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Are Corneal Transplants on the Way Out?

The Tej Kohli Cornea Institute is committed to the treatment and prevention of corneal blindness, and our work often takes the form of providing patients with corneal transplants. These transplants can ultimately save people from infection, pain and blindness. However, new research is offering a potential alternative to corneal transplants in the form of eye drops. How do these eye drops work, and could they become a go-to treatment? Here, we explore the most recent development in corneal medicine and what it means for treating eye problems.

Corneal transplants are sometimes used to treat the late stages of keratoconus, an eye condition in which the cornea weakens and thins, leading to blurry and distorted vision that can ultimately leave the patient blind. In a corneal transplant, the damaged cornea is removed and replaced with healthy cornea tissue from a donor. These transplants help people regain their vision, but like any surgery, they can be risky and require long recovery periods. Fortunately, a new treatment could eliminate the need for corneal transplants in some keratoconus patients—eyedrops.

If eyedrops sound like a simple solution, it’s because, in many ways, they are. First, the cells that cover the cornea are cleared off. Then, vitamin B-2 (riboflavin) eyedrops are applied. The eyedrops are then absorbed by the cornea and an ultraviolet light is shone on the eye to bind the vitamin to the cornea, strengthening it.

This procedure, called ‘corneal cross-linking’, effectively prevents the cornea from weakening further. It does not necessarily heal eye damage up to treatment, but it can halt the progression of keratoconus and prevent the need for a corneal transplant. It has been approved by the FDA and is beginning to gain prominence at eye clinics in various locations.

What does the development of corneal cross-linking mean for corneal transplants and the future of eye care? While these eye drops can treat patients in the earlier stages of keratoconus, they do not offer a corrective solution for people who are suffering from extreme vision impairment. These late-stage patients still must turn to a cornea transplant for the possibility of better sight.

But over time, as more people are treated with corneal cross-linking, fewer corneal transplants will have to be performed—and perhaps eventually, if people are properly treated with preventative procedures, the need for corneal transplants will be eradicated. Instead of having to undergo an intense surgery, patients can practise less drastic measures, halting the deterioration of the cornea with eye drops and correcting vision with contacts.

By focusing on research for treatments such as corneal cross-linking, the Tej Kohli Cornea Institute is working to bring creative, effective solutions to the forefront of corneal medicine. We set the world record for providing 2000 corneal transplants in a single year, but we are excited that other treatment options might lessen the need for corneal transplants in the future. Ultimately, our goal is to give the gift of sight to everyone who needs it, and this most recent development could certainly aid us in our mission.