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Artificial cornea offers better results for infants, some blind patients

those children recovered some vision, sometimes remarkably so, and none had an infection or a problem with the implant. In the seven cases where the child was 4 years old or older and could explain to some degree how much he or she could see, every child could at least see fingers held at an arm's length, and some children improved to 20/30 vision.

"Finally, we seem to have a method in hand to improve the vision of these children, many of whom have endured several surgeries that have failed," said James Aquavella, M.D., the University of Rochester ophthalmologist who is pioneering the use of the implant and who operated on most of the children in the study.

"These are children for whom, until now, there really has not been a good option. While this study is somewhat small and these children need to be followed for more time, we have decided that for now this is the treatment of choice for children who have corneas that are cloudy or opaque. It's either do this, or do nothing," he added.

Aquavella is discussing the work at the Cornea Society meeting in Las Vegas, while pediatric ophthalmologist Matthew Gearinger, M.D., of the Eye Institute is presenting at AAO. The study overall included 23 separate procedures on 17 patients; most of the procedures were performed by Aquavella in Rochester, while four were done by Esen K. Akpek, M.D., of the Wilmer Eye Institute at Johns Hopkins University.

The work addresses vision problems in some of the toughest-to-treat children. Oftentimes, in addition to needing a new cornea, these children require treatment for other ongoing conditions like glaucoma, cataracts, and retinopathy. And in children, successful transplants can be more difficult to perform than in adults.

"The vibrancy of a child's immune system has been one of the main reasons why cornea transplants haven't worked well in children," said Gearinger. "The risk of rejection is huge, and it just goes up with every subsequ
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Source:University of Rochester Medical Center


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