Australian first technology: Patients regain their sight better and faster thanks to new transplant operation  

4 June, 2007

A groundbreaking corneal transplant operation performed at the Royal Victorian Eye & Ear Hospital has the potential to help thousands of Australians with corneal blindness regain their sight faster and better than before.

In an Australian first, surgeons at the hospital used new, highly specialised equipment to perform a partial corneal transplantation, removing and replacing only the diseased layer of the cornea, rather than the entire cornea.

Mr David Wall, a retiree from Mount Eliza, was the first person in Australia to undergo this 40-minute procedure, which international research has shown leads to fewer complications, heals faster and enables significantly better vision outcomes.

Mr Wall said he is already experiencing improved vision in his left eye, after 12 months of living with blurred vision, a result of a rare complication associated with having a cataract removed.

“I found it really frustrating and limiting only having vision in one eye, so when the hospital doctors offered me the chance to undergo this new procedure I leapt at it,” Mr Wall said.

Thousands of Australians suffer from various diseases of the cornea - the thin, clear surface of the eye and the eye’s main focussing element. Some corneal diseases only affect one of the five layers which comprise the cornea (the endothelial layer) but until now, doctors have had to remove and replace the whole cornea in a transplant procedure. 

Traditional corneal transplant surgery, which was pioneered over 100 years ago, involves making an incision to remove the diseased cornea and replacing it with a donated cornea. The donated tissue is attached with sutures (stitches).

While traditional corneal transplants have a success rate of over 90%, the recipient’s eye can take up to 12 months to heal and complications associated with the sutures include the cornea coming loose, infections and astigmatism (distorted vision)

In this new procedure, using DSAEK (Descemet’s stripping and automated endothelial keratoplasty) equipment, surgeons only make a small incision, and remove and replace the diseased layer of the cornea. In most cases no sutures are required. Benefits of this procedure include less rejections, as little as 1 month of healing and reduced chances of infection and astigmatism occurring.

Professor Rasik Vajpayee, the hospital’s head of Corneal Surgery, who performed the operation on Mr Wall, said this new, automated procedure was one of the most exciting developments in the ophthalmology field world-wide.

“It is crucial that ophthalmologists research and trial cutting edge treatments, as the ageing population, and the linked increase in eye disease, is placing greater demand on our services,” Prof Vajpayee said.

“This new treatment has the potential to help Australian sufferers of endothelial corneal blindness to see again, offering them the ability to lead an independent life.”

Since performing the first DSAEK operation in Australia, additional operations have been scheduled. The Royal Victorian Eye & Ear Hospital is the only hospital in Australia to have the DSAEK equipment to perform this new procedure.

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