UV Light-mediated Corneal Crosslinking as (Lymph)Angioregressive Pretreatment to Promote Graft Survival After Subsequent High-risk Corneal Transplantation [CrossCornealVision]

What this Trial Is About

Researchers are evaluating corneal crosslinking (CXL) as a pre-treatment before full-thickness penetrating corneal transplantation in patients with pathologically prevascularized corneas. The study aims to improve graft survival by reducing pathological corneal neovascularization (CoNV) before transplantation. This multicenter, randomized, controlled trial compares the outcomes of patients receiving CXL before surgery to those undergoing transplantation without pre-treatment. Participants in the intervention group will receive corneal crosslinking 8 to 10 weeks prior to transplantation, with a possible repeat treatment if less than 50% reduction of CoNV is observed. The control group will proceed directly to transplantation without CXL. Corneal transplantation involves securing the graft with nylon sutures, and in the intervention arm, fine needle diathermy may be used to occlude residual vessels if needed. In contrast, fine needle diathermy is not performed in the control group to avoid risks. During the study, participants will undergo baseline examinations including slit lamp assessments, corneal tomography, optical coherence tomography, visual acuity testing, and quality-of-life questionnaires. Follow-up visits occur at 3, 6, 12, 18, and 24 months after transplantation, with repeated evaluations and documentation to monitor graft function, CoNV regression, rejection episodes, and vision outcomes. Participants can contact the study site anytime with concerns, and additional visits may be scheduled as needed. The primary outcome is the time to first episode of endothelial graft rejection within 24 months post-transplantation.

Pretreatment to Promote Graft Survival After Subsequent High-risk Corneal Transplantation [CrossCornealVision]