Artificial Cornea To Reach Patients This Year

kkleiner writes "A German-led team of researchers has developed a new version of an ophthalmological polymer to which the eye will bond and still function normally. 'The new polymer could help restore sight to thousands waiting for corneal transplants around the world. The artificial cornea has passed clinical trials and is ready to see expanded use in patients this year. ... In order to work in the human body, an artificial cornea has to meet some stringent requirements. First, it has to bond to the human eye around its edge. ... The center of the artificial cornea, however, does not promote cell growth and remains clear so that it can be seen through. The artificial cornea also has to move freely with the eyelid and balance moisture on its faces.'"

Comments

The future of medicine

[MrEricSir]

I didn't see this coming.

Re:The future of medicine

[Anonymous Coward]

Yes, truly visionary.

Re:The future of medicine

[AnonymousClown]

I didn't see this coming.

Well, if you're reading about the Spanish Inquisition, then....shit, I don't know where to take this....

Re:The future of medicine

[Monkeedude1212]

Yeah, but are they comfortable? I'm not sure if I would want to trade sight for sore eyes.

Re:The future of medicine

[Anonymous Coward]

There's nothing to see here... move along

Re:The future of medicine

[Anonymous Coward]

That couldn't have been cornea if you tried.

Re:The future of medicine

[interkin3tic]

In case there are medical complications, I sure hope they have a good lawyer on retina.

Re:The future of medicine

[kkwst2]

That would have been voted higher, but it's only funny in Boston.

Re:The future of medicine

[weszz]

The real question is... Will it blend?

Re:The future of medicine

[gstoddart]

That would have been voted higher, but it's only funny in Boston.

Say chowdah, Frenchy. :-P

Having a new cornea put in?

[Totenglocke]

So you'd have your cornea removed and a new one put in? As someone who's had many eye injuries in my life, let me be the first to say "ouch".

Re:Having a new cornea put in?

[Anonymous Coward]

So you'd have your cornea removed and a new one put in? As someone who's had many eye injuries in my life, let me be the first to say "ouch".

Actually, a cornea transplant isn't painful at all. You are asleep for the whole operation...Recovery on the other hand, while not painful to the eye, is a pain in the ass. I had to have such a transplant done due to a degenerative eye disease and I for one would love something like what this article is talking about. It would be much nicer to have the whole cornea replaced instead of just a section of it (which is what I had done, a small section about the size of my pupil was replaced.)

Re:Having a new cornea put in?

[Abcd1234]

So you'd have your cornea removed and a new one put in?

Well, given the first corneal transplant was done in *1905*, and was one of the first organ transplants ever performed, yes, that's exactly what would happen.

Re:Having a new cornea put in?

[Anonymous Coward]

For my transplant I was only asleep while they immobilized my eye, I was awake for the actual surgery. BTW, your cornea doesn't feel anything, when you "feel" something in your eye or some other similar pain, it's usually your eyelid that actually feels the pain.

Re:Having a new cornea put in?

[M8e]

BTW, your cornea doesn't feel anything, when you "feel" something in your eye or some other similar pain, it's usually your eyelid that actually feels the pain.

Or in the ass...

Actually, a cornea transplant isn't painful at all. You are asleep for the whole operation...Recovery on the other hand, while not painful to the eye, is a pain in the ass.

Re:Having a new cornea put in?

[mcgrew]

I've had two eye surgeries (link and link), and the first was completely painless. a bit, but the arthritis was excruciating. Also, I had to hold my head down for two weeks after the surgery, and that was no fun at all. But it beat going blind, and I don't have to wear those thick glasses I wore all my life.

I know a guy who will probably cheer this, as he's already had two cornea transplants for some degenerative disease.

Re:Having a new cornea put in?

[SleazyRidr]

How can they operate on your eye while you're asleep. Aren't your eyes closed?

Puns

[HForN]

"The artificial cornea has passed clinical trials and is ready to see expanded use in patients this year. .."
I see what you did there.

Something important to remember

[erroneus]

I read through the whole article until I got near the end. It was only then that I realized that while the article said "cornea" I kept thinking "retina" for some unknown reason. In any case, an artificial cornea is a terrific breakthrough. People who use laser eye surgery to correct their vision can only do so a limited number of times. After that, a cornea would need to be replaced. Ideally, a replacement cornea would be able to correct vision without further adjustments.

