Dr. Kathryn Colby, chair of ophthalmology at the University of Chicago, checks the vision of the first patient to undergo Descemet stripping, 69-year-old Eric Thorp, during his two-year follow-up visit. Thorp reported his vision returned gradually over the course of a few weeks after surgery, like "the fog lifting out of London." Photo by Kevin Jiang/University of Chicago Medicine
CHICAGO, July 13 (UPI) -- Removing a layer of cells in patients with a common eye disease can prevent the need for corneal transplant, which is expensive and carries a long list of potential complications, according to researchers in Chicago.
Most patients with Fuchs endothelial dystrophy who underwent Descemet stripping in a small proof-of-concept study conducted at the University of Chicago Medical Center had some measure of vision return, suggesting the procedure could prove to be preferable to receiving a cornea transplant.
FED is the most common reason people receive a cornea transplant -- 14,000 were performed in 2015 because of the condition -- and it is effective. The downside for many patients is the required lifetime use of steroid eye drops to prevent rejection of the new cornea, and the drops often cause glaucoma, cataracts and infections.
Descemet stripping involves removal of a layer of cells inside the cornea, which allows the surrounding tissue to rejuvenate -- healthy peripheral cells to migrate to the center of the cornea and restore the removal of fluid from layers of the eye. As the fluid clears, vision is slowly restored.
"It's too soon to call this a cure. We performed the first operation just over two years ago. But when it works, it's a wonderful thing," Dr. Kathryn Colby, chair of the ophthalmology and visual science department at the University of Chicago, said in a press release. "It's quick, inexpensive and it spares patients from having someone else's cells in their eyes, which requires local immunosuppression."
For the study, published in the journal Cornea, Colby performed Descemet stripping during the last two years on 11 patients between the age of 51 and 91, two of whom had the procedure done on both eyes.
Six months after surgery, 10 treated eyes had clear corneas and eight had 20/20 vision or better. The other three eyes did not respond to surgery and received cornea transplants.
Among the eyes treated, four regained clear vision within a month of surgery, four had improved vision within three months and two responded to the treatment in more than three months.
Future research will focus on genetic clues to Fuchs dystrophy, which is a polygenic disease, to help determine the patients who will best respond to Descemet stripping.
"Although Descemet stripping is a relatively simple procedure, its potential is revolutionary," Colby said.
