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AphakiaNCT03050697

Evaluation of the Safety and Performance of the HARMONI® Toric Lens

A study testing HARMONI® Modular Toric Intraocular Lens and Cataract extraction with intraocular lens (IOL) implantation in people with Aphakia and Corneal Astigmatism, run by ClarVista Medical at 1 site in New Zealand.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study was to evaluate the safety and effectiveness of the HARMONI® Modular Intraocular Lens System with a toric optic (HMTIOL) in subjects with pre-existing corneal astigmatism in need of cataract surgery. Read more about this study

Who is it for?
Ages 22 years and older
Conditions the study is for
Aphakia, Corneal Astigmatism, Cataract
What is being tested?
HARMONI® Modular Toric Intraocular Lens and Cataract extraction with intraocular lens (IOL) implantation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
16 participants
Where
1 siteNew Zealand
Study dates
28 Sep 2016to 28 Jul 2017
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 22 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Planned removal of visually significant bilateral cataract by manual phacoemulsification cataract extraction
  • Pre-existing corneal astigmatism in at least 1 eye of 0.75 to 2.50 diopter (D)
  • Target dioptric lens power within the range of 16 - 26 D
  • Willing to discontinue contact lens wear for the duration of the study
  • BCVA projected to be ≤0.2 logarithm minimum angle of resolution (LogMAR)
  • Stable cornea
  • Dilated pupil size at least 7.0 millimeters (mm)
  • Able to understand and provide informed consent.

Who cannot join

  • History of any intraocular or corneal surgery in study eye (including refractive)
  • Pregnant or lactating
  • History of any clinically significant retinal pathology or ocular diagnosis in study eye that could alter or limit final postoperative visual prognosis
  • History of ocular conditions which could affect the stability of the IOL in study eye
  • Any anterior segment pathology likely to increase the risk of complications from phacoemulsification cataract extraction in study eye
  • Any visually significant intraocular media opacity other than cataract in study eye
Show all 10Show fewer
  • Uncontrolled glaucoma in study eye
  • Uncontrolled systemic disease
  • Severe dry eye that would impair the ability to obtain reliable study measurements
  • Systemic medication that may confound the outcome or increase the intraoperative and postoperative risk to the subject.

Trial locations and contacts

1 site in 1 country.

New Zealand1 site
  • ClarVista Investigative Site

    Auckland, 99311

Other trials in New Zealand

About this study

Official title: A Prospective, Multicenter Study to Evaluate the Safety and Performance of the Exchangeable ClarVista HARMONI Modular Toric Intraocular Lens System for the Treatment of Pre-Existing Corneal Astigmatism and Aphakia Following Cataract Surgery

The purpose of this study was to evaluate the safety and effectiveness of the HARMONI® Modular Intraocular Lens System with a toric optic (HMTIOL) in subjects with pre-existing corneal astigmatism in need of cataract surgery.

Read the detailed description

Subjects with visually significant bilateral cataracts (cortical, nuclear, posterior subcapsular, or a combination) were implanted unilaterally (in one eye only) or bilaterally (in both eyes) with the HMTIOL. A total of 7 study visits were planned, including a preoperative visit, operative visits for each eye, and 4 follow-up visits at 1 day, 1 week, 1 month, and 3 months postoperative. The total duration of participation for each subject was up to 6 months, including the preoperative period (up to 3 months).

Alcon Research, LLC, acquired ClarVista Medical in 2017. This study was designed and conducted by ClarVista Medical, Inc. The study results were collected, analyzed, and provided by ClarVista Medical, Inc. to Alcon Research, LLC.

Being tested
HARMONI® Modular Toric Intraocular Lens, Cataract extraction with intraocular lens (IOL) implantation
Keywords
Toric, Intraocular lens
Medical subject headings
Aphakia, Astigmatism, Cataract

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • HARMONI® Modular Toric Intraocular LensDevice

    Also called HMTIOL

    Two-component system consisting of a base and a separate toric optic

  • Cataract extraction with intraocular lens (IOL) implantationProcedure or surgery

    Cataract removal via manual phacoemulsification, followed by HMTIOL implantation

Study groups in NCT03050697
Study groupRoleWhat they receive
HMTIOLExperimentalHARMONI® Modular Toric Intraocular Lens implanted in the capsular bag following removal of the cataractous lens, intended for lifetime use
Receives: Device: HARMONI® Modular Toric Intraocular Lens; Procedure: Cataract extraction with intraocular lens (IOL) implantation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Manifest Refraction Cylinder (MRCYL) for Eyes Implanted With HMTIOL

    A manifest refraction (manual vision test) was conducted using letter charts and a phoropter. Manifest refraction cylinder is the amount of added correction needed to compensate for any astigmatism that may be present. MRCYL was measured in diopters and reported as a negative number, with a less negative number indicating a lesser amount of added correction. No formal statistical hypothesis testing was planned.

