1 donor cornea, 2 patients helped
New surgical approach may help meet demand for donor corneas
2011-02-02
(Press-News.org) SAN FRANCISCO–German researcher Claus Cursiefen, MD, also affiliated with Harvard School of Medicine, reports good results with a new surgical strategy that uses a single donor cornea to help two patients with differing corneal diseases. In the United States keeping pace with demand for donated corneal tissue for use in transplant surgery is a cause for concern, while in Europe and Asia shortages lead to treatment delays. Dr. Cursiefen's new approach restored good vision to patients who had Fuchs' dystrophy (degeneration of certain corneal cells) or keratoconus (thin, cone-shaped cornea) while also addressing the supply problem. The study appears in February's Ophthalmology, the journal of the American Academy of Ophthalmology.
Advanced keratoconus (and other diseases of the anterior portion of the cornea) is often treated with a surgery called deep anterior lamellar keratoplasty (DALK). Fuchs' dystrophy and similar diseases can be treated via several surgical techniques, including the recently developed Descemet's membrane endothelial keratoplasty (DMEK). Dr. Cursiefen and his colleagues noted that, once the tissues needed for DALK were removed from a donor cornea, the precise tissues needed for DMEK remained. They reasoned that scheduling two patients for surgery on the same day, with the DALK patient always scheduled first, would make it possible to use one cornea for two patients. Since about 80 percent of the cornea diseases that require transplants can be treated with DALK or DMEK, this approach might potentially nearly double the available corneal tissue supply and make timely treatment available to many more patients.
"In this exploratory study, we were able to use one cornea to successfully treat two patients, for 10 of 12 consecutive donor corneas," Dr. Cursiefen said. "Only twice during surgery did we find that a full corneal transplant, rather than DALK, was needed. Our early follow-up with all patients shows good visual outcomes and few complications," he added.
At their six month follow up, successful DALK patients achieved, on average, 20/35 vision, and DMEK patients achieved 20/31 vision, on average. The two patients scheduled for DALK who instead received full transplants achieved 20/50 vision, on average. All surgeries were performed at the University Eye Hospital, Friedrich-Alexander University Erlangen-Nurnberg, Germany, in 2009.
Drawbacks of this approach are that both DALK and DMEK are demanding surgeries that at present can only be performed at leading-edge ophthalmic hospitals, and, because both techniques are relatively new, longer-term outcomes and effectiveness remain to be determined. Also, preparation and care of the split corneas requires sophisticated planning and preparation, and access to additional corneas is essential in case full transplants became necessary. Further research will determine whether the approach becomes widely accepted.
INFORMATION:
Eds: Full text of the study is available from the Academy's media relations department.
About the American Academy of Ophthalmology
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons—Eye M.D.s—with more than 29,000 members worldwide. Eye health care is provided by the three "O's" – opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.
ELSE PRESS RELEASES FROM THIS DATE:
2011-02-02
If you're a woman and your mother had a stroke, you may have a risk of heart attack in addition to a higher risk of stroke, according to new research on family history and heart disease published in the American Heart Association journal Circulation: Cardiovascular Genetics.
In a study of more than 2,200 patients, female heart patients were more likely to have mothers who had suffered a stroke than fathers who did.
"Our study results point towards sex-specific heritability of vascular disease across different arterial territories — namely coronary and cerebral artery ...
2011-02-02
An examination of data from a nationally representative sample of patients discharged from hospices demonstrated that compared with nonprofit hospice agencies, for-profit hospices had a higher percentage of patients with diagnoses associated with lower skilled-care needs (such as dementia) and longer lengths of stay, according to a study in the February 2 issue of JAMA.
During the past 10 years, the for-profit hospice sector has increased substantially, with a doubling of these types of hospices from 2000 to 2007, while the number of nonprofit hospices has remained essentially ...
2011-02-02
After a good night's sleep, people remember information better when they know it will be useful in the future, according to a new study in the Feb. 2 issue of The Journal of Neuroscience. The findings suggest that the brain evaluates memories during sleep and preferentially retains the ones that are most relevant.
Humans take in large amounts of information every day. Most is encoded into memories by the brain and initially stored, but the majority of information is quickly forgotten. In this study, a team of researchers led by Jan Born, PhD, of the University of ...
2011-02-02
An analysis of previous studies indicates that compared with chemotherapy alone, use of the cancer drug bevacizumab in combination with chemotherapy or biological therapy is associated with an increased risk of treatment-related death, according to an article in the February 2 issue of JAMA.
A fatal adverse event (FAE) is defined as a death caused in all likelihood by a drug and is a major cause of fatality in the United States. Bevacizumab was approved in combination with chemotherapy for treating many types of advanced cancer, including colorectal cancer, non-small ...
2011-02-02
An analysis of data from more than 90,000 Medicare managed care enrollees who received care for rheumatoid arthritis finds that more than one-third did not receive the recommended treatment with a disease-modifying antirheumatic drug, and that receipt varied by demographic factors, socioeconomic status, geographic location and health plan, according to a study in the February 2 issue of JAMA.
Despite evidence-based guidelines recommending early and aggressive treatment of active rheumatoid arthritis (RA), recent population-based studies of disease-modifying antirheumatic ...
2011-02-02
SALT LAKE CITY—As day-old embryos, fruit flies called Drosophila enter a stage in which their cells freely divide and proliferate as the insect grows dramatically in size.
This is true for all animals, which undergo most of their growth prior to sexual maturation. Until now, researchers have known nothing about the metabolic state that occurs when cells divide during early development. But in a study published online Tuesday, Feb. 1, 2011, in Cell Metabolism, University of Utah human genetics researchers show that this cell division in Drosophila depends on a metabolic ...
2011-02-02
PHILADELPHIA—Medical physicists at Thomas Jefferson University and Jefferson's Kimmel Cancer Center have demonstrated a new real-time tumor tracking technique that can help minimize the amount of radiation delivered to surrounding healthy tissue in a patient—up to 50 percent less in some cases—and maximize the dose the tumor receives.
Respiratory and cardiac motions have been found to displace and deform tumors in the lung, pancreas, liver, breast, and other organs. Because of this, radiation oncologists must expand the margin during radiotherapy. Consequently, a large ...
2011-02-02
BOSTON – For-profit hospice agencies had a higher percentage of patients with diagnoses associated with less skilled care and longer lengths of stay (LOS) in hospice, than their nonprofit counterparts, a difference that may leave "nonprofit hospice agencies disproportionately caring for the most costly patients," Beth Israel Deaconess Medical Center researchers report.
The findings appear in the Feb.2 issue of the Journal of the American Medical Association (JAMA).
"There was a big increase in the number of for-profit hospice agencies from 2000 to 2007, and previous ...
2011-02-02
As Internet authorities prepare to announce that they have handed over all of the available addresses, a USC research group that monitors address usage has completed the latest in its series of Internet censuses.
There is some good news, according to computer scientist John Heideman, who heads a team at the USC Viterbi School of Engineering Information Sciences Institute that has just released its results in the form of a detailed outline, including a 10-minute video and an interactive web browser that allows users to explore the nooks and crannies of Internet space themselves.
video: ...
2011-02-02
"Look to the ant thou sluggard and consider her ways and be wise." This proverbial wisdom was taken to heart recently by an international group of ant experts who have published the genome sequences of four ants in a series of coordinated releases in the journal Proceedings of the National Academy of Sciences (PNAS). The quartet includes the genomes of the red harvester ant Pogonomyrmex barbatus; the Argentine ant Linepithema humile; the fire ant Solenopsis invicta, and the leaf-cutter ant Atta cephalotes, whose genome will be published on Feb. 10 in Public Library of Science ...
LAST 30 PRESS RELEASES:
[Press-News.org] 1 donor cornea, 2 patients helped
New surgical approach may help meet demand for donor corneas