More interestingly, an artificial cornea can do things to improve the health of the eye. For example, an artificial cornea could be made to block UV rays or even be polarized. I'm still waiting for telescopic vision corneas but I doubt that will happen. But the idea of having built-in sunglasses is interesting to me... not that I would have it done unless it were necessary to replace my cornea anyway...

Re:Something important to remember

[Anonymous Coward]

even be polarized

Yes, I'd love to see people standing with their heads at 90 degrees just to be able to use certain ATMs.

Re:Something important to remember

[Abcd1234]

People who use laser eye surgery to correct their vision can only do so a limited number of times. After that, a cornea would need to be replaced. Ideally, a replacement cornea would be able to correct vision without further adjustments.

More importantly, there are a number of diseases related to the cornea that ultimately necessitate a corneal transplant. Technology like this would obviate the need for tissue donation, which is a huge step for people suffering from such illnesses.

Re:Something important to remember

[john83]

For example, an artificial cornea could be made to block UV rays or even be polarized. I'm still waiting for telescopic vision corneas but I doubt that will happen. But the idea of having built-in sunglasses is interesting to me... not that I would have it done unless it were necessary to replace my cornea anyway...

Certainly, a UV filter seems plausible to me. However, you normally use two lenses to make a telescope, so unless it could form some very exotic diffractive object, I think you'd need at least a pair of thick glasses to make a telescope. You might be able to make a magnfying glass though.

Re:Something important to remember

[Anonymous Coward]

But the idea of having built-in sunglasses is interesting to me... not that I would have it done unless it were necessary to replace my cornea anyway...

They have contacts that block UV. I find mine more comfortable than glasses. Still, I wear sunglasses when it's bright.

Re:Something important to remember

[hitmark]

if its more reliable/repairable then laser, i can see it become popular.

Re:Something important to remember

[TheRaven64]

If it binds to the eye, I wonder if the same approach can be used for corneal modifications, as a less destructive alternative to laser surgery. I'd love to have a pair of contact lenses that just bonded to my cornea and got replaced in a decade or so if my prescription changed significantly. I also wonder how easy they would be to remove if used in this way. If there is something that's safe to put in the eye, which dissolves the bond, you could just get some eye drops to remove them, have a doctor insert the new ones, and have perfect vision after a relatively simple procedure every few years.

Re:Something important to remember

[Rigrig]

You could polarize the eyes differently, so you don't need glasses for 3D movies anymore.

Re:Something important to remember

[erroneus]

Wow. Imagine seeing 3D in real life! That would be just awesome!

Re:Something important to remember

[Anonymous Coward]

"More interestingly, an artificial cornea can do things to improve the health of the eye. For example, an artificial cornea could be made to block UV rays or even be polarized."

Both could be done easier by replacing the lens instead. Which might already be done, given there are artificial lens replacements (artificial cataract replacement) which includes corrective lenses (such as Crystalens). According to the wikipedia entry for "intraocular lens", a uv filter has already been done.

You can't do everything of course, given the cornea is responsible for most of the lensing effect in the eye (even more than the lens) but I have pretty shitty vision (my cornea would supposedly collapse) and they recommend the IOL if I ever wanted to get rid of eyeglasses and contacts.
You c

Re:Something important to remember

[Zerth]

Natural corneas already block UV rays. People with current-gen artificial corneas, at least some of which are UV-transparent, can actually see a tiny bit of UV. Still looks purple, though.

Unless it greatly increases the risk of some kind of eye cancer, I'd probably stick with the UV-transparent ones for the "hey, did you know that UV led is still on?" trick.

Re:Something important to remember

[chill]

What are the average wait times around the world? I had a cornea transplant in the U.S. and my doctor wanted to find the best compatible tissue. Total wait time was 2 weeks from my (and my insurance) saying "do it" and him getting the tissue and actually doing the surgery.

Honestly, with this first being performed in 1905 and being the single most common transplant surgery done in the world, I expected that in any industrialized nation there was an ample supply of donor tissue. In non-industrialized nations I'm not sure the artificial tissue would be any cheaper, but I guess it obviates the need for a donor-bank-recipient network. Just place your order and await FedEx.

