Archive for October, 2012
The Alabama Eye Bank (AEB) is literally touching the world with sight.
Fifty countries and counting, AEB and an organization it established, Global Sight Network (GSN), are working together to not only bring sight to the sightless but partner with doctors performing new kinds of surgeries using donated corneas.
Traditional corneal transplant surgery, called Penetrating Keratoplasty, required removal of the patient’s entire cornea, which may have only been partially diseased or damaged, and was replaced with a healthy donor cornea. Innovative new surgeries, such as the ones described below, can now take place with only the damaged cells of the endothelial layer of the cornea being removed and replaced. These surgeries are safer and heal more quickly. The cornea has five layers, which perform various functions. The endothelium is a single layer of cells on the inner surface of the cornea that acts to keep it dehydrated and pump in nutrients.
“For many years the Alabama Eye Bank (AEB) has worked to help change lives dramatically for the better. Supplying the best corneal transplant tissue to those in need regardless of finances is just part of what they do. Even so, February 7, 2012, was a special day for many, thanks to AEB. That day marks the transfer of some of the world’s most refined and life-changing eye surgery to the residents of Nicaragua,” Dr. John Parker, UAB ophthalmologist, said.
Dr. Parker was referring to a corneal transplant using DMEK (Descemet’s Membrane Endothelial Keratoplasty), a type of corneal transplant that is done without stitches, which heals at least 10 times faster than a standard transplant. The surgery was performed by missionary surgeon Dr. Miguel Naveiras of Oviedo, Spain on a young woman named Nubia Ortiz who had experienced corneal swelling that had limited her activities to a minimum.
In addition, Dr. Parker himself performed a similar procedure on the same day in Nicaragua called DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty). In DSAEK the unhealthy or damaged corneal tissue (endothelial layer) is replaced with healthy donor corneal tissue from the eye bank. The entire eye operation can be completed in about 30 minutes.
Back in Birmingham UAB researchers were confirming a new use for AEB-GSN corneas: glaucoma shunt coverage. The breakthrough provides a choice for patients undergoing glaucoma surgery to relieve pressure build up in the eye, between pericardium (which is most commonly used to cover these drainage devices), and glycerol-preserved corneas provided by GSN. Pericardium is the membrane which surrounds the heart, while glycerol corneas are specially preserved corneas that are not suitable for sight-restoring transplant but can be used for shunt coverage and patch grafts for other ocular surgeries.
The study by the UAB researchers that was recently published in the Journal of Glaucoma showed that in patients undergoing tube implantations for the first time, corneal grafts were less likely to thin or erode over time than the pericardium grafts, and therefore are less likely to encounter risk for infection or subsequent reparative surgery. Corneas preserved in glycerol have a longer shelf life (up to five years) and can be stored at room temperature.
Eric Wigton, MD, lead researcher in the glaucoma shunt study, said, “This is the first study to directly compare glycerol preserved corneal tissue to another patch graft material in glaucoma shunt surgery. It demonstrates that corneal tissue is at least as effective as pericardium in preventing tube erosion and may also delay the time to erosion. Additionally, it is less cosmetically obvious than other available materials.”
Years ago we never could have imagined a world so small that a gift given by a family in Alabama would be flown half-way around the world to restore sight, or that donated corneas could be used in any way other than a traditional penetrating keratoplasty surgery.
It all starts with the kindness and willingness of donor families to say yes to AEB counselors when asked about donating their loved one’s corneas. The need is always great, but so is the potential for meeting that need thanks to the generosity of donors and their next-of-kin.
Hospitals and their staff also play an important role in meeting the need. “We are so grateful to all the nurses across Alabama who believe in what we do. Their positive influence acts as a bridge to consent. Whether we’re providing tissue for transplant, research or education, we want to thank everyone for using their influence in a positive way for the gift of sight,” Ellen Kerns, Vice President of Technical Services, said.
For Immediate Release
Alabama Eye Bank (AEB) President and CEO Doyce Williams has been appointed to serve on the Cornea Preservation Time Study (CPTS) Advisory Committee. The committee will examine the potential for extending the time that corneal surgery can be performed from the current seven days up to 14 after a cornea is recovered from a donor.
The study has been awarded $12.3 million, the largest grant of its kind from the National Eye Institute. According to Dr. Jonathan Lass, chairman of the Case Western Reserve Department of Ophthalmology, the study will collaborate with Case Western Reserve University School of Medicine and the Jaeb Center for Health Research in Tampa, FL.
