Department News

Artificial Cornea Program
University of Illinois Eye and Ear Infirmary
Department of Ophthalmology and Visual Sciences

The University of Illinois Eye and Ear Infirmary's Artificial Cornea Program helps people with severe eye disease or injury for whom traditional corneal transplantation from human donors is not an option. Artificial cornea implantation, called keratoprosthesis, or k-pro, is a procedure designed to help patients whose conditions are the most difficult to treat.

Dimitri Azar MD, professor and head of the Department of Ophthalmology and Visual Sciences, is an expert on the kpro procedure, having trained at Harvard Medical School under Claes Dohlman MD, the cornea surgeon who developed the procedure.

To learn more about keratoprosthesis, click here: http://www.medcompare.com/spotlight.asp?spotlightid=159

Eye Surgery Restores Vision in 'Hopeless' Cases

Ophthalmologists at the University of Illinois Medical Center at Chicago have performed two cornea replacements using a newly redesigned artificial cornea, restoring sight in patients who had exhausted all other options.

Two surgeries were performed at UIC in December. A third and fourth procedure are scheduled for Feb. 6.

Dr. Dimitri Azar , Field Chair of Ophthalmologic Research and professor and head of ophthalmology and visual sciences at UIC, led the team that performed the operations. He was assisted by Dr. Jose de la Cruz, a fellow in cornea and refractive surgery.

In artificial cornea replacement, called keratoprosthesis, an artificial plastic cornea is anchored to a hole through the donor's cornea, the clear strong surface area of the eye that allows light in. The artificial cornea is necessary when standard cornea transplants have failed, causing the implanted cornea to become opaque or invaded by blood vessels.

In standard cornea transplants, clear, healthy donor tissue is used to replace the patient's cornea after it has become opaque and can no longer transmit light. The most common causes of damage to the cornea are degenerative diseases and scarring due to infection or trauma.

Although research began in the 1960s, earlier attempts to create an artificial cornea have not been successful.

"In the earlier versions, there were often infections and long-term damage to the corneal scaffolding that holds the keratoprothesis in place," said Azar. "The newer version, which we have three to five years' experience with in Boston , does not have these problems."

Azar says there is a great need for an alternative to cornea transplant. Azar and de la Cruz both worked with Dr. Claes Dohlman at Harvard who developed the artificial cornea.

"Patients whose corneas are damaged by infection or injuries like chemical burns often have poor outcomes, their cornea transplants either deteriorating or becoming opaque," de la Cruz said. "Many times, their physicians continue to attempt new transplants or give up entirely on restoring their vision, simply because there has been no other option."

L.C. Phillips, 53, of Chicago, one of the first two patients to receive the artificial cornea at UIC, had lost almost all vision in his left eye after an infection two years ago.

"My vision was limited to a sort of blur or shadow, and getting around had gotten complicated," he said.

Phillips had already had two cornea transplants, and both had failed, de la Cruz said.

"Because it was very likely that transplants would continue to fail, the keratoprosthesis was his only hope for restored vision."

"Since the surgery in December, Phillips' vision has been restored to 20/50 and we expect it to continue to improve," said Azar. Phillips wears a special contact lens, which will need to be replaced every few months. He places an antibiotic drop in his eye each day.

"It's a blessing to be able to see again," he said.

In the past, the artificial cornea was used only in cases of severe corneal burns, where corneal transplants were doomed to failure, but Azar said the success of the new keratoprosthesis design will extend its applicability to most patients who suffer from repeated transplant failures. The new keratoprosthesis is still not successful in cases of severe inflammatory corneal disease, which requires strong systemic immunosuppressive treatment to save the eye, he said.

de la Cruz, who recently trained physicians in New York City in the technique, expects modern keratoprothesis to be widely adopted once physicians learn that earlier problems with artificial corneas have been solved. "There is an enormous need," he said. "I think we have a great many patients who have been told that there is nothing further that can be done."