The EndoArt® device is intended to treat patients with chronic corneal edema due to endothelial dysfunction, in whom prior multiple keratoplasty (EK/PK) have failed, and who are not reasonable candidates for any form of corneal transplant, including penetrating keratoplasty. The EndoArt® (Corneal Artificial Endothelial layer) is a permanent synthetic implant. It is made of a clear, transparent, foldable, biologically compatible hydrophilic copolymer. The device serves as an inert physical barrier, blocking the ingress of fluid from the Anterior Chamber (AC) into the cornea.
The study is a prospective, multi-center, open-label, single arm pivotal clinical investigation. The objective is to evaluate the safety and effectiveness of EndoArt® implantation in subjects with chronic corneal edema, in whom multiple prior keratoplasty (EK/PK) procedures have failed, and who are not reasonable candidates for any form of corneal transplant, including penetrating keratoplasty. Safety will be assessed by evaluating the rate of any device related SAE occurred through the 12-month follow-up period. The primary effectiveness endpoint is the proportion of subjects achieving an improvement in visual acuity of at least 0.20 LogMAR for subjects with baseline BCVA better than 1.30 LogMAR, or an improvement to at least 1.30 LogMAR for subjects with baseline BCVA equal or worse than 1.30 LogMAR, at 12 months postoperatively. Subjects with chronic corneal edema, in whom multiple prior keratoplasty (EK/PK) have failed, and who are not reasonable candidates for any form of corneal transplant, including penetrating keratoplasty will be the study target population. Only subjects who have signed the informed consent form and meet all the eligibility criteria listed below will be qualified for enrollment. The study will include a total of 123 surgically treated subjects. This clinical investigation will be conducted in a maximum of fifteen (20) clinical sites in the USA.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Implantation of EndoArt® is similar to other anterior segment surgical procedures such as DSEK/DMEK
The rate of any device related SAE
SAEs may include, but are not limited to, e.g., secondary surgical intervention, severe infectious keratitis requiring hospitalization, and corneal perforation
Time frame: 12 months
Improvement in visual acuity as measured by BCVA
The proportion of subjects achieving a change in visual acuity of at least 0.20 LogMAR for subjects with baseline BCVA better than 1.30 LogMAR, or a visual acuity of 1.30 LogMAR or better at 12 months postoperatively for subjects with baseline BCVA of 1.30 LogMAR or worse
Time frame: 12 months
All AE rate
Rate of each AE
Time frame: 12 months
BCVA Success rate
BCVA Success rate of bad Vision Population (Baseline BCVA ≥ 1.30 LogMAR)
Time frame: 12 months
CCT
Change in central corneal thickness as measured by OCT from baseline to 12 months
Time frame: 12 months
Change in manifest refraction
The change in manifest refraction
Time frame: 12 months
Corneal clarity
Change in central general clarity grading score (using a scale of 0-normal to 4-severe)
Time frame: 12 months
Distribution of BCVA change
BCVA change
Time frame: 12 months
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Enrollment
123
Distribution of BCVA outcomes (using FrACT10)
BCVA outcomes
Time frame: 12 months
BCVA Success rate
BCVA Success rate of good Vision Population (Baseline BCVA \< 1.30 LogMAR)
Time frame: 12 months