We Pursue Eye Research
Current Studies
Current Studies
Small Incision Transplants (DSEK and DMEK)
Background: The cornea is the clear window on the front of the eye. It is about the thickness of a credit card. Although the cell layer lining the back of the cornea is less than 10% of the corneal thickness, problems with that single cell layer can make the entire cornea become cloudy.
Impact:
* Beginning in 2003, we helped pioneer a new transplant technique, known as DSEK, in which the defective cell layer is stripped away and a thin layer of healthy donor tissue is implanted through a small incision.
* We have shown that this procedure is far safer and provides much faster visual recovery than a traditional full thickness transplant (known as keratoplasty).
* Over 600 cornea surgeons from 26 countries around the world have attended our DSEK courses.
* We published the first DSEK textbook, and maintain the largest database of DSEK procedures in the world.
* Now we have pioneered an even newer cornea transplant technique that can replace a single defective cell layer. This technique, known as DMEK, provides unparalleled vision for transplants recipients.
* We have shown that with DMEK the risk that the recipient’s body will reject the new transplant is dramatically reduced by at least 15-fold.
* We have successfully trained local eye bank personnel in the delicate tissue preparation techniques required for these new transplant procedures.
Preventing Cornea Transplant Rejection
Background: Each year approximately 40,000 Americans undergo a cornea transplant to restore vision so they can return to work, support a family, and resume essential daily activities such as reading and driving. One of the biggest risks transplant recipients face is that immunologic graft rejection will cause the new donor cornea to fail. Corticosteroid eye drops are typically used for months or even years to prevent cornea transplant rejection. Unfortunately, these eye drops have some serious side effects. Surprisingly, no prospective randomized studies have been done to determine the best corticosteroid-dosing regimen, so solid evidence on what is the best dosing for transplant patients is lacking. We have found that the new, minimally invasive transplant procedure called DMEK has a very low risk of rejection. So we are initiating a large study to see if we can reduce the topical corticosteroid strength, and avoid some of the steroid side effects, while maintaining a low risk of rejection after DMEK. We will enroll 440 patients in the study and follow each patient for one year.
Impact: This landmark study will provide valuable new information to help cornea transplant recipients maintain newly restored vision.
Improving Cornea Transplant Survival
Background: Cornea transplants usually remain clear for at least 10 years, but in some patients they fail much sooner. The purpose of this study is to figure out why transplants sometimes fail early and to develop innovative treatments to extend transplant survival. The fluid inside the eye bathes the back surface of the cornea and provides key nutrients that help maintain the health of the cornea. In this study we will identify the changes that occur in this fluid when a cornea transplant starts to fail.
Impact: This study will provide new insights into why transplants fail and help us prolong transplant survival.
LASIK/ Contact Lens Study
Background: Near-sightedness is increasing at such an alarming rate in the United States, that our children and grandchildren now have almost a 50% chance of becoming near-sighted. Contact lenses and LASIK (laser refractive surgery) are the most popular vision correction choices among young adults. The Cornea Research Foundation is conducting an international survey of 5,000 contact lenses wearers and LASIK patients to compare satisfaction rates and complications.
Impact: This will be the first study to directly compare patient satisfaction with these two popular vision correction methods.
New Treatment for Eye Infections
Background: A variety of organisms cause eye infections. Some are resistant to current treatments and can take months to eradicate. Contact lens use greatly increases the risk of developing a corneal infection. We are evaluating an investigational treatment with riboflavin (vitamin B) and ultraviolet light to determine if it clears eye infections more quickly than current antibiotics.
Impact: If proven effective, this new treatment could become an important new weapon to help us fight eye infections.
Corneal Collagen Cross Linking for Keratoconus
Background: Sometimes the cornea, the clear window on the front of the eye, weakens and bulges out, causing distorted vision. This condition is called keratoconus, which means cone-shaped cornea. It typically strikes teenagers and affects people in their prime working years and is the leading cause for corneal transplants in young people. In rare cases, people may experience a similar bulging of the cornea after refractive surgery and this is called ectasia. We are enrolling 200 patients in a study to evaluate cross-linking.
Impact: If proven successful, this investigational treatment would be the first to actually treat the underlying weakness in eyes with keratoconus or ectasia, and it could help patients achieve better vision and avoid the need for a corneal transplant.
Lens for Extremely Near-sighted Young Adults
Background: Some young people are so extremely near-sighted that they have difficulty performing normal daily activities. We are evaluating an investigational lens that can be placed through a small incision into the front part of the eye to provide excellent distance vision. Participants retain the natural lens in the back of the eye so they can still focus up close as well as at a distance.
Impact: If proven effective, this lens could allow extremely near-sighted young people live a more normal life.
Finding the Genetic Basis for Fuchs’ Dystrophy
Background: Fuchs’ dystrophy causes the cornea to become cloudy with age. This condition runs in families but we don’t know yet what causes it. The purpose of this study, sponsored by the National Eye Institute, is to identify the genes involved in Fuchs’ dystrophy so that we can provide early diagnosis and develop new treatments to prevent progression.
Impact: Patients with Fuchs’ dystrophy have been excited to help us to find out what causes this condition in our effort to find a cure before their children and grandchildren are affected by it.
Cornea Donor Study
Background: Surgeons have generally assumed that it is best to give a cornea transplant recipient a donor cornea that is of similar age or younger, but the supply of young organ donors is limited. This multi-center study, sponsored by the National Institute of Health (NIH) will complete 10 years of follow up in 2012.
Impact: The overall graft health and survival rate was similar for the younger and older donor groups at five years. This has increased the use of older donor corneas, which has helped expand the limited supply of corneal tissue. The 10-year results are eagerly anticipated.
Artificial Iris:
Background: Some people are missing the colored part of the eye, called the iris, either because it failed to form properly, or because they were hit in the eye and it was damaged. This can cause severe light sensitivity and reduce vision. We are evaluating an investigational artificial iris that can be implanted inside the eye to provide a more normal appearance and reduce glare and light- sensitivity.
Impact: Lack of an iris is a relatively rare condition but can be extremely debilitating, so a device that can reduce glare and light sensitivity can make daily activities much easier for those who are affected.
