Symfony Toric Intraocular Lens Visual Outcomes

NCT03082599 — Not applicable, Completed, 120 participants, Carolina Eyecare Physicians, LLC

ClinicalTrials Daily  ·  Areas  ·  Conditions  ·  Drugs  ·  Sponsors  ·  

Visual Outcomes of an Extended Depth of Focus (EDOF) Intraocular Lens (IOL)

RegistryNCT03082599
StatusCompleted
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, treatment
Enrollment120 (Actual)
SponsorCarolina Eyecare Physicians, LLC (Other); collaborators: Science in Vision, Abbott Medical Optics
ConditionsCataract Bilateral, Astigmatism Bilateral
InterventionsPresbyopia and astigmatism correcting intraocular lens (Device)
Datesstart 2017-02-17, primary completion 2018-04-03, completion 2018-04-03, first posted 2017-03-17, last updated 2020-01-27
Locations4 sites in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Cataract Bilateral All trials for Astigmatism Bilateral All trials of Presbyopia and astigmatism correcting intraocular lens

-Summary

In July 2016, the FDA approved an extended depth of focus (EDOF) IOL (Tecnis Symfony, Abbott Medical Optics) helping to improve the sharpness of vision at near, intermediate and far distances reducing the need of glasses after cataract surgery. It is available in both a non-toric version and a toric version for patients with astigmatism. The difference between this lens and the multifocal (MIOL) counterpart is that the EDOF, similarly to a monofocal IOL, has one focal point (elongated in the EDOF) while the multifocals have 2 focal points; therefore, having less of a halo and glare problem. Pivotal trial results where Symfony was compared to a monofocal IOL showed similar uncorrected distance visual acuity (UCDVA), better intermediate (77% vs. 34% 20/25 uncorrected intermediate visual acuity - UCIVA) and near vision (Symfony patients were able to read two additional, progressively smaller lines compared to the monofocal IOL).A One potential disadvantage of the EDOF IOL compared to a MIOL is the visual performance at near.B One option to deal with this potential shortcoming is to set the non-dominant eye for a small residual myopic error (-0.50 D)C what is referred to as nano-vision or mini mono-vision.

Expand all sections  ·  Collapse all

+Arms and interventions

ArmTypeInterventionsDescription
Emmetropia both eyes (OU) groupActive comparatorDevice: Presbyopia and astigmatism correcting intraocular lensSymfony Toric IOL target refraction both eyes emmetropia (±0.25D).
Nanovision groupExperimentalDevice: Presbyopia and astigmatism correcting intraocular lensSymfony Toric IOL target refraction for the dominant eye will be plano (±0.25D) and for the non-dominant eye -0.50 ±0.16 D.
  • Presbyopia and astigmatism correcting intraocular lens (Device): The Symfony Toric IOL (ZXTx) is an extended depth of focus (EDOF) IOL design to improve the sharpness of vision at near, intermediate and far distances reducing the need of glasses after cataract surgery in patients with astigmatism.

+Outcome measures

Primary outcomes

  • Binocular Distance-corrected Near (40 cm) Visual Acuity. [3 months]: Visual acuity with correction (glasses) measured at 40 cm.
  • Reduction of Manifest Cylinder (Diopters). [3 months]

Secondary outcomes

  • Uncorrected Near (40 cm) Visual Acuity [3 months]: Visual acuity without correction (no glasses) measured at 40 cm.
  • Uncorrected Intermediate (66 cm) Visual Acuity [3 months]: Visual acuity without correction (no glasses) measured at 66 cm.
  • Uncorrected (4 m) Visual Acuity [3 months]: Visual acuity without correction (no glasses) measured at 4 m.
  • Modified Patient-Reported Visual Symptoms Questionnaire (PRVSQ) [3 months]: Percentage of patients who reported any visual symptoms such as halos, glare, starburst, light sensitivity when answering the self administered questionnaire.
  • Patient Reported Spectacle Independence Questionnaire [3 months]: Percentage of participants who reported wearing glasses none or a little of the time in the self administered questionnaire.

Other outcomes

  • Residual Mean Spherical Equivalent Refraction [3 months]
  • Residual Refractive Sphere [3 months]
  • Residual Refractive Cylinder [3 months]
  • Percentage of Eyes With Postoperative Manifest Refraction Spherical Equivalent (MRSE) Accuracy to Target ≤ 0.5D [3 months]

+Eligibility

Sex: All, ages: 40 Years to 99 Years

Inclusion Criteria:

1. Subject is undergoing bilateral cataract extraction with intraocular lens implantation.
2. Willing and able to provide written informed consent for participation in the study
3. Willing and able to comply with scheduled visits and other study procedures.
4. Scheduled to undergo standard cataract surgery with topical anesthesia in both eyes within 6-15 days between surgeries.
5. Subjects who require an IOL power in the range of +5.0 D to +34.0 D only.
6. Potential postoperative visual acuity of 0.2 logMAR (20/32 Snellen) or better in both eyes.