Re:Something important to remember

[Abcd1234]

Honestly, with this first being performed in 1905 and being the single most common transplant surgery done in the world, I expected that in any industrialized nation there was an ample supply of donor tissue.

It's not so much an issue with tissue availability as it is issues with compatibility, rejection, etc. If you can make an equally capable, synthetic cornea, you can do away with all that, and that strikes me as a substantial win (though, at least at the outset, probably not a win on cost).

I mean, I'm assuming this technology was developed for *some* reason. :)

Re:Something important to remember

[Charliemopps]

With this technology there will be no chance for Rowdy Roddy Piper to uncover the alien conspiracy!

Re:Something important to remember

[Teckla]

People who use laser eye surgery to correct their vision can only do so a limited number of times. After that, a cornea would need to be replaced.

I think the majority of such surgeries are LASIK, which reshapes the lens by removing tissue, rather than the cornea.

I believe PRK is similar to LASIK except it reshapes the cornea by removing tissue. I'm not sure why LASIK is so much more popular than PRK.

Any eye surgeons out there care to shed some light on the subject?

Re:Something important to remember

[drsmithy]

I believe PRK is similar to LASIK except it reshapes the cornea by removing tissue. I'm not sure why LASIK is so much more popular than PRK.

Recovery time and discomfort. With LASIK you have basic sight back pretty much straight away, and a full recovery in a few days (ie: go in Friday afternoon, be back at work Monday). With PRK you need to assume you'll be out of action for at least full week.

On the other hand, PRK has fewer complications and gives you much more leeway for future surgery.

At least, that's what the folks at the LASIK centre told me (looking to get it done later this year - still haven't decided on PRK vs LASIK).

Re:Something important to remember

[drsmithy]

I believe PRK is similar to LASIK except it reshapes the cornea by removing tissue. I'm not sure why LASIK is so much more popular than PRK.

Forgot to add: I think LASIK is also quite a bit cheaper, since it's much more common - most people are budget driven.

Re:Something important to remember

[Abcd1234]

Maybe that's reason enough, then? *shrug*

I mean, if tissue is readily available (something that doesn't surprise me), tissue matches are easy, and rejection is trivially manageable, what *is* the advantage of artificial corneal implants, aside from the "whoa neat" factor?

Re:Something important to remember

[takev]

Lets hope that all the theaters are going to the same direction of polarization. Or for that matter the same technology, I would think your polarization would interfere with the polarization of LCD shutter glasses.

Re:Something important to remember

[PitaBred]

Most LEDs run in the IR spectrum, not UV. And without UV filtering, you would have to pay very close attention to wearing sunglasses every time you go outside.

Re:Something important to remember

[Anonymous Coward]

LASIK doesn't reshape the lens, only the cornea. The difference between LASIK and PRK is that in LASIK they cut and fold a thin flap off the surface of the cornea, then use the laser to modify the shape (the same as PRK), then place the flap back on top of the operated area. This way the outermost surface of the eye is the same as it was before the surgery, and protects the healing process. PRK is more prone to complications like bacterial infection because the tissue that was burnt by the laser is open to the elements while it heals. My eye surgeon also said that LASIK produces slightly more consistent results. (I've got 20/15 in both eyes now instead of the uncorrectable-by-glasses astigmatic mess I used to have, so I can vouch for it)

Re:Something important to remember

[CharlyFoxtrot]

In diseases like keratoconus, a degenerative eye disorder, there are cases in which even transplanted corneas degenerate again in time. A synthetic obviously wouldn't have this problem. I suppose it could also be custom made to the eye making for a better fit than organic parts sliced off of a corpse which are bound to be imperfect. Corneal transplants are rejected in keratoconus cases in roughly about 10% of cases and people who have rejected one graft seem more predisposed to reject following grafts as well. Those people would also be helped by this procedure.
As someone who has (relatively mild at the moment) keratoconus I certainly welcome this news.

Re:Something important to remember

[CharlyFoxtrot]

Be sure to have it done by a qualified professional that thoroughly checks your eyes topology beforehand ! LASIK is contraindicated if you have some condition like keratoconus which can be mild or asymptomatic and undiagnosed. You can ruin your eyes if you have LASIK in this case however, I have seen examples on keratoconus sufferers message boards.

