Rome, Dec. 14. (Adnkronos Health) — From zero to 6 tenths with a half-hour operation: a 76-year-old patient returns to see after 5 years of blindness. It is the result of the first transplant in Italy, the hundredth in the world, made with an endothelial prosthesis in polymeric material that works as an endothelium of an artificial cornea. The exceptional intervention was performed at the Policlinico Sant’Orsola in Bologna by Luigi Fontana, professor of Diseases of the visual apparatus at the University of Bologna and director of Ophthalmology of the Bologna IRCCS, who has already replicated the operation four times.
«We are talking about a prosthesis in polymeric material that works as an endothelium of an artificial cornea — explains Fontana — The corneal endothelium is a membrane that performs a fundamental task for maintaining the transparency of the cornea and therefore to see correctly: for this reason in patients suffering from deficits of its functioning, donor transplantation was until now the only intervention able to restore visual function.With an intervention that uses a prosthesis in polymeric material, similar to plastic, the main added value lies in the lower percentage of rejection and in the little invasiveness of the intervention, almost ambulatory «.
Corneal transplantation — explains a note from the Policlinico Sant’Orsola in Bologna — is still the most widespread intervention by number of patients: in Italy more than 5,000 are performed every year. The techniques have evolved over time, however, there are still conditions in which donor endothelium transplantation has a short duration or impossibility of being performed: we are talking about patients who have already undergone failed endothelium transplants due to rejection or the presence of other eye diseases. The results of the first operation performed at Irccs Sant’Orsola and subsequent ones, therefore, confirm the potential of using an artificial material to treat some forms of corneal opacification. More specifically, we are talking about a thin layer of a synthetic material 50 microns thick and 6.5 mm in diameter: like a small soft and foldable contact lens that once introduced into the eye is made to adhere to the inner wall of the cornea.
We are not yet at the point of thinking that the artificial endothelium can completely replace the transplantation of donor tissue: the latter is in fact — explains the note — still able to guarantee an excellent visual result with low risks of complications and satisfaction in patients who fully recover their sight.But ongoing studies demonstrate the safety and efficacy of this type of implants in patients with particular and complex corneal diseases.
Giancarla, the patient who regained her sight thanks to the surgery, is suffering from a disease called endothelial decompensation with a consequent clouding of the cornea and glaucoma. In recent years she had already undergone two transplant operations with donor endothelial cells, both of which failed. Before the operation she was considered a patient ‘visus moto manu’: a condition similar to total blindness, because she was able to distinguish only shadows and light but not shapes. At the end of August she underwent surgery with artificial endothelium implantation, the first in Italy and the 100th in the world, currently her cornea is transparent and her visual capacity is 6 tenths. An extraordinary result — concludes the note — considering the starting conditions and the patient’s past.
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Source — https://www.univadis.it/viewarticle/bologna-recupera-vista-con-trapianto-cornea-artificiale-primo-in-italia