Exclusion Criteria:

1. Severe preoperative ocular pathology: amblyopia, rubella cataract, proliferative diabetic retinopathy, shallow anterior chamber, macular edema, retinal detachment, aniridia or iris atrophy, uveitis, history of iritis, iris neovascularization, medically uncontrolled glaucoma, microphthalmos or macrophthalmos, optic nerve atrophy, macular degeneration (with anticipated best postoperative visual acuity less than 20/30), advanced glaucomatous damage, etc.
2. Uncontrolled diabetes.
3. Use of any systemic or topical drug known to interfere with visual performance.
4. Contact lens use during the active treatment portion of the trial.
5. Any concurrent infectious/non-infectious conjunctivitis, keratitis or uveitis.
6. Clinically significant corneal dystrophy
7. History of chronic intraocular inflammation.
8. History of retinal detachment.
9. Pseudoexfoliation syndrome or any other condition that has the potential to weaken the zonules.
10. Previous intraocular surgery.
11. Previous refractive surgery.
12. Previous keratoplasty
13. Severe dry eye
14. Pupil abnormalities
15. Subject who may reasonably be expected to require a secondary surgical intervention at any time during the study (other than yttrium aluminum garnet (YAG) capsulotomy, i.e. LASIK)
16. Anesthesia other than topical anesthesia (i.e. retrobulbar, general, etc).
17. Any clinically significant, serious or severe medical or psychiatric condition that may increase the risk associated with study participation or may interfere with the interpretation of study results.
18. Participation in (or current participation) any ophthalmic investigational drug or ophthalmic device trial within the previous 30 days prior to the start date of this trial.

+Posted results

Participant flow

MilestoneEmmetropia Both Eyes (OU) GroupNanovision Group
Started4039
Completed3939
Not completed10

Outcome results

  • Binocular Distance-corrected Near (40 cm) Visual Acuity. (Primary), Mean, diopters: Emmetropia Both Eyes (OU) Group 0.30 +/- 0.14; Nanovision Group 0.26 +/- 0.13
  • Reduction of Manifest Cylinder (Diopters). (Primary), Mean, diopters: Emmetropia Both Eyes (OU) Group 1.15 +/- 0.77; Nanovision Group 1.38 +/- 0.80
  • Uncorrected Near (40 cm) Visual Acuity (Secondary), Mean, diopters: Emmetropia Both Eyes (OU) Group 0.25 +/- 0.12; Nanovision Group 0.19 +/- 0.12
  • Uncorrected Intermediate (66 cm) Visual Acuity (Secondary), Mean, diopters: Emmetropia Both Eyes (OU) Group 0.06 +/- 0.10; Nanovision Group 0.04 +/- 0.08
  • Uncorrected (4 m) Visual Acuity (Secondary), Mean, diopters: Emmetropia Both Eyes (OU) Group -0.03 +/- 0.08; Nanovision Group -0.02 +/- 0.08
  • Modified Patient-Reported Visual Symptoms Questionnaire (PRVSQ) (Secondary), Number, percentage of participants: Emmetropia Both Eyes (OU) Group 100; Nanovision Group 97.4
  • Patient Reported Spectacle Independence Questionnaire (Secondary), Number, percentage of participants: Emmetropia Both Eyes (OU) Group 64.8; Nanovision Group 92.3
  • Residual Mean Spherical Equivalent Refraction (Other pre specified), Mean, diopters: Emmetropia Both Eyes (OU) Group -0.20 +/- 0.22; Nanovision Group -0.33 +/- 0.33
  • Residual Refractive Sphere (Other pre specified), Mean, diopters: Emmetropia Both Eyes (OU) Group -0.30 +/- 0.20; Nanovision Group -0.48 +/- 0.37
  • Residual Refractive Cylinder (Other pre specified), Mean, diopters: Emmetropia Both Eyes (OU) Group 0.20 +/- 0.25; Nanovision Group 0.29 +/- 0.27
  • Percentage of Eyes With Postoperative Manifest Refraction Spherical Equivalent (MRSE) Accuracy to Target ≤ 0.5D (Other pre specified), Number, percentage of eyes: Emmetropia Both Eyes (OU) Group 100; Nanovision Group 88.4

Adverse events

Time frame: Average 3 months. Adverse events were collected from the moment patient enrolled in the study until exit.

ArmDeathsSerious adverse eventsOther adverse events
Emmetropia Both Eyes (OU) Group0/40 (0.0%)0/40 (0.0%)0/40 (0.0%)
Nanovision Group0/39 (0.0%)0/39 (0.0%)0/39 (0.0%)

+Locations (4)

FacilityCityCountryStatus
Associated Eye CareStillwater, MinnesotaUnited States
Ophthalmic Consultants of Long IslandGarden City, New YorkUnited States
Carolina Eyecare Physicians, LLCMt. Pleasant, South CarolinaUnited States
Slade & Baker Vision CenterHouston, TexasUnited States

+Study documents

+Investigators