Re:Something important to remember

[Genda]

The cornea is a simple lens and you'd almost certainly have to replace the lens in the eye with a more complex set of optical elements to get telescopic vision. A simpler answer would be to place nano-scale laser arrays on the inner surface of the lens, such that it could paint images directly onto the retina. Having an ultra high performance video imaging system inside your eye would be wicked cool. Now if you want telescopic vision, just get a really good small scope with an imaging device and a transmitter to your eye and let the good times roll.

Re:Something important to remember

[Jesus_666]

Sunglasses are much better. I mainly wear mine at night so I can so I can watch you weave then breathe your story lines. I find that when wearing tinted contacts I can not I can not keep track of visions in my eyes so I tend to avoid them.

Besides, people just love to switch the blade with the guy in contacts, oh yes. No danger of that with shades. Rhymes better, too.

Re:Something important to remember

[CubicleView]

Something that blocks UV would presumably be damaged by UV. The only workable improvement I can think of at the moment would be in the clarity of the material.

Re:Something important to remember

[mcgrew]

People who use laser eye surgery to correct their vision can only do so a limited number of times.

And for the severely myopic it won't give you anywhere near 20/20 vision, unlike a lens implant. The implants are far more expensive and more invasive -- they stick a needle in your eye, turn the focusing lens to mush with ultrasound, suck it out, and put the artificial lens in. The newer lenses actually let you focus. I got one for a cataract (the only way to correct a cataract is a lens replacement) and after wearing very thick glasses all my life for myopia, and later contacts for myopia AND reading glasses for age related farsightedness, I don't need corrective lenses at all, not even reading glasses. The vision in my right eye is still 20/400, but the eye I had the surgery done to is better than 20/20.

There a link to a journal somewhere else in this thread with more info if you're interested.

I'm still waiting for telescopic vision corneas

Your eye actually has two lenses; the cornea, and the lens behind the iris that does the focusing; that's the one they can replace already. I don't see how they could have telescopic eyes, though, although having better than 20/20 vision is pretty damned close.

Re:Something important to remember

[mcgrew]

probably not a win on cost

A CrystaLens, which replaces the focusing lens behind the iris, will cure nearsightedness, farsightedness, astigmatism, and cataracts. The surgery cost about $7,000 per eye, which is cheap compared to some surgeries. I imagine this tech would be even cheaper; the CrystaLens was FDA approved in 2003, so is still under patent. They're about $1000 more than the older monofocal IOLs.

Re:Something important to remember

[Abstrackt]

Wow. Imagine seeing 3D in real life! That would be just awesome!

Eh, it'd probably be cheaper just to watch Avatar again.

Re:Something important to remember

[weszz]

*raises hand...* Had Lasik 2 years ago, and now have Keratoconus... Turns out I shouldn't have had Lasik done, but I had no idea, and they didn't find it then. It normally shows up mid to late 20's I believe.

Re:Something important to remember

[weszz]

intacs are removable... COMPLETELY reversible or tweakable with no tissue removed. Just a very fringe treatment still...

Re:Something important to remember

[TheBig1]

I think the majority of such surgeries are LASIK, which reshapes the lens by removing tissue, rather than the cornea.
I believe PRK is similar to LASIK except it reshapes the cornea by removing tissue. I'm not sure why LASIK is so much more popular than PRK.

Speaking as someone who just went through PRK surgery, I can assure you that you are incorrect. Both LASIK and PRK remove tissue from the cornea; the difference is that in PRK the tissue is removed at the surface, while with LASIK there is a flap on the cornea created and lifted, and tissue is removed underneath the flap.

The reason LASIK is more popular is that it has a faster recovery time and a less painful recovery. Mine was done over a month ago and I am still not quite at full vision (although I had functional vision within about a week). LASIK patients tend to have functional vision within a couple of days, and (if you can believe the literature) have full recovery within a couple of weeks.

Cheers

Re:Something important to remember

[TheBig1]

Forgot to add: I think LASIK is also quite a bit cheaper, since it's much more common - most people are budget driven.

From what I have seen in my area at least, PRK is actually cheaper -- the reason being that there is no need for a microkeratome or Intralase laser to create the flap. Licensing for the Intralase is a couple hundred per patient, and the cost is passed on to you. My PRK surgery was $1600 / eye, whereas LASIK would have been $1800. (Granted, this is in Canada, from a highly respected and reputable surgeon; in the USA YMMV).

