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Ophthalmology department studies alternatives to corneal

By Jeff Jensen
Arizona Daily Wildcat,
March 28, 2000
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UA doctors in the department of ophthalmology are working to perfect a better alternative to corneal transplants.

Department head Dr. Robert Snyder and Drs. Michael Berman and Robert Tyszko are examining a method known as endothelial transplants.

"Endothelial transplant is important because for some people this is the only part of the eye's cornea damaged, like those with a specific disease called Fuch's Endothelial Dystrophy," Tyszko said.

"Our feeling is that it would be less invasive and cause fewer adverse outcomes if we could perfect a technique that replaces the endothelium rather than the whole cornea," he added.

The endothelium layer of the cornea regulates fluid exchange between chambers of the eye with a pump-like function. This function, however, is dependent on cell density so if there are not enough endothelial cells present, the cornea cannot remain optically clear.

This procedure would allow for the use of donor corneas that would not previously have been used because only the endothelial layer would need to be transplanted, Berman said.

"The long and short of it is that people need corneal graphs from a donor with a good endothelium," Berman said.

Corneal transplants currently have a high success rate, but serious problems such as astigmatism and other irregularities may cause long delays in visual recovery.

The necessity of severing nerves during the transplant also increases instances of trauma and ulceration.

The endothelial transplant would possibly cause less trauma to the eye because there would be no need for a suture, thus producing less risk of infection, Berman said.

Tyszko said this is a very new method, currently being studied by a small group of researchers in Europe. The UA team would be among the first in the country to work on this transplant.

However, only the European groups have tested on live patients and the UA researchers are currently working on cadaver eyes. Tyszko pointed out that no animal testing will be used.

These researchers will explore the transplantation of a specific membrane and the posterior layer of the endothelial cells. The membrane would be torn free, rolled and inserted and reattached to the ailing eye.

But Berman warned that this procedure is a long way from being used on patients in the United States and there are many points to be worked out.

"It's something we're trying," Berman said. "It might or might not work really."

This year-long study is being funded through a $17,000 gift from Tucson resident Adele Behar.

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