Synthetic Cornea Transplants
One alternative to human cornea transplants is synthetic cornea transplants. Synthetic corneas have been implanted successfully in patients who have had previous, sometimes multiple, corneal transplants fail or were rejected due to autoimmune response. A third group, ineligible for human cornea transplants, are people whose corneas are highly vascularized.
The synthetic cornea transplant device made by AlphaCor is a 7 mm diameter disc made of a biocompatible material about 0.6 mm thick. The center of the disc is clear, and is surrounded by an opaque “skirt” around the periphery. The skirt has a pore size that allows “invasion by human fibroblasts” that literally attach the disc naturally in place.
One of the advantages of the AlphaCor is that these transplants eliminate the risk of cross-contamination that might accompany implantation of a human cornea. Eye banks typically screen corneas for clarity, disease or damage before releasing them for transplant. However, contamination possibilities remain. Contamination from hepatitis, AIDS and Creutzfeldt-Jakob disease (a neurological brain-wasting disease that has been described as a human form of mad cow disease) are serious risks.
Another advantage to receiving the synthetic corneal transplant is that patients need only administer a topical steroid for a short period of time rather than undergo immunosuppressive therapy associated with natural corneal transplants.
The synthetic cornea transplant procedure is done in two steps, several months apart. In the first step, the AlphaCor disc is implanted beneath the natural cornea. The damaged cornea is replaced over the synthetic cornea, which is left in place for three or so months. During that time the natural fibroblasts cells grow into the skirt of the disc. These will hold it securely in place. Once these cells have grown into the skirt, the second part of the procedure is done to remove the damaged cornea. Once removed the patient is able to see clearly through the synthetic corneal transplant disc.
While the success rate for natural corneal transplants is 90% after 3 years, the AlphaCor is not as successful. One study showed retention to one year at 80% and another for two years at 62%. It is also likely that you will need glasses to attain clear vision after this procedure.
Cost is another factor. The cost of one synthetic cornea runs around $7,000 per disc. Adding the cost of just one synthetic cornea to the surgeon’s fees for surgery can run about $10,000 per eye. Compared to the cost for one human cornea at about $1,800 each and $5,000 for the total cost of the transplant, makes this procedure one to consider very carefully.
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