Evaluate the Safety and Efficacy of the Vizio Aqueous Microshunt for the Treatment of Refractory Glaucoma
Glaucoma is a leading cause of irreversible blindness in the world and remains a largely unmet clinical need, especially for trial participants with refractory glaucoma. Available aqueous drainage devices may reduce IOP, but often require continued use of medications. Ocumedex is testing the Vizio Aqueous Microshunt (VAM), a promising medical device engineered to safely and consistently lower IOP to a threshold (approximately 12 mmHg) that may halt further damage to the optic nerve without the use of supplemental medication. The Vizio Aqueous Microshunt is a next generation device initially developed by MicroOptx, Inc. In early 2023, Innomedex, LLC acquired the assets of MicroOptx and formed the company, Ocumedex Inc. Ocumedex is now sponsoring the Vizio Clinical Study based on the product development that was conducted by MicroOptx under an ISO13485 compliant quality system inclusive of all development testing that is required prior to human use. MicroOptx, developed a first-generation device which was named the Beacon Aqueous Microshunt. The Beacon device had undergone early clinical trials in the United States, Canada and Germany in which 55 trial participants were implanted and clinically followed. The results of this clinical work clearly demonstrated the efficacy endpoint of significantly reducing intraocular pressure and alleviating the need for medications. The safety endpoint of the Beacon device had an adverse event rate that was higher than expected and hence further product development was initiated. The elevated adverse event rate was attributed to healing response of the first-generation material, implantation technique andtrial participant selection. Based on this information, the next generation device, Vizio, was developed with a new implant material which has demonstrated significantly improved healing in GLP animal studies. Additionally, physician training and proctoring has been refined to ensure proper device implantation as well as refined inclusion/exclusion criteria to ensure proper trial participant selection. Ocumedex is committed to developing technology that is safe and efficacious for the treatment of trial participants suffering from the devasting disease of glaucoma. With product improvements validated by bench and animal testing in addition to clinical trial rigor implemented, the Vizio product is set to initiate human implants and have a meaningful impact for trial participants. Additionally, unlike other surgical options available, the Vizio device shunts aqueous humor from the anterior chamber to the surface of the eye. This distinction is important: 1) Vizio drains aqueous humor into an open space with a known pressure (atmospheric), which may improve predictability and consistency of IOP control (vs. draining into a closed space, such as bleb or episcleral venous pressure); and 2) Shunting aqueous humor to the tear film, providing lubrication to the eye and improving ocular surface symptoms which are common in trial participants with glaucoma.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Ocular microshunt placement for the treatment of Glaucoma
Centro de Diabetes Ocular El Dios de Israel, S.A
Colonia Escalón, San Salvadore, El Salvador
RECRUITINGEfficiency of IOP reduction as measured through Applanation Tonometry
The primary endpoint is a binary measure of at least 20% reduction from baseline in diurnal IOP at twelve months from baseline. IOP will be measured on day 1, week 1, week 2, month 1, month 2, month 3, month 6, month9, and month 12. Baseline and month 12 IOP measurements will be diurnal. Medication use will be monitored during the follow ups and assessed at month 12 to measure whether participant is on the same number or fewer topical IOP-lowering medications, based on intent-to-treat population.
Time frame: 12 months
Safety of the Vizio device and procedure as monitored through adverse event reporting. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Rate of occurrence of serious procedure-related and/or device-related adverse events (AEs) observed throughout the study will be reported on the AE CRF. Adverse Events, whether related or unrelated to the investigational medical device, include 1) unintended disease or injury, or 2) any unfavorable or untoward clinical signs (including an abnormal laboratory finding). Adverse events (AEs) will be graded by the Investigator based on severity according to the following: • Mild - An event that is easily tolerated by the participant, causing minimal discomfort and not interfering with daily activities. • Moderate - An event that causes some interference with daily activities and may require minimal medical intervention. • Severe - An event that results in significant interference with daily activities, may be incapacitating, requires medical intervention or hospitalization, or is potentially life-threatening • Life-Threatening: The participant is at immediate risk of death.
Time frame: 12 months
Responder Rate
Responder rate for complete success at 12M: Defined as at least 20% mean diurnal IOP reduction from baseline after device implant with no IOP lowering medications
Time frame: 12 months
Overall Safety
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Rate of all ocular and non-ocular adverse events (intraoperative complications and postoperative events), including rate of pre-specified ocular adverse events (per ANSI Z80.27) and abnormal findings by pachymetry, slit lamp biomicroscopy, gonioscopy, fundoscopy, specular microscopy and patient-reported symptoms
Time frame: 12 months