New Adhesive May Aid in LASIK Safety

Researchers at Kansas State University have developed a new adhesive with the goal of reducing risks in LASIK surgery. Research shows that a new protocol that involves using ultraviolet light, fibrinogen, and riboflavin may improve the glue to keep the corneal flap in place.

According to those involved in the research, the best corneal flap adhesion is a glue created with the combination of riboflavin and fibrinogen, and then adding binding proteins and ultraviolet light. The ultraviolet light is the same kind used in tanning salons. This is also a nontoxic biodegradable glue used during cataract surgery.

The flap detaching from the cataract is a major risk after LASIK surgery because, once the lens is cut to get to the cornea to be reshaped, the attachment between the cornea and the surface is permanently weakened. If an accident occurs and the flap is knocked loose, the cornea itself can be contaminated, which may result in the need for a corneal transplant.

Although corneal transplants, which replace just a part of the existing cornea, are the most common type of organ transplant, and are a routine outpatient procedure, the Mayo Clinic reports nearly 20 percent of them fail. So, chalk up corneal transplant as an outlier risk of LASIK surgery.

A second study analyzed reactions of the glue at the molecular level to see exactly how the adhesion works. There is hope the glue can be further developed for applications in different medical treatments throughout the body.

If you would like to learn more about LASIK procedures or how to care for your eyes post-LASIK surgery, please find an experienced eye surgeon in your area through eyes.com today.

Higher Cataract Formation Risk in Older DSEK Patients

According to a study published in the British Journal of Ophthalmology, patients who are at least 50-years-old and have undergone Descemet’s stripping endothelial keratoplasty (DSEK) are more likely than younger patients to develop cataracts.

This is because older people’s eyes are losing accommodation and leaving the natural lens in after DSEK is less beneficial, says one of the author’s of the study. However, younger patients are much more likely to be able to respond to cataract surgery and so this is still a viable option for them.

The author and her colleagues write that DSEK patients should be counseled about the potential risks of cataracts forming after the eye surgery, and what their options are.

The study included 60 phakic eyes that had undergone DSEK, but only included first-treated eyes in patients that were treated bilaterally. The median age of the patients was 52. Results showed that 22 eyes, or 37 percent, needed cataract surgery after DSEK. At the time the surgeries were needed, median age of the patients was 57. The probability of undergoing cataract surgery after DSEK was up to 40 percent within three years. However, in 20 patients who were no older than 50, the probability of undergoing cataract surgery within three years was only seven percent.

If you have questions about DSEK or cataracts, please contact an experienced eye doctor in your area through www.eyes.com today.

Single Donor Cornea Can Help Two Patients

Doctors in Germany, led by Ludwig M. Heindl, M.D. of Friedrich-Alexander University Erlangen-Nurnberg, have published a study in this month’s issue of Ophthalmology demonstrating that a single donor cornea can help two different recipients.

Not all cornea transplant recipients need the full thickness of the donor cornea, of which Dr. Heindl and colleagues took advantage. They split the donor corneas into two layers—the anterior lamella and the endothelium-Descemet’s membrane.

The first layer, the anterior lamella was then transplanted onto the eyes of a patient suffering from keratoconus. This type of corneal transplant is known as a deep anterior lamellar keratoplasty, or DALK.

Next, the second layer was transplanted into a different patient who had Fuchs’ endothelial dystrophy. This surgery is called Descemet’s stripping endothelial keratoplasty (DSEK).

This resourceful approach may have very positive implications for the future of corneal transplant surgery, allowing patients with different eye diseases and conditions to receive separate transplants from the same cornea. This should hopefully reduce the wait time for donor corneas and reduce the overall cost of cornea transplantation.

To learn more about corneal transplants or to get treatment for a cornea condition that affects your vision, please contact a local ophthalmologist today and set up a consultation.

Ophthalmologist Rand Paul Wins Senate Race in Kentucky

In Tuesday’s midterm elections, Congressman Rand Paul defeated Democrat Jack Conway to become Kentucky’s newest US Senator and the first ophthalmologist win a Senate seat. He is joined by fellow Republican John Boozman of Kansas, who is an optometrist. Several ophthalmologists have run for Congress, but Paul is the first to move from the House of Representatives to the Senate.

Senator-elect Paul was a Tea Party favorite in the Kentucky Senate race, and is the son of noted libertarian Congressman Ron Paul, who ran unsuccessfully for President of the United States in 1988 as the Libertarian Party nominee and again twenty years later competing for the Republican nomination. Rand’s father Ron Paul is also a physician, serving as an Air Force flight surgeon in the 1960s. Both Rand Paul and his father are considered extremely conservative, but Rand Paul is more closely associated with the emergent Tea Party movement.

Rand Paul still owns his private ophthalmology practice in Bowling Green, Kentucky, where he has specialized in corneal transplants, LASIK, and glaucoma treatment. Paul is also a member of the Lions Club, a service organization known worldwide for helping needy individuals with optical health, both diagnosis and treatment.

Some controversy emerged in June over Paul’s decision to let his certification from the American Board of Ophthalmology (ABO) lapse over a dispute with the organization. This means that Paul is not a “board-certified” ophthalmologist as he had claimed, being certified only by the National Board of Ophthalmology, which Paul himself founded in protest against the ABO. Paul is still licensed in Kentucky in good standing, and is still qualified to practice ophthalmology despite lacking board certification.

Despite a viciously negative campaign, Paul won a convincing victory over his rival, Kentucky Attorney General Jack Conway, with 56% of the votes compared to Conway’s 44%.

Biosynthetic Corneas Help Restore Vision

A clinical trial of biosynthetic corneas conducted by Dr. Per Fagerholm of Linkoping University in Sweden and Dr. May Griffith of the University of Ottowa’s Ottowa Hospital Research Institute has produced very encouraging results. Dr. Griffith has been working with her colleagues for over a decade to produce a viable biosynthetic cornea suitable for implantation in humans. Collaborating with Dr. Fagerholm, she began a clinical trial two years ago of this first-ever biosynthetic corneal implant in humans.

For two years, Drs. Griffith and Fagerholm closely followed the progress of the 10 patients who received the biosynthetic corneas. Now, they have found that the patients’ cells and nerves had successfully integrated with the biosynthetic implant. The regenerated corneas act like healthy, natural ones, even becoming touch-sensitive and producing tears normally.

This study is the first so far to demonstrate that an artificial cornea can successfully be integrated with the eye tissue and produce a regenerative effect. With millions of patients worldwide waiting for a human cornea transplant, the potential of this technological innovation is clearly impressive.

The patients in this clinical trial had advanced keratoconus (conical cornea) or scarring of the central cornea. With further advancements in the biosynthetic material and the surgical implantation technique, Drs. Fagerholm and Griffith hope to establish the effectiveness of biosynthetic corneas for treating a broader range of eye diseases and conditions that usually require a corneal transplant.

To learn more about cornea transplants and other eye surgery procedures, please visit eyes.com or find an ophthalmologist in your area.

Biosynthetic Cornea May Provide Alternative to Transplant

Ottawa, Canada – Patients whose vision is impaired by a damaged cornea may soon have an alternative to a donor transplant to restore their vision. May Griffith of Linköping University in Sweden and Ottawa Hospital Research Institute has been working with colleagues to develop techniques for fabricating tissue replacements that can be used in place of  natural donor tissue.  Their most recent achievement is the successful testing of an artificial, biosynthetic cornea over the course of two years. Results with their synthetic cornea have proven to be as good or better than donor transplantation.

While more testing needs to be done on this artificial cornea and donor cornea transplantation is still the preferred treatment of corneal blindness, donor corneas are always scarce. Plastic corneas have been developed and used for years, but problematic side effects like infection and glaucoma have made them purely a last resort option.

This new corneal implant is special because it is made almost entirely from natural collagen, grown in vitro by corporate partner Fibrogen from yeast cells. This collagen was then molded into the shape of a cornea, mimicking the cornea’s stroma layer, which is mostly collagen.

All ten patients on whom the biosynthetic implants were tested had their vision restored to a level similar to corneal transplant patients, except that they needed contact lenses to smooth over bumps created by the implants. The team is currently testing alternatives to the sutures that cause those bumps, such as tissue adhesives.  Results were also excellent in cell growth, with all ten patients seeing the return of the infection-fighting epithelial cell layer.

New Artificial Cornea May Be Viable Alternative to Corneal Transplants

Washington – Scientists have developed a new type of artificial cornea by inserting a tiny amount of collagen into the eye in order to spur natural corneal cell regrowth. Initial reports indicate that the procedure has successfully restored vision in many of the trial patients.

The first wave of the study was conducted in Sweden. The sample size was very small – only 10 people. Therefore, additional studies evaluating a larger sample size will be required to conclusively determine the effectiveness of the procedure. If successful, this new artificial cornea may become a viable alternative to corneal transplants. In many parts of the world, there is a shortage of donated corneas, necessitating an alternative to meet this demand.

The cornea is a film-like covering of the eye’s surface that is responsible for focusing light on the retina. It is a fragile structure that is easily damaged by injury or infection. Approximately 42,000 people undergo corneal transplants in the United States each year. However, in many other countries, the demand for donor corneas far outweighs the supply.

Researchers are also working on several other alternative treatments such as plastic-like artificial corneas and stem cell treatments which may improve corneal growth. The current treatment being evaluated is considered a bioartificial cornea since it uses the same natural substances found in your cornea (collagen) to promote healing.

To create the bioartificial cornea, researchers molded human collagen grown in yeast into the shape of a contact lens in order to mimic the shape of a natural cornea. The damaged corneal tissue was then removed from patients’ eyes and the bioartificial cornea was implanted in its place. Corneal cells began growing in the collagen, tear production normalized, and corneal nerves began to regrow. None of the patients rejected the artificial cornea; rejection is a common risk with corneal transplants.

After two years, six of the ten patients experienced significantly improved vision with glasses and two patients experienced similar vision to before the procedure.

It is important to note that this technology currently only addresses upper layer corneal problems which comprise approximately 10% of corneal transplant cases. Moving forward, researchers will attempt to develop the technology to address full-thickness corneal damage which impacts the endothelial cells in the lower layer of the cornea.