Pioneering eye operation may end need for donors

A blind woman has had her sight restored by a pioneering operation developed by a British surgeon which could ultimately end the need for corneal transplants from donors.

Jennifer Matcham, 64, lost her sight as a result of cumulative problems, but within days of the new procedure, she was able to read close to the bottom of the eye test chart without glasses.

"One day I was blind and the next I could see. It was so sudden I could hardly believe it. My life has been transformed," Mrs Matcham of Liphook, Surrey, said.

The technique, developed by Michael Tappin, of the Royal Surrey County Hospital, is a refined version of the traditional corneal transplant in which the transparent surface of the eyeball is removed from a donor and stitched into the recipient's eye.

The thickness of the cornea and the need for stitching with the traditional technique means patients have to wait up to 18 months until the eye settles down, and most end up with astigmatism (distorted vision) requiring glasses.

With the new technique, only the endothelial cells from the innermost layer of the cornea are scraped off and transplanted, eliminating the need for stitching and speeding recovery.

Endothelial cells pump water out of the cornea, keeping it clear, but when the cells are damaged the cornea becomes waterlogged and cloudy, a condition which accounts for up to half the 2375 transplants performed in Britain last year.

In future, doctors hope replacement endothelial cells may be grown in the laboratory, circumventing the need for donors and reducing the risk of rejection.

Mr Tappin said: "There are two problems with corneal transplants - distortion [because of the thickness of the transplanted cornea that has to be stitched in place] and rejection. This technique should overcome both."

Of 15 operations carried out, nine had been successful, he said. It is called the TenCell treatment - True Endothelial Cell Transplant.

"The great thing with this technique is you burn no boats. You can repeat the procedure or do a traditional graft [corneal transplant]."

The next logical step is to grow endothelial cells in a laboratory, either from an existing cell line or harvested from the patient.

Eyes are among the most difficult organs to obtain for corneal transplant and there is a waiting list for the operation. Relatives are reluctant to donate eyes because they are visible and an integral part of a deceased's face, unlike a kidney or liver.

- INDEPENDENT