Eye TransplantationHISTORY

EYE TRANSPLANTATION

Presented byTehreem Ali Aqsa Majeed Aqsa Muzammil Tayyaba Alvi

HISTORY

………… Once upon a time …………

Once upon a time…… Galen ( Greek physician ) proposed corneal transparency could be restored.ANCIENT GREEK ERA

His idea traveled and reached in 18th century

• French surgeon Gillame Pellier de Quengsy, proposed Keratoprosthesis….

•Opaque cornea could be Transplanted by transparent one..

HOW TO RESTORE CORNEA?????

19th century experiments begin

•Transparent cornea from other animal could be used (Karl Himely, 1813)

•Franz Reisinger initiated experiment on rabbits and chicken (1818)

Look Franz . We could use animal cornea to replace.

19th century continue….•Samuel Bigger 1837, corneal transplant in gazelle First successful. (Allograft)

•Richard Kissam 1838, Xenograft Corneal transplantation in Human … unsuccessful

Remember!!!I got first successful corneal transplant.

Story continue….•Xenograft vs allograft….

•1905 Eduard Zirm successful corneal transplant….

Allograft … I told you Allograft ONLY

Ah Come ON! Think outside the box Xenograft is possible

What parts of eye can be transplanted?

Cornea Eye lids Tear duct

What is Cornea?• Cornea is smooth and clear as glass, but is strong and durable.

•  It shields the rest of the eye from germs, dust, and other harmful matter.

• Outer most lens that controls and focus the entry of light into the eye.

Eye Diseases :when we can transplant corneaTrauma/infection to the cornea Keratoconus Dystrophy

Pseudophakic Bullous Keratopathy Endothelial Diease

Cornea Transplantation Types

•Penetrating Keratoplasty

•Lamellar Keratoplasty

The Surgery Method• Corneal transplants are performed on an outpatient basis

under local anesthesia.• The surgeon performed the surgery while looking at the eye

through a Microscope.• A cookie cutter-like knife called a Trephine is used to cut and

remove the Cornea.• A similar knife is used to cut and remove a Donor Cornea.• Donor Cornea placed where the recipient’s cornea was

removed.• It is sewn into place with very fine sutures which are smaller in

diameter than a human hair.

Entralase enabled keratoplasty

The IntraLase Enabled Keratoplasty software can be programmed to produce different configurations with computer precision.The IntraLase ophthalmic surgical laser is cleared for the creation of a lamellar cut/resection of the cornea for lamellar keratoplasty and for the creation of a PENETRATING CUT/INCISION for penetrating keratoplasty

The IntraLase Enabled Keratoplasty application allows the user to perform three cut segments: a posterior side cut lamellar cut anterior side cut.

Red 90 degreesBlue 30 degreesYellow 150 degreesDotted line angle measurement

Corneal Allograft Rejection

RednessSensitivity to LightVisual symptoms pain

Clinical Features

Types of Rejection1.Epithelial RejectionHost epithelium grows inward from the

remaining host cornea and limbus to cover the graft

 Epithelial rejection occurs in roughly 2% of graft rejections.

2. Sub Epithelial RejectionSub epithelium infiltrates with leukocytesSub epithelial rejections are the least

common type of rejection with an occurrence rate of 1%

Endothelial Rejection occurring in 50% of rejection episodesBegins at the vascularized portion of host-host junction and progress across endothelial surfaceUnable to dehydrate corneal graft.

Inflammation

Bone- Marrow derived cells recruited into cornea through limbal circulationchronic inflammation causes the generation of blood vessels and lymphatic in normal avascular cornea

Eye banking

Who can be Donor?•Almost anyone between the ages of 2 and 75 can be an eye donor, regardless of poor vision, diabetes, or cancer. In fact, only under the following conditions can eye donation definitely not occur: HIV or AIDS, Active Hepatitis, Active Syphilis, Rabies, Viral Encephalitis, Leukemia, Active Lymphoma, or Active Meningitis. 

Eye Banking

• Remove as early as possible • It should be store undr stearile conditions• Cornea fron infants is rarely used• Evaluation

STORAGE TYPES SHORT-4deg.C(days)• Moist chamber(1day),M.K.Media(2-4days) INTERMEDIATE-14days- 4deg.C(wks)

• K-Sol, Dexsol,OptisolGS,Procell, Eusol-C LONG(months)• EuropeanOrgan culture-

120days(37deg.C)• Eurosol-31deg.C-28days(New)• Cryoprev.-Unlimited-(-80degC)

Success Rates of Cornea Transplants

Success rates are also affected by the problem that needed to be fixed with the transplant. For example, research has found that the new cornea lasts for at least 10 years in:

89% of people with keratoconus73% of people with Fuchs' dystrophy60% to 70% of people with corneal scarring

EYE Banking Statistics• Donations 2014

2013 % Change• Eye Banks Reporting 76

76 0.0%• Total Whole Eyes and Corneas Donated 128,675 123,079

4.5%• Total Number of Donors 65,558

62,274 5.3%

THE FUTURE OF EYE TRANSPLANTATION

MAGICAL EYE

WHOLE EYEBALL TRANSPLANT

GRANT OF $1 MILLION FOR RESEARCHERS AT CALIFORNIA UNIVERSITY.THE WHOLE EYE BALL CAN BE TRANSPLANTE TO A PERSON ALONG 2000 NEURONS GENERATING THE OPTIC NERVE …… Future is doing the impossibels. Jeffrey Goldberg

CYBER BICONIC CONTACT LENSE

ARTIFICIAL RETINAArtificial retina could

someday help restore vision. "Semiconductor Nanorod-Carbon Nanotube Biomimetic Films for Wire-Free Photostimulation of Blind Retinas" Nano Letters. The loss of eyesight, often caused by retinaldegeneration, is a life-altering health issue for many people, especially as they AGE

FUN FACTS ABOUT EYES