Tuesday, May 13, 2003

Artificial cornea implant done here


For some, new device is last hope to regain sight

By Tim Bonfield
The Cincinnati Enquirer

Pat Canelli hopes becoming the second American to receive an improved type of artificial cornea will restore the vision he lost years ago in his left eye. He'll find out in about three months if the device works.

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Dr. Edward Holland operates on Pat Canelli of Lawrenceburg Monday to implant an AlphaCor artificial cornea. The surgery took place at St. Elizabeth Hospital South in Edgewood.
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Being manipulated by a surgical device, the artificial cornea is ready to insert into the eye.
(Michael E. Keating photos)
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On Monday, the 73-year-old Lawrenceburg resident received an AlphaCor artificial cornea, made by the Australian company Argus Biomedical. The first American patient to receive the device had surgery Thursday at Emory University Hospital in Atlanta.

Canelli's surgery was performed Monday morning at St. Elizabeth Medical Center in Edgewood, Ky., by Dr. Ed Holland, director of cornea services at the Cincinnati Eye Institute. Hours later, Dr. Holland installed another AlphaCor cornea in a woman who had traveled from St. Louis.

"There have been previous efforts to develop artificial corneas. This approach is dramatically different because of the way it is made," Holland said. "This is much safer for patients."

Nationwide, about 37,000 people a year get human cornea transplants to repair lost vision from a variety of injuries, infections and genetic conditions. About 90 percent of those transplants last at least three years.

But some people, like Canelli, repeatedly reject human cornea transplants. "My body rejected (human tissue transplants) four times. The last one lasted about a year," Canelli said.

While able to see from his right eye, his damaged left eye sees only blurred shapes of light and dark.

Worldwide, 55 people have received the new artificial cornea. Those numbers are likely to grow.

Holland predicts he will perform about 10 to 20 artificial cornea transplants a year. Next week, two cases are scheduled to be performed in Louisville. And more are planned at several other medical centers in coming weeks.

The AlphaCor device stands out, Holland said, because it is smaller and more flexible than previous replacement corneas. But most important, its outer ring is made of a spongy polymer that appears to be the first method to successfully bond with the eye by allowing corneal cells to grow into the edge of the device.

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"The problem in the past has been that the area where the plastic meets the tissue can break down, which can lead to infection and loss of the eye," Holland said.

Jim McCollum, president of the U.S. office of Argus Biomedical, said less than 10 percent of people who need cornea transplants will be candidates for the artificial device. "This is designed for high-risk patients that, right now, have no other real alternatives," he said.

No one is exactly sure how long the artificial corneas can last. Early studies show that more than 80 percent are functioning a year after implantation.

At $7,000 each, the AlphaCor cornea is not likely to replace corneas from human cadavers, which cost about $1,800 to collect, test and process, Holland said.

For Canelli, his biggest problem with the artificial cornea is remaining patient. It takes about three months for the cells to grow into the device. During that time the device is covered by the previously damaged cornea, which means patients have to wait to see again.

E-mail tbonfield@enquirer.com




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