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CompletedNCT04059289JJ-EYHANCEUpdated Mar 31, 2020

Intermediate Vision in a Driving Simulator Environment: Comparison of the J&J EYHANCE With a Conventional Monofoc. IOL

An observational study in Lenses, Intraocular, Pseudophakia and Near Vision, sponsored by Aalen University. Completed at 1 site in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-03-31.

Sponsored by Aalen University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
11
Ages
18 Years and older
Sex
All
01

Study summary

To compare (low contrast) visual acuity (VA) and contrast sensitivity (CS) - both at intermediate distances under nighttime driving conditions in a driving simulator between patients with bilateral EYHANCE IOLs OR bilateral conventional monofocal IOLs. Visual function testing in the driving simulator will be assessed without AND with (static) glare.

Additionally: Assessment of individual response times, scanpath characteristics, evaluation of test retest reliability and self-evaluation of (intermediate) vision and visual impairment related to glare.

Read the detailed description

To compare (low contrast) visual acuity (VA) and contrast sensitivity (CS) - both at intermediate distances under nighttime driving conditions in a driving simulator between patients with bilateral EYHANCE IOLs OR bilateral conventional monofocal IOLs. Visual function testing in the driving simulator will be assessed without AND with (static) glare.

Additionally: Assessment of individual response times, scanpath characteristics, evaluation of test retest reliability and self-evaluation of (intermediate) vision and visual impairment related to glare.

Simulator

Patients are instructed to drive with a constant speed of 40 km/h on a virtual parcours (straight lane). For testing of either (low contrast) visual acuity or contrast sensitivity, 8-position LANDOLT C's are presented at three locations (within the simulator car, AUDI A4, Ingolstadt/FRG):

(i) At the center of the instrument panel (distance 0.xx m) (ii) At the center of the navigation monitor (y.yy m) (iii) At the center of the rear monitor (z.zz m) A high resolution acoustic attention guidance for immediate gaze direction of the patients towards the three above-mentioned visual stimulus locations (i-iii) is mandatory.

Patients responses are recorded and response times can be extracted from the recordings.

Clinical ophthalmological-optical examinations

  • Medical/ophthalmological history
  • (Uncorrected and Best-corrected) visual acuity (RE,LE,BE) with remote and intermediate (66cm) 8 position LANDOLT C's.
  • LANG I stereotest (near distance)
  • Ocular alignment \& ocular motility
  • Efferent \& afferent pupillomotor status
  • Mesopic contrast sensitivity without/with glare (Optovist, VISTEC Inc./Olching/FRG)
  • Intraocular straylight perception (Q-Quant, OCULUS Inc, Wetzlar/FRG)
  • Slit lamp (anterior segment)
  • Ophthalmoscope (central fundus and fixation)

    • Primary objectives: log visual acuity (logVA) at preset low contrast level of 1:2.7 (logCS = 0.2) AND log contrast sensitivity (logCS) at a preset visual acuity level of 0.1 = 2/20)
    • Secondary objectives: test retest reliability (as operationalized by LOA = limits of agreement) AND response time (i.e. time interval between onset of stimulus presentation and final response) AND scanpath characteristics (fixation duration, fixation stability, annotation to regions of interest; saccade amplitude) self-evaluation (questionnaire, using visual analogue scales = VAS)

SHAPIRO WILK test (statistical testing for proving/disproving normal distribution) Descriptive statistics (either MEAN, standard deviation, in case of normally distributed data - else, MEDIAN, inter-quartile range (IQR).

Assessment of test/retest reliability: BLAND ALTMAN plots, limits of agreement (LOA) Between-group comparison: t-test (unpaired samples), in case of normally distributed data - else, WILCOXON signed-rank test

02

Conditions studied

  • Lenses, Intraocular
  • Pseudophakia
  • Near Vision
  • Driving

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Keywords

  • glare
  • contrast sensitivity
  • driving simulator
  • intermediate visual acuity
  • pseudophakia
  • posterior chamber intraocular lenses
  • benchmark
  • straylight
  • nighttime driving
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

Subjects of male or femal gender above the age of 18 years at least two months post surgery after bilateral uneventful IOL surgery (bilateral implantation of either EYHANCE IOL OR monofocal IOL)

Inclusion criteria

  • Informed consent
  • S.p. (at least two months post surgery) bilateral uneventful IOL surgery (bilateral implantation of either EYHANCE IOL OR monofocal IOL)
  • Ophthalmological history normal, except cataract and uneventful IOL surgery
  • Distant visual high-contrast acuity > 20/25 in either eye
  • Normal stereopsis (all figures of the LANG I random dot stereo test correctly recognized)

Exclusion criteria

Exclusion Criteria:

  • Age below 18 years
  • Chronic eye disease (except cataract)
  • History of ocular surgery (except complication-free IOL surgery)
  • Visual pathway lesions
  • Strabismus
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
11 participants (actual)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • Intraocular lens type I

    Tecnis EYHANCE IOL (Johnson \& Johnson, New Brunswick/USA)

    Other: Posterior chamber intraocular lens (IOL)

  • Intraocular lens type II

    Clareon IOL (Alcon Pharma. Freiburg/FRG)

    Other: Posterior chamber intraocular lens (IOL)

Interventions

  • OtherPosterior chamber intraocular lens (IOL)

    This is NOT an interventional study; the intervention (surgical procedure) has been performed PRIOR to the inclusion in this study

    Also known as: Tecnis EYHANCE IOL (Johnson & Johnson, New Brunswick/USA), Clareon IOL (Alcon Pharma. Freiburg/FRG)

05

What researchers measure

Primary outcomes

  1. logVA

    logarithm of visual acuity at preset low contrast level of 1:2.7 (logCS = 0.2)

    Time frame: at least two months after uneventful intraocular lens implantation

  2. logCS

    logarithm of contrast sensitivity at a preset visual acuity level of 0.1 (= 2/20)

    Time frame: at least two months after uneventful intraocular lens implantation

Secondary outcomes

  1. Reproducibilities of logVA

    as operationalized by LOA (limits of agreement)

    Time frame: at least two months after uneventful intraocular lens implantation

  2. Resonse times of logCS

    time interval between onset of stimulus presentation amd final response

    Time frame: at least two months after uneventful intraocular lens implantation

  3. Scanpath characteristics (I)

    fixation duration

    Time frame: at least two months after uneventful intraocular lens implantation

  4. Scanpath characteristics (II)

    fixation stability

    Time frame: at least two months after uneventful intraocular lens implantation

  5. Scanpath characteristics (III)

    annotation to regions of interest (ROIs)

    Time frame: at least two months after uneventful intraocular lens implantation

  6. Scanpath characteristics (IV)

    saccade amplitude

    Time frame: at least two months after uneventful intraocular lens implantation

  7. Self-evaluation (questionnaire) (i) distant vision with best distant correction

    Distant vision (self-eval., vis. analogue scales: 0 = unsatisfactory ... 10 = optimal)

    Time frame: at least two months after uneventful intraocular lens implantation

  8. Self-evaluation (questionnaire) (i) intermediate vision with best distant correction

    Intermed. vision (self-eval., vis. analog. scales: 0 = unsatisfactory ... 10 = optimal)

    Time frame: at least two months after uneventful intraocular lens implantation

  9. Self-evaluation (questionnaire) (i) mesopic vision with best distant correction

    Mesopic vision (self-eval., vis. analog. scales: 0 = unsatisfactory ... 10 = optimal)

    Time frame: at least two months after uneventful intraocular lens implantation

  10. Self-evaluation (questionnaire) (i) glare sensitivity with best distant correction

    Glare sensitivity (self-eval., vis. analog. scales: 0 = unsatisfactory ... 10 = optimal)

    Time frame: at least two months after uneventful intraocular lens implantation

  11. Self-evaluation (questionnaire) (i) General post-op vision with best distant corr.

    Post-op vision (self-eval., vis. analog. scales: 0 = unsatisfactory ... 10 = optimal)

    Time frame: at least two months after uneventful intraocular lens implantation

06

Study locations

1 site
  • University of Applied Sciences, Study Course Ophthalmic Optics
    Aalen, Baden-Württemberg 73430, Germany
07

Registry details

Key details

Study ID
NCT04059289
Lead sponsor
Aalen University
Collaborators
University Hospital Tuebingen
Responsible party
Sponsor
First posted
Aug 16, 2019
Start date
Jan 7, 2020
Primary completion
Mar 15, 2020
Completion
Mar 15, 2020
Last update
Mar 31, 2020

Oversight

Data monitoring committee
No
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