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May 2008 Issue

Edward Holland, MD, affiliate professor of ophthalmology at UC
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Older Eye Corneas Are Just as Good for Transplanting

By Katie Pence
Published May 2008

People on long waiting lists for corneal transplants, which could help recover their eyesight, may not have to wait much longer.

According to a new study conducted by researchers at UC, older corneas may transplant as well as younger ones, which will expand the age of cornea donation to 75 and increase the corneal donor pool.

This study was published in the April 2008 edition of the journal Ophthalmology.

Edward Holland, MD, co-author of the study and adjunct professor of clinical ophthalmology at UC, says that there has been controversy among corneal surgeons about using older eye tissue.

Corneal transplantation is a surgical procedure where a damaged or diseased cornea—the clear part of the eye in front of the iris and pupil—is replaced by donated corneal tissue.

“There has been a long-standing bias among corneal surgeons to use younger donors,” Holland says. “But starting in the late 1990s, we’ve been addressing

the shortage of corneal tissue due to the U.S. Food and Drug Administration regulations and the elimination of usable corneas due to Lasik surgery.”

Lasik surgery permanently changes the shape of the cornea using a laser. A mechanical microkeratome—a blade device—or laser is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, or the middle section of the cornea.

Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced. This procedure may repair eyesight but it leaves the cornea virtually useless for transplants.

In this new study, the research team randomly assigned cornea recipients younger or older tissue and found the corneas of both groups survived just as well five years later.

The study, funded by the National Eye Institute, involved 105 surgeons at 80 medical centers across the nation.

Approximately 1,100 people with a swelling known as Fuchs’ dystrophy and postoperative cataract surgery swelling were recruited for the study.

“At the five-year mark, the success rate was the same, about 86 percent, for both those in the age range of 12 to 65 years and those in the age range of 66 to 75 years,” Holland says. “This was very encouraging.”

says this study will hopefully encourage corneal surgeons to use older tissue and will increase the donor pool by 20 to 35 percent, which is significant growth.

“It will also reduce health care costs because the number of cancellations for scheduled surgery will be reduced,” he says. “In addition, more corneas can be used locally instead of requiring shipment from across the country.

“We feel that this finding
will significantly impact the lives of those who have been waiting

for corneal transplants and will help surgeons across the country deliver these life-changing operations in a timelier manner,” Holland adds. 

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