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First in Florida to Use Unique Artificial Cornea in Transplant

Published: September 17, 2003

Jacksonville, Fla.- A University of Florida ophthalmologist located at Shands Jacksonville became the first in the state to perform two corneal (front layer of the eye) transplants Monday using artificial corneas flown in from Australia.

The two-staged surgery begins with surgically removing a portion of the patient’s damaged cornea, creating a pocket or flap in which the artificial cornea is inserted, explained Arun Gulani, M.D., director of cornea and refractive surgery at the UF Department of Ophthalmology Jacksonville. The pocket acts as a natural bandage, holding the artificial cornea in place and aiding in the healing process.

"I was scared to death but I didn't feel one bit of pain," said Irene Parker when she recalled the first stage of the surgery.

The artificial cornea consists of a bio-compatible, flexible material specially designed to be accepted by the patient’s remaining tissue and to eventually grow together as one.

It may take up to three months for the patient’s eye to fully incorporate the artificial tissue but once this has occurred the patient is ready for the second stage. In this stage the flap of native tissue covering the artificial cornea is removed, allowing the patient access to vision.

Parker described her vision prior to the procedure as almost nonexistent. "I couldn't make out anything…I fell all over everything when I tried to walk."

Artificial corneas are currently only being used to treat some of the most complex and high-risk cases, in which all other available options have been exhausted. Many of these patients have undergone numerous surgeries, have extensive corneal scarring from an accident or progressive disease, or have rejected a corneal transplant from a human donor.

"This may seem very selective in the type of patients it treats but the reality is there are so many people across the U.S. waiting for something like this," said Gulani, who performed the two artificial corneal transplant surgeries on Monday. "I am very excited to offer this surgery in the Jacksonville community."

The Australian company, Lions Eye Institute of Western Australia, has selected only a few doctors from around the world to perform this procedure based on experience, post-operative results and innovative thinking. The company selected Gulani because of his experience with ocular surface reconstruction including full and partial corneal transplants using human donor corneas and placenta tissue. He is also internationally known for his development of new instruments and techniques that have improved many eye surgeries. Although Gulani has performed similar procedures numerous times, this marks his first procedure using an artificial cornea.

In the coming weeks, Gulani will be performing several more of these transplants, which have the approval of the Food and Drug Administration.

Parker is very optimistic about her surgery and the thought of being able to see again. "I hope it works," she said with a smile.

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