Re:Something important to remember

[TheBig1]

On the other hand, PRK has fewer complications and gives you much more leeway for future surgery.

At least, that's what the folks at the LASIK centre told me (looking to get it done later this year - still haven't decided on PRK vs LASIK).

That is why I chose PRK over LASIK. In LASIK the cornea never completely heals, and (according to some studies) only ever regains a small percentage of the strength of an unaltered cornea. For most people this is not an issue, but for me (due to martial arts and an otherwise active lifestyle) I felt that PRK was the better choice. The recovery time is definitely longer, though; it has been over a month and I still am not quite at my BCVA (best corrected visual acuity) of 20/15; I am currently at 20/20+1 in my right eye and 20/25-1 in my left. However, this is still improving slowly; apparently it takes about 6 months for the eyes to completely heal and provide stable vision again.

That being said, I am still quite happy with my choice; while my visual acuity has not yet reached my previous acuity with glasses, I am still seeing better than I ever had before without glasses, and can do things outside without worrying about rain and stuff getting on my glasses. For me, it was worth it, and PRK was the correct decision, but be sure to talk with your surgeon and eye doctor at length about the options, and which is best for you.

Cheers

Re:Something important to remember

[hitmark]

to bad they only work for mild nearsightedness.

Re:Something important to remember

[CharlyFoxtrot]

*raises hand...* Had Lasik 2 years ago, and now have Keratoconus... Turns out I shouldn't have had Lasik done, but I had no idea, and they didn't find it then. It normally shows up mid to late 20's I believe.

Man that sucks. I've heard of people getting it earlier but I first noticed it in my late 20's myself. In hindsight I'm probably lucky to be such a lazy SOB because I kept putting off having LASIC despite my mother's advice to have it done. Oh well, luckily with news like this, riboflavin crosslinking and stemcell research moving ahead in leaps and bounds there's plenty of reason for us to be optimistic.

Re:Something important to remember

[weszz]

no all bad, im my early 30's now, and headed to an eye surgeon in about 2 hours to see what I can do since i think it's still early... heard a bunch about intacs and how they are suppose to help (there is also the possibility that i's not keratoconus, but the version that is made FROM botched LASIK.

either way i'm fairly confident insurance will cover it as a necessary thing to prevent blindness, and they told me they would cover it as long as a doc says it's necessary, so first step make the doc tell them it's necessary (which the doc that did the lasik, but isn't covered by my insurance believes it is), then get a piece of paper from them saying they will cover it, then get it fixed as much as possible...

Re:Something important to remember

[Nietzsche]

In case you haven't looked into it, I highly recommend C3R (http://en.wikipedia.org/wiki/Keratoconus#Corneal_collagen_crosslinking_with_riboflavin). I also have keratoconus and unfortunately it has now pretty severely degraded my vision. If C3R had been available when I was first diagnosed (about 12 years ago) my corneas would be doing much better right now. The procedure is becoming more common in North America. I had mine done in Toronto (www.bochner.com) but I know that more and more places are starting to do it.

And, regarding the story, I too and very excited by the prospects of it. While C3R has halted the progression of keratoconus, an artificial cornea could greatly improve my vision.

RE: Artificial Cornea to Reach Patents This Year

[masterwit]

I read that as patents at first, but jokes aside I decided to do a brief search on patents. There seems to be a method out similar to that described in the article, although my guess would be the article is more about the all important application too...
 

Abstract
Germanium-containing organic polymers are obtained by polymerizing 3-trichlorogermylpropionic acid obtained by reacting halogermanium-phosphoric acid complexes with acrylic acid. The polymers are markedly effective in treating opthalmological disorders.
[2/29/1980] http://www.patentstorm.us/patents/4296123/fulltext.html

But I will save judgment there because I do not know the details.
Also in the article:

Storsberg helped develop a new version of an opthalmological polymer which the eye will bond to and still allow to function properly.

Anyone who cannot do a simple spellcheck on that word...haha nevermind I enjoyed the read. (Spelled: ophthalmological)

Re: Artificial Cornea to Reach Patents This Year

[masterwit]

Reply needed sorry:

The patent listed deals a bit with a chemical used by the German scientists, but does not include much outside of that. Still interesting imo...whatever.

well first things is a trashed cornea

[RobertLTux]

You would most likely have somehow trashed your cornea to even have this kind of thing an option.

Re:well first things is a trashed cornea

[weszz]

Not necessarily... I'm going to see an eye doc today about intacs for kerataconus (sp?), or the steepening of the eye as a genetic disorder. I have it in just one eye, and I didn't do anything to trash my eye, but a cornea transplant is one possible fix.

For anyone interested in what this looks like, with my left eye closed I get a ghost vision where there are 2 clear images, one is just overlayed on the other... when the TV menu is up, I can read what is on one line, and I also see it on the line just above it as a ghost image... it's odd, but this would be one possible treatment for it.

Re:well first things is a trashed cornea

[WhiteDragon]

I didn't do anything to trash my eye, but a cornea transplant is one possible fix.

Don't forget to ask your doctor about the possibility of an Accomodating IOL. I think they are occasionally prescribed for cataracts so I don't know if they are a good option for you.

Re:well first things is a trashed cornea

[weszz]

interesting, I will have to remember that. thanks!

I just really don't want to go back to contacts... I had LASIK so I wouldn't need them... Didn't know at the time that I should not have been a candidate a few years later...

Right now I was looking into intacs which are plastic semi circle implants in the upper tissue of the eye to flatten it out

This is great news

[Anonymous Coward]

I've got Keratoconus, a nasty degenerative corneal condition that has to potential to leave me legally bind. This news just made my day!

FINALLY! A solution to my pain...

[adosch]

I can finally get replacement eyes for all the stupid acts of humanity I've witnessed in my short lifetime that have dulled my sensitivity to this world.

Re:FINALLY! A solution to my pain...

[vandelais]

Are you the butterfly ballot election guy from Florida's recount? http://3.bp.blogspot.com/_sHB-X1i5MOU/SKIH1_P7gCI/AAAAAAAAAWY/b7t-bPpashA/s400/florida_hanging_chad_recount.jpg And you thought you faded into obscurity.

Re:FINALLY! A solution to my pain...

[SeaFox]

I can finally get replacement eyes for all the stupid acts of humanity I've witnessed in my short lifetime that have dulled my sensitivity to this world.

Replacement corneas cannot make you forget the time you were tricked into clicking that Goatse link.

Re:Attention Space Nutters

[Jesus_666]

This is an example of something that doesn't require space and has 14 billion potential sales. This is why Space Nuttery is DEAD. BIOTECH is the future.

Phh. Do you have any idea how big the market for Philips screws is? Biotech is dead. The steel industry's the future.

Imagine corneas grown in a lab from your own cells, in your local mall.

Finally, the news keratoconus sufferers have been waiting for! Also, I'm itching to find out how they will manufacture abiological components from my own cells.

Much more important than mining asteroids for water, when there's already 10x10^18 kg of water here on Earth.

Again, biotech is useless. Do you have any idea how many tons of biomass we have? Much, much more than we have Philips screws - and also much more than we have space stations. There's simply no demand for more biomass.

OUCH

[mcgrew]

What happened to my comment? That should have read:

I've had two eye surgeries (link and link), and the first was completely painless. The second was only painful because I have arthritis in my neck and they bolted my head to the table for the surgery. The eye didn't hurt a bit, but the arthritis was excruciating. Also, I had to hold my head down for two weeks after the surgery, and that was no fun at all. But it beat going blind, and I don't have to wear those thick glasses I wore all my life.

Wierd; I previewed it, too.

Re:Fellow keratoconus suferer here.

[weszz]

look into intacs, it MAY help.

They are 2 semi circle rings put into the upper layer of the eye to flatten the eye back out. I'm going to talk to a Doc about them this afternoon while I still have one good ey and one double vision one...

Re:FINALLY! A solution to my pain...

[mcgrew]

Just buy a pair of rose colored glasses.

BTW, they can't replace your whole eye, but you can already get the lens behind yor iris replaced.

Interesting

[nabeelarkisdata]

wow thats interesting. need to keep us updated

But for someone with keratoconus

[rutledjw]

This could be AWESOME! I mean, I can't really complain as a whole. 20 years ago I'd be looking at a corneal transplant, now I can wear gas permeable lenses for the rest of my life sans transplant.

Things like laser eye correction were not a possibility, I wonder if they could attach a "shaped" cornea to help my vision?

Either way, very cool stuff...