Simple procedure may replace cornea transplant

New York : A new, minimally invasive procedure could improve treatment for many patients with a common eye disease, without the potential side effects and cost of the current standard of care a cornea transplant, new research has found.

In the study involving patients suffering from Fuchs endothelial dystrophy (FED), the researchers showed that removing a few square millimetres of a single layer of cells on the inside of the cornea allowed rejuvenation of the surrounding tissue, without the need for a corneal transplant.

This simple procedure restored clear vision to three out of four patients suffering from FED, the most frequent cause for corneal transplantation in the US.

"It's quick, inexpensive and it spares patients from having someone else's cells in their eyes, which requires local immunosuppression," said lead researcher Kathryn Colby, Professor at the University of Chicago.

The proof of concept study was published in the journal Cornea.

Over the past two years while at Harvard Medical School, Colby performed the new procedure, known as Descemet stripping.

Descemet stripping involves removing a small patch of the corneal endothelium (the pumping cells that stop working in FED) attached to an underlying layer (the Descemet membrane).

In patients with FED, water accumulates in the cornea, the clear front window of the eye, because of the dysfunction of the pumping cells, causing reduced vision, glare and haloes.

If left untreated, the condition progresses to painful blindness.

Removal of the central dysfunctional cells enables healthier peripheral cells to migrate to the centre of the cornea, where they re-establish pumping capacity and removal of fluid from the layers above. This gradually restores clear vision.

"Although Descemet stripping is a relatively simple procedure, its potential is revolutionary," Colby said.