    Measured: Month 1 postoperative, Month 3 postoperative

  2. Mean Manifest Refraction Cylinder (MRCYL) Prediction Error (PE) for Eyes Implanted With HMTIOL

    A manifest refraction (manual vision test) was conducted using letter charts and a phoropter. Manifest refraction cylinder is the amount of power needed to correct any astigmatism that may be present. MRCYL was measured in diopters and reported as a negative number. MRCYL PE was calculated as postoperative MRCYL adjusted to 6 meters minus MRCYL target residual refractive error (TRRE), with a lower absolute value indicating a more accurate cylinder power calculation. No formal statistical hypothesis testing was planned.

    Measured: Month 1 postoperative, Month 3 postoperative

  3. MRCYL PE for Eyes Implanted With HMTIOL Per Vector Analyses

    Manifest refraction cylinder is the amount of power needed to correct any astigmatism that may be present. MRCYL PE is calculated as postoperative MRCYL adjusted to 6 meters minus MRCYL target residual refractive error (TRRE), with a lower absolute value indicating a more accurate cylinder power calculation. No formal statistical hypothesis testing was planned.

    Measured: Month 1 postoperative, Month 3 postoperative

  4. Mean Reduction in Cylinder Power for Eyes Implanted With HMTIOL

    A manifest refraction (manual vision test) was conducted using letter charts and a phoropter. Manifest refraction cylinder is the amount of power needed to correct any astigmatism that may be present. MRCYL was measured in diopters and reported as a negative number. Cylinder power reduction was calculated as the absolute preoperative magnitude of corneal cylinder (K) minus the absolute postoperative magnitude of MRCYL at the corneal plane. No formal statistical hypothesis testing was planned.

    Measured: Baseline (Day 0 preoperative), Month 3 postoperative

  5. Mean Percent Reduction in Cylinder Power for Eyes Implanted With HMTIOL

    A manifest refraction (manual vision test) was conducted using letter charts and a phoropter. Manifest refraction cylinder is the amount of power needed to correct any astigmatism that may be present. MRCYL was measured in diopters and reported as a negative number. Cylinder power reduction was calculated as the absolute preoperative magnitude of corneal cylinder (K) minus the absolute postoperative magnitude of MRCYL at the corneal plane. Therefore, the cylindrical power percent reduction was the cylinder power reduction divided by the absolute value of preoperative magnitude of corneal cylinder (K) × 100. A higher number (greater percent reduction) indicates better astigmatism correction by the toric IOL. No formal statistical hypothesis testing was planned.

    Measured: Baseline (Day 0 preoperative), Month 3 postoperative

  6. Mean Manifest Refraction Spherical Equivalent (MRSE) Prediction Error (PE)

    A manifest refraction (manual vision test) was conducted using letter charts and a phoropter. The manifest refraction spherical equivalent (MRSE) was calculated as follows: sphere + 1/2 cylinder, and measured in diopters (D). MRSE PE was calculated as postoperative MRSE adjusted to 6 meters minus MRSE target residual refractive error (TRRE). The lower the absolute number, the more accurate the IOL power calculation is. No formal statistical hypothesis testing was planned.

    Measured: Month 1 postoperative, Month 3 postoperative

  7. Mean Absolute Misalignment of IOL Meridian - Target Versus Actual at Operative Visit

    Absolute misalignment of IOL meridian was defined as the summation of IOL misplacement and IOL rotation. A lower number indicates minimal IOL misalignment. No formal statistical hypothesis testing was planned.

    Measured: Day 0 (operative)

  8. Mean Absolute Rotation of IOL Meridian by Visit

    IOL orientation was measured with slit-lamp photography. IOL rotation was defined as the difference between axis of IOL orientation on the day of surgery and the subsequent postoperative visit. IOL rotation was measured in degrees. No formal statistical hypothesis testing was planned.

    Measured: Baseline (Day 0 preoperative), Day 1 postoperative, Week 1 postoperative, Month 1 postoperative, Month 3 postoperative

  9. Number of Eyes With Absolute Rotation of IOL Meridian by Visit

    IOL orientation was measured with slit-lamp photography. IOL rotation was defined as the difference between axis of IOL orientation on the day of surgery and the subsequent postoperative visit. IOL rotation was measured in degrees and is reported categorically. No formal statistical hypothesis testing was planned.

