Corneal edema is the most common indication for corneal transplantation, accounting for approximately 70% of penetrating keratoplasty (PK), and 100% of endothelial keratoplasty (EK) procedures annually. There is currently no disease-modifying treatment for corneal edema. Topical treatments like hypertonic saline are not effective on a long-term basis. For those with advanced disease, where edema and vision loss are not controlled by topical treatment, the only option is a corneal transplant. A potential approach to avoidance of the risks of corneal transplantation is to inject cultured human corneal endothelial cells (HCECs) into the anterior chamber of the eye. This approach may avoid surgery by re-populating the inner most aspect of the cornea with functioning endothelial cells. Emmecell has developed a treatment based on technology integrating biocompatible magnetic nanoparticles with cultured HCECs to treat corneal edema in a minimally invasive way. The primary objective of this phase 1, prospective, multi-center, open-label, dose-escalation study is to evaluate the safety and tolerability of 3 doses of EO2002 with and without endothelial brushing (EB) or Descemet Stripping (DS) in eyes with corneal edema secondary to corneal endothelial dysfunction that qualify for surgery involving full-thickness corneal transplantation or EK.
The study is designed to occur in 2 groups. The objective with the first group is to preliminarily evaluate the safety of 4 escalating doses. The purpose of the second group is to gather additional safety information on the 3 highest doses when administered according to a randomized schedule and evaluated by masked observers. Group 1: Phase 1 prospective, multi-center, open-label, dose-escalation study designed to evaluate the safety and tolerability of EO2002 with and without endothelial brushing (EB) or Descemet Stripping (DS) in eyes with corneal edema secondary to corneal endothelial dysfunction that qualify for surgery involving full-thickness corneal transplantation or EK. Four doses will be studied in approximately 21 study participants that meet the inclusion/exclusion criteria. Safety and tolerability will be the primary focus for 26 weeks following treatment with EO2002. Group 2: The three highest doses will be administered to up to 21 subjects in a randomized, double-masked design.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
42
EO2002 (magnetic human corneal endothelial cells \[HCECs\]) with and without endothelial brushing (EB) or Descemet Stripping (DS)
Low dose of EO2002 (magnetic human corneal endothelial cells)
Mid dose of EO2002 (magnetic human corneal endothelial cells)
High dose of EO2002 (magnetic human corneal endothelial cells)
Los Angeles Location
Greater Los Angeles, California, United States
San Diego Location
San Diego, California, United States
Miami Location
Miami, Florida, United States
Palm Beach Gardens Location
Palm Beach Gardens, Florida, United States
Atlanta Location
Atlanta, Georgia, United States
Des Moines Location
Des Moines, Iowa, United States
Kansas City Location
Overland Park, Kansas, United States
Grand Rapids Location
Grand Rapids, Michigan, United States
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability of EO2002]
Incidence of Treatment-Emergent Adverse Events \[Safety and Tolerability of EO2002 (+/- EB or Descemet Stripping)\] in subjects with corneal edema at week 26.
Time frame: 26 Weeks
Effect of EO2002 (+/-EB or DS) on corneal thickness
Evaluate the effect of a single injection of EO2002 (+/-EB or DS) on corneal thickness as determined by pachymetry
Time frame: 26 Weeks
Effect of EO2002 (+/-EB or DS) on best corrected visual acuity (BCVA).
Evaluate the effect of a single injection of EO2002 (+/-EB or DS) on best corrected visual acuity (BCVA) as determined by ETDRS letter score.
Time frame: 26 Weeks
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