A 91-year-old man has become the first patient in England to have his sight saved by an artificial layer in his cornea, with experts saying the approach could eventually become a standard treatment and help drive down the NHS’ record waiting list.
The Guardian reports that Cecil Farley had problems with his right eye for about 15 years before losing his vision. He needed a cornea transplant to save his sight but his previous surgery – a graft with a human cornea – failed and doctors warned the next might too. And the shortage of human corneas from deceased donors meant Farley faced a year-long wait.
But an NHS first allowed him to bypass the queue: the implantation of an artificial cornea. While still early days for such implants, experts say the approach could eventually become a standard treatment and help drive down the health service’s record waiting list.
“I can still see my wife after 63 years of marriage,” Farley said. “You don’t realise how debilitating it is until it happens to you.”
The device, called EndoArt, was created by EyeYon Medical and is the first artificial implant that can replace the inner lining of the cornea. This lining plays an important role in regulating the hydration of the cornea, and if it is damaged, whether from injury or disease, it can result in blurred vision and other problems.
EndoArt is similar to a contact lens: it is a dome-shaped, foldable, transparent and clear implant that the company says is made of a material designed to stick to the back of the cornea. Once inserted into the eye it can be manoeuvred into position with an air bubble and secured in place with a single stitch.
Farley underwent the operation, known as an endothelial keratoplasty, in February, making him one of only 200 recipients of the artificial implant worldwide to date.
Thomas Poole, a consultant ophthalmologist at Frimley Health NHS foundation trust who carried out the operation, said he and his colleague Hanbin Lee had successfully given four patients artificial corneas in the past two months and initial results had shown an improvement in vision.
The implant costs about £1 800, in the same bracket as using a human cornea.
“I think this may end up replacing human corneas for certain types of corneal graft patients,” Poole added. “In maybe 10 or 20 years’ time this may become the norm where we don’t need a human cornea and we can just take one out of the box.”
NHS Blood and Transplant says that to meet all surgery and research needs, it requires a weekly stock of 350 eyes. Between April 2021 to March 2022 it received on average 88 donations a week.
According to the NHSBT transplant activity report 2020-21, as of 31 March 2021, 10% of people who had joined the organ donation register had chosen not to donate their corneas – which could be down to the emotion and symbolism people attribute to the eyes.
The Guardian article – Artificial cornea implant saves sight of man, 91, in NHS first (Open access)
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