    Measured: Baseline (Day 0 preoperative), Day 1 postoperative, Week 1 postoperative, Month 1 postoperative, Month 3 postoperative

  10. Percentage of Eyes With Best Corrected Distance Visual Acuity (BCDVA) by Visit

    Visual Acuity of the eye was tested while reading charts at 20-foot equivalent distance from the participant with the correction obtained from manifest refraction testing. BCDVA is reported categorically using the Snellen fraction, which compares the participant's result to the result expected from a 'normal' visual system. The numerator represents the distance between the participant and the chart, and the denominator represents the distance at which a person with 'normal' vision would be able to discern the same letter size. 20/20 is considered to be 'normal' vision, whereas visual acuity of 20/40 means the participant is able to read a certain size letter 20 feet away that a person with 'normal' vision would be able to read from 40 feet away. A larger denominator, therefore, indicates a lower visual acuity. No formal statistical hypothesis testing was planned.

    Measured: Baseline (Day 0 preoperative), Week 1 postoperative, Month 1 postoperative, Month 3 postoperative

  11. Percentage of Eyes With Uncorrected Distance Visual Acuity (UCDVA) by Visit

    Visual Acuity of the eye was tested while reading charts at 20-foot equivalent distance from the participant with an optical infinity adjustment of +0.25 diopter (D). UCDVA is reported categorically using the Snellen fraction, which compares the participant's result to the result expected from a 'normal' visual system. The numerator represents the distance between the participant and the chart, and the denominator represents the distance at which a person with 'normal' vision would be able to discern the same letter size. 20/20 is considered to be 'normal' vision, whereas visual acuity of 20/40 means the participant is able to read a certain size letter 20 feet away that a person with 'normal' vision would be able to read from 40 feet away. A larger denominator, therefore, indicates a lower visual acuity. No formal statistical hypothesis testing was planned.

    Measured: Baseline (Day 0 preoperative), Day 1 postoperative, Week 1 postoperative, Month 1 postoperative, Month 3 postoperative

  12. Standard Error of the Mean in Lens Power A-constant for Refinement

    The A-constant (lens power constant) is a theoretical value that is used to calculate the power of the intraocular lens. It relates the lens power to the eye's axial length and keratometry. It is not expressed in units; it is specific to the design of the IOL and its intended location and orientation within the eye.

    A-constants are typically empirically developed for new IOLs based on hundreds of clinical uses. Data from a sufficient number of eyes are needed in order to reduce bias due to surgical technique, unusual eyes, and differences in equipment, such that the standard error of the mean in the lens power constant would be less than ±0.10 mm (approximately ±0.2 diopter). This study represented the first clinical use of the HMTIOL.

    Measured: Day 0 operative

  13. Number of Ocular Adverse Events Through Month 3

    Ocular adverse events were identified as outlined in ISO 11979-2014 Annex B. No formal statistical hypothesis testing was planned.

    Measured: Up to Month 3 postoperative

  14. Number of Device-Related Secondary Surgical Interventions (SSI) Other Than Optic Exchange and Rotational Adjustment of the HMTIOL

    A secondary surgical intervention (SSI) was defined as a surgical procedure that occurred after primary implantation and was conducted for the purpose of resolving residual refractive error (RRE) and optimizing visual outcomes. No formal statistical hypothesis testing was planned.

    Measured: Up to Month 3 postoperative

  15. Number of Device Deficiencies Post Implantation

    A device deficiency was defined as a failure of the device to meet its performance specifications or expectations, or otherwise not perform as intended. This could include either a malfunction or damage to the device or any part thereof, regardless of the source of malfunction or damage, including user error, and regardless of the presence of injury (or lack thereof) to subject, user, or bystander. No formal statistical hypothesis testing was planned.

    Measured: Up to Month 3 postoperative

  16. Number of Eyes With Preservation of Best Corrected Distance Visual Acuity (BCDVA) at Month 1 and Month 3

    Preservation of BCDVA was defined in terms of lines lost when reading the ETDRS chart at each visit compared to the prior best-achieved BCDVA. Loss of < 1 line included subjects with less than a 1 line loss, no change or improvement in BCDVA. No formal statistical hypothesis testing was planned.

    Measured: Month 1 postoperative, Month 3 postoperative

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Feb 2017
  2. Study start28 Sep 2016
  3. Primary completion7 Jun 2017
  4. Study completion28 Jul 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03050697
Sponsor's protocol ID
CP-00004
Status last verified
Jun 2020
First submitted
14 Sep 2016
Last updated
12 Jun 2020
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing HARMONI® Modular Toric Intraocular Lens and Cataract extraction with intraocular lens (IOL) implantation in people with Aphakia and Corneal Astigmatism, run by ClarVista Medical at 1 site in New Zealand.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Jun 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in New Zealand. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Jun 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Manifest Refraction Cylinder (MRCYL) for Eyes Implanted With HMTIOL (time frame: Month 1 postoperative, Month 3 postoperative). The study lists 16 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jun 2020.

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