When a cornea (clear, front part of the eye) is recovered from a donor, a surgeon will transplant it in a recipient within seven days, which has historically been considered the optimum period for transplant. The study is designed to determine whether delaying surgery from 8 to 14 days would impact the quality of the cornea compared to the seven-day period.
“The study will analyze data from 1,300 patients. The implications are tremendous for distributing corneas outside the United States because it is currently believed that performing surgery beyond one week does not ensure the cornea will maintain its highest level of quality. A much greater opportunity for distribution would occur if the study affirms no difference in quality if surgery is performed up to one week later,” Williams said.
The supply of donated corneas nationwide meets current needs – about 40,000 transplants in 2010. But with an aging population and health concerns about the future donor pool, researchers want to ensure the supply can meet an expected growth in demand over the next two to three decades.
Williams, an adjunct instructor for the UAB Department of Ophthalmology, has served as president of AEB for more than 32 years. During this time, the eye bank has ranked each year among the top 10 eye banks in the U.S. in the number of corneas procured, rising as high as second.
A charter member of the Eye Bank Association of America, AEB is a nonprofit charitable organization that was founded in 1969. The Eye Bank’s headquarters is located in Birmingham with regional offices in Huntsville, Mobile and Montgomery. The Eye Bank’s objective is to obtain quality human eye tissue and distribute it to qualified physicians where the need exists anywhere in the world. AEB serves 49 states and 43 countries.
For Immediate Release
Joseph Beckham (205) 313-8322
Priscilla Fowler, MD, director of Cornea and External Disease at the Department of Ophthalmology at the University of Alabama at Birmingham, recently accepted membership to serve on the Global Sight Network (GSN) Medical Advisory Board.
GSN, established four years ago by the Alabama Eye Bank (AEB) in partnership with 32 eye banks nationwide, provides corneas not used for transplants in the United States and preserves them for long-term storage. Among their optical uses are cornea patch grafts and glaucoma shunt surgery.
The Medical Advisory Board (MAB), formed to fulfill states’ requirements to distribute these sight-saving tissues, also provides medical guidance and insight on operations and industry trends to GSN.
“We are so pleased to have Dr. Fowler join us on the MAB. Her knowledge and expertise will add value to our existing well-experienced board. We look forward to drawing from her insights and appreciate her willingness to serve,” Alan Blake, chairman of the MAB, said.
Dr. Fowler received her fellowship in Cornea and External Disease/Refractive Surgery at Wills Eye Institute in Philadelphia, PA, in 2011, her residency in ophthalmology at the University of Alabama at Birmingham and transitional internship in the Baptist Health System. Fowler graduated from the University of South Alabama College of Medicine and received a B.A. in biology at the University of Virginia.
This is a stance that we have always taken, but never really stopped to think about as a primary objective of the Alabama Eye Bank. We are in the “sight restoring” business but we don’t want to make it sound so cold and business-like that we lose focus on what else are we restoring to each person’s life once they can see.
Try and walk around your house with your eyes shut and no cheating. Seriously, try and make it from one side of your house to the other without sight. Try and make a sandwich. Try to brush your teeth and fix your hair in the morning. Try and take out the garbage to the street corner. What if you have children…try and help them with their homework, you can’t see their smiles, you can’t grill out for their birthdays, you can’t see their smiles light up as they try and pull off the coveted “perfect cannonball” into the pool or the tears from their first heart-break.
The point that I’m hoping to make here is your hope for an emotionally fulfilled life is diminished daily with a constant string of disappointment & regret. I’m not trying to be all dark and doomsday here because I KNOW there are countless numbers of people who live VERY fulfilling lives that are blind. What I’m trying to paint here is a very HONEST perspective for those of us who CAN SEE, of what ONE DAY in the life of someone that CAN NOT is like. Instead of seeing their daughter draped in beauty or their son standing proud and hopeful of a new future at the alter…they are left with darkness and the sounds of the wedding march ringing in their ears to the rhythm of their hope being chipped away at.
These thoughts, however depressing and somber they may be, are a VERY realistic perspective that the families we interact with daily are experiencing and feeling. By visiting our DONATION webpage and registering to be an eye-donor and by your financial contributions, you are helping the Alabama Eye Bank restore hope to a man, a woman, a father or a mother by enhancing their quality of life to enjoy the small pleasures of getting to gaze upon the ones they love and experience memories of smiles gleaming in color and love wrapped in the warm glow of a fire.