Cornea disease and refractive surgery specialist, Majid Moshirfar, M.D., F.A.C.S., of the John A. Moran Eye Center at the Ï㽶ÊÓƵ of Utah performed the first ever laser-based cornea transplant in Utah on April 20, 2007.
The procedure is called IntraLase-Enabled Keratoplasty" (IEK"). The IntraLase laser is the first laser in the U.S. used to create corneal incisions for full-thickness corneal transplants. This achievement continues the tradition of leading-edge firsts by the world-renown Moran Eye Center in Salt Lake City. Moran was also the first eye center in Utah to: use implantable contact lenses, perform custom LASIK, implant artificial corneas, treat vision correction with LASEK and more.
In corneal transplant surgery, the surgeon removes the central portion of the cloudy cornea and replaces it with a clear cornea, usually donated through an eye bank. When the cornea becomes cloudy, light cannot penetrate the eye to reach the light-sensitive retina. Poor vision or blindness may result. Corneal transplantation has restored sight to thousands, who otherwise would be blind due to corneal injury, infection, or inherited corneal disease or degeneration. In 2004, 46,841 corneal grafts were supplied by over 42,000 donors through US eye banks; 32,106 corneal transplants were performed in the US.
Cornea transplant surgery is typically done with a Trephine Corneal Cutter, a hand-held bladed "cookie cutter" that stamps onto the cornea to make a circular incision with straight vertical edges. This technique requires suturing around the circumference of the tissue graft to maintain the position of the new cornea. Sutures stay in the eye for at least one year, possibly longer and patients generally don't achieve full visual recovery for at least one year. After traditional corneal transplantation, very little pressure is required to displace the donor tissue from the patients eye.
The IEK procedure allows the surgeon to use a computer-guided ultra-fast femtosecond laser to create precisely shaped incisions. Fitting together like a puzzle, these shaped incisions may result in a more stable graft and faster healing, and require fewer sutures to keep the graft in place. Sutures may also be removed much earlier (before six months in initial cases). Another potential advantage is better corrected vision with less irregularity and less astigmatism with potentially better uncorrected vision.
Past experience with exacting laser techniques indicates that this method will provide a more stable graft that will speed patient healing and visual recovery. Risk for displacement is greatly reduced as shaped incisions have demonstrated a seven-fold increase in strength. These are all clinical benefits that have not been possible with the manual trephine corneal cutter.
Several leading eye banks are now developing techniques that take advantage of the IntraLase FS laser to harvest donor tissue, providing optimally-shaped corneal grafts for the convenient use of surgeons.
Specialists in Corneal Disease & Refractive Surgery at the Moran Eye Center include: Mark D. Mifflin, M.D., Geoffrey Tabin, M.D. and Majid Moshirfar, M.D., F.A.C.S. Research into Glaucoma is also being done at the Moran Eye Center in the Zhang Laboratory, by Kang Zhang, M.D., Ph.D.
For more information please contact: Steve Brown, Communications Manager, Moran Eye Center, 801/587-7693, steven.brown@hsc.utah.edu.