Single Donor Cornea Could Treat Three Patients

A new study reports how one donor cornea may be divided and transplanted into multiple patients with disease or damage to the cornea.

Researchers at the All India Institute of Medical Sciences (New Delhi, India) used one cornea from a 44-year-old donor who had died of cardiac arrest to complete transplants in three patients. The procedures were all performed on the same day and all were successful. The corneal tissue was divided into three parts. The first patient, a 40-year-old man, received the front portion of the donor cornea through a procedure known as automated lamellar therapeutic keratoplasty (ALTK), in which a thin slice of tissue is removed; new tissue grew over the transplant was observed after four days. His visual acuity improved from 20/200 to 20/60 after three months.

The second patient received the rear portion of the cornea through a technique known as descemet stripping automated endothelial keratoplasty (DSAEK), which involves replacing damaged endothelium, or the layer of cells on the inside of the cornea. Minor swelling in the graft cleared within two weeks, and visual acuity improved from 20/400 to 20/40 after three months.

The third patient was a 5-year-old boy who had chemical burns in his right eye. Stem cells from the donor cornea, at the junction of the cornea and conjunctiva transplanted to improve his vision, which was limited to counting fingers close to his face. New tissue grew in the child after one week, and at the three-month follow-up visit, his vision had improved to 20/200.

"Our strategy of using a single donor corneal tissue for multiple patients opens up the possibility of optimal use of available donor corneal tissue and will reduce the backlog of patients with corneal blindness in countries in which there is a dearth of good-quality donor corneal tissue,” wrote lead author Dr. Rasik B. Vajpayee, M.S., F.R.C.S. "With more corneal surgeons converting to techniques of customized component corneal transplantation in the form of anterior and posterior lamellar disc corneal transplantation, the use of a single donor cornea in more than one patient may become standard surgical practice.”


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All India Institute of Medical Sciences