Improved Cornea Surgery Technique Provides Enhanced Transplant Success

In a research presentation
at the American Academy of Ophthalmology’s Annual Meeting, Massimo Busin,
MD, department head and professor of ophthalmology at the Villa Serena
Hospital, Forli, Italy, described a technique that significantly improved
results in patients being treated for endothelial disease of the cornea,
the transparent covering of the front of the eye that provides much of its
optical power. When the cell density in the endothelial layer is reduced
below a level compatible with its normal function, the cornea swells and
becomes less transparent, and vision is impaired.

Since endothelial cells do not regenerate, the disease is treated by
transplanting healthy donor tissue. The standard approach has been complete
cornea transplantation (PK, or penetrating keratoplasy). Today, DSAEK
(descemet-stripping automated endothelial keratoplasy)—where only
endothelial tissue attached to a thin layer of deep stroma is transplanted
and the normal structure of the recipient cornea is not disrupted–is
increasingly preferred by corneal surgeons. Most patients receiving DSAEK
recover good vision within weeks (versus six months to a year with PK), and
the risk of complications during and after surgery is minimized. A
significant drawback of DSAEK, though, has been the limited survival of the
transplanted endothelium, with a reduction of up to 50 % of preoperative
density as early as six months after DSAEK.

Dr. Busin described a modified DSAEK technique developed by his group
that resulted in rates of donor endothelial cells survival equivalent to

“Our approach reduced the rate of endothelial cell loss in the
transplanted tissue to an average of 23% at one year post-surgery, which is
similar to values recorded after PK,” said Dr. Busin. “Our ‘pull through’
technique simplifies the DSAEK procedure and, more importantly, resolves
the main obstacle that has delayed corneal surgeons’ transition to DSAEK.”

About the American Academy of Ophthalmology

AAO is the world’s largest association of eye physicians and
surgeons-Eye M.D.s-with more than 27,000 members worldwide. Eye health care
is provided by the three “O’s” – opticians, optometrists and
ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it
all: eye diseases and injuries, and perform eye surgery. For more
information, visit the Academy’s Web site at aao.

American Academy of Ophthalmology