Pig tissue cornea implants offers new treatment for advanced keratoconus
Hyderabad: According to a recent study conducted by doctors at L V Prasad Eye Institute (LVPEI) in Hyderabad, cornea implants made from pig tissues might offer a new treatment option for patients with advanced keratoconus.
Keratoconus causes the cornea to become too thin and bulge, resulting in blurred vision and, in severe cases, significant vision impairment.
The study, published in the US-based Journal of Refractive Surgery, aimed to determine the efficacy of xenogeneic corneal implants, whereby damaged or diseased corneal tissue is replaced with tissue from a different species, typically pigs. Doctors said this reduces the need for human corneas, which are already hard to find in many places.
During the clinical trial, doctors placed a small, soft, disc-shaped piece of tissue called a lenticule, made from porcine (pig) collagen, into the corneas of nine patients with advanced keratoconus. The average age of the patients was 28 years.
Following the procedure, all of the patients' vision improved significantly as none of their bodies rejected the implants. Their logMAR improved from 1.43 to 0.78. However, in two cases, the tissue around the implant started to thin again and further treatment was required.
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Distance vision improved
"All the patients have been followed up regularly and are doing well,'"said Dr Rashmi Deshmukh, the study's lead author from LVPEI, told TOI, adding that as well as improving distance vision without glasses, the results showed that the bulging part of the eye became flatter over time. Doctors said that the implants are effective because they resemble human corneas. "Among the species that have been explored so far, porcine collagen most closely resembles human collagen, which is why it is the preferred choice.
However, it may be possible in the future for corneal implants to be made from collagen of other species too," said Dr Rashmi.
The doctors said that the study was necessary because usual cases of keratoconus could be treated with minimal surgery, after which contact lenses or glasses could be used to improve visual acuity. However, these treatments could only be used if the cornea was sufficiently thick. There were, however, limited treatments available for cases where keratoconus advanced and the cornea became too thin.
Only corneal transplantation (keratoplasty), another surgical procedure, was possible.
Although pig implants have provided a breakthrough, doctors still need to examine the 'crosslinking process' to determine whether any of the chemicals involved cause an inflammatory reaction in the eye. "Further research is needed to see if there is any way to modify the pig implant to allow important nutrients to reach the front part of the cornea (the part above the implant) to maintain healthy eyes," said Dr Rashmi.
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