXL Wave). The NIBUT will be assessed three times and the sum of these three measurements will be calculated. |
| Conjunctival hyperaemia using the McMonnies photographic scale | 7 day before surgery, Day 1, Day 7, Day 28 and D84 | Change from baseline before cataract surgery (Day-7) and from baseline after cataract surgery (Day1) at each applicable time point for the following parameters, in the first operated eye. Scale from 0 to 5 (worse) |
Countries
Spain
Contacts
CONTACTGautier LALEVEE
Outcome results
None listed