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Dr. Sugar led a team that studied age of cornea donors. |
Expanding the donor pool, improving success of transplants
For years, U-M Kellogg Eye Center faculty have played a significant role in corneal transplantation. Kellogg ophthalmologists helped to establish the Michigan Eye- Bank in 1957, which resided in the Kellogg Eye Center until 2006. Faculty members have long collaborated with the Eye-Bank on research. In one recent example, Alan Sugar, M.D., cornea surgeon and professor of ophthalmology, led the Kellogg arm of a national study on cornea donor tissue.
The study, sponsored by the National Eye Institute with tissue provided by the Midwest Eye-Banks, found strong support for raising the age limit for donors. A key finding of the study: the pool of corneal transplant donors — often limited to those 65 years of age and younger — should be expanded to include donors up to 75 years of age.
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Dr. Shtein searches for ways to predict whether a cornea will be rejected after a transplant. |
According to the Cornea Donor Study, the success rate was the same whether the transplants were performed with corneas from donors ages 12 to 65 years or from donors ages 66 to 75. “This study indicates that corneas from older individuals are just as successful for corneal transplantation as those from younger donors,” said Dr. Sugar. He observes that in addition to expanding the pool of cornea donors, the study will help surgeons learn more about the procedure itself.
“The study team is analyzing additional data that will help us understand more fully the factors involved in a successful cornea transplant,” he said. The Cornea Donor Study will continue for another five years, allowing more time to follow patients and interpret data.
At the same time, cornea specialist Roni M. Shtein,
M.D., is looking at another important aspect of corneal
transplantation. One of the biggest concerns for patient
and physician is that the new tissue will be rejected. In
her study, Dr. Shtein will identify the characteristics of a
patient’s cornea that could predict rejection of the new
tissue. Specifically she will examine patterns of corneal
neovascularization —
the growth of blood vessels in the
cornea —
which is normally clear. In the first phase of
the study she will determine the best way to measure
these patterns. In the next and larger portion of the
study, Dr. Shtein will develop ways to analyze characteristics
of corneal neovascularization that can predict
rejection or failure of the transplant.
“This study is very specific in that it will allow us to identify high risk blood vessels,” says Dr. Shtein.“There is a great deal of interest now in medications used to treat excessive blood vessels in retinal diseases like diabetic retinopathy and wet macular degeneration. Perhaps these drugs, with some modification, could one day help reduce the risk of corneal transplant rejection,” she adds.
For more information, see the Cornea and External Disease, Cataract and Refractive Surgery Clinic at the Kellogg Eye Center.
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