Clinical Trial Comparing Two Non-Surgical Treatments for Severe Blepharoptosis

Mass Eye and Ear

Status

Completed

Conditions

Traumatic Brain Injury

Myasthenia Gravis

Ptosis, Eyelid

Stroke

Blepharoptosis

Chronic Progressive External Ophthalmoplegia

Treatments

Device: Magnetic Levator Prosthesis (MLP)

Device: Kinesiotape Frontalis Sling (KTFS)

Study type

Interventional

Funder types

Other

NIH

Identifiers

NCT04678115

2019P003055

R01EY029437 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This clinical trial will evaluate two non-surgical devices designed to improve eye lid opening for patients with severe Blepharoptosis (incomplete opening of the eyelids).

Full description

Two non-surgical devices for patients with Blepharoptosis will be evaluated. The Magnetic Levator Prosthesis (MLP), is an external device that makes use of a newer class of permanent magnets (made of alloys of neodymium (Nd), iron (Fe) and boron (B)) to restore eyelid movement. The Kinesiotape Frontalis Sling (KTFS), involves the use of tape to help facilitate levator muscle contraction to open the eyelid. Video recordings of spontaneous and volitional blinks will be used to evaluate the effects of each device on eyelid reanimation.

The clinical trial will employ a crossover design in which participants will try each device at home in counterbalanced order with a washout period between. In each period of the crossover, participants will receive training (during study visits at Massachusetts Eye and Ear) in how to apply the device and will then try the device at home for one week with daily follow up by video calls. At the end of the one-week period of home use there will be a study visit at Massachusetts Eye and Ear when the device will be returned and additional video recordings of eye blinks will be made.

At the end of the crossover period, participants will be asked to complete a questionnaire comparing the two devices and to select their preferred device.

Enrollment

16 patients

Sex

All

Ages

5+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Presence of ptosis for at least one eye which occludes the visual axis in the resting position (without frontalis drive, lifting with forehead muscles)
Moderate cognitive function or better defined as greater than or equal to 18 out of 30 on a pre-screening of the Mini-Mental State Exam (MMSE)

Exclusion criteria

Absence of ptosis which occludes the visual axis
Presence of a corneal ulcer of any size
Age less than 5 years
Severe Cognitive impairment defined as MMSE score less than 18, behaviors consistent with delirium (combinations of disorientation, hallucinations, delusions, and incoherent speech), or lethargy.
Presence of corneal hypoaesthesia;
Orbicularis weakness on the side of the ptosis
Mechanical ptosis, including ptosis due to orbital or lid tumor, cicatricial processes affecting the movements of the upper lid, and enophthalmos.
Previous ptosis surgery less than 3 months prior to Visit 1.
Lid position affected by lid or conjunctival scarring.
History of herpes keratitis.
Periocular neurotoxin (eg, Botox, Xeomin, Dysport, Myobloc) injections on the side of the ptosis within 3 months prior to Visit 1 and during the study.
History of hyperthyroidism or thyroid eye disease (ie, exophthalmos, upper eyelid retraction, diplopia secondary to extraocular muscle involvement). Hypothyroidism that is controlled on